Commentary: Talking to patients about surgical innovations

BMJ 2011; 342 doi: (Published 26 May 2011) Cite this as: BMJ 2011;342:d2871
  1. Jane M Blazeby, professor of surgery 1, honorary consultant surgeon2,
  2. Angus G K McNair, general surgery speciality registrar3, honorary research fellow1
  1. 1Surgical Research Unit, School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK
  2. 2Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW
  3. 3Severn School of Surgery, Severn Deanery, Bristol
  1. Correspondence to: J M Blazeby j.m.blazeby{at}

Surgeons talk to patients before operating on them, but what is communicated during consultations is generally unknown and understudied. Consultations in which new procedures are discussed are also unchartered territory because surgical innovation often takes place outside the context of standard regulatory approval. Treasure and colleagues raise these issues with respect to aortic valve surgery in young people.1 Standard surgery offers a low immediate risk of death (1%) but necessitates life time anticoagulation and repeat surgery that carries a higher risk. An alternative procedure, the Ross pulmonary autograft, is associated with a 3% in-hospital mortality and better lifestyle outcomes, but it is technically more difficult than routine valve replacement and not within the armamentarium of all …

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