By Alex G. Little MD, Walter H. Merrill MD
Drs. Little and Merrill draw on their services often thoracic and cardiac surgical procedure to study tracheobronchial operations, lung quantity relief operations, lung transplantation, minimally invasive esophagectomy, pleural operations, revascularizations, myocardial operations, and aortic and nice vessel operations. for every operation, top practitioners supply particular recommendation on what to concentrate on to avoid problems -- and the way to regulate them in the event that they do ensue.
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Extra info for Complications in Cardiothoracic Surgery: Avoidance and Treatment
With other leaders, invite your team to begin weekly team meetings. Explain why you are having the meetings, and what you hope the meetings will accomplish. Encourage your team to read and talk about safety science. Teach your team about type II problem solving. Choose a problem and work together to resolve it. Begin to brief and debrief for every case. Establish and use a Glitch Book. Work with your team to develop a list of high-risk critical events. Discuss the events and practice how you will manage them.
Extend your thinking beyond yourself and your patients to the contexts and relationships that influence your practice. Analyze your work from the perspective of type II problem solving, using the safety pyramid to guide your thinking. Read Amy Edmundson’s paper and reflect about whether your team is good at learning new routines. Consider the influence of your leadership style and whether you should lead your team differently. Develop better relationships with others you work with. Read about social constructionism.
VATS offers several advantages over thoracotomy. For example, VATS lobectomy results in decreased pain, fewer perioperative complications, shorter chest tube duration, decreased length of stay, faster return to functional status, and decreased inflammatory response . VATS allows operative exposure via small incisions. Importantly, even when limited utility incisions are made, no rib spreading occurs. As with thoracotomy, morbidity is associated with intercostal nerve injury. During VATS, trauma to the intercostal nerve should be minimized by using the smallest port that is feasible, depending on the instrumentation required.
Complications in Cardiothoracic Surgery: Avoidance and Treatment by Alex G. Little MD, Walter H. Merrill MD