Surgeon suspended over 'branding' his initials on a liver!!

"Boncho was here 2013"

I do it all the time, common practice in surgery…




*Pics or it didn't happen *pfft

webedoomed
reply to post by schuyler

 

I can kinda get what you're saying, but yes, branding would involve deforming tissues unnecessarily, which would be harming the liver, even if just a little bit.

I think it's less of the objective, and more about the ethics. You just can't allow something like this.

As I understand your post >>>>>

"It's more about the ethics" and "It can't be allowed"


Well my stance is that good surgeons perform miracles however they do it to achieve

the end result of prolonging and saving life!

reply to post by lacrimoniousfinale


Okay, fair enough... I am sure they will look into who has initials, access and ability so clear, a colleague can read and fully understand the meaning of the marks on the patients liver in a subsequent operation.

Something tells me the guilt phase isn't a complex matter.

reply to post by eletheia


Branding in no way helps to "perform the miracle". This is science. They are supposed to be held to strict, ethical standards, and the consequences of deviating from these standards are too high to allow.

You can't allow this, period.

It's absolutely unnecessary for the branding to be done.

The whole point is that this was without consent, and a clear breach of ethics.

If a doc told me he could save my life but really wanted to put a sig on his work, I'd say no. If he said that's cool, I'd chuckle and say go ahead.

This isn't about what you or I would do, it's about a doctor gone rogue and breaching ethical practice. He did this without consent. You might be okay with that, but I'd end the guy if he did it without my consent.

As I understand it, the liver is one of the fastest healing tissues. It continuously recycles it's cells due to the fact that it has to process so much.

I'm surprised that a scar would remain on the liver for very long.
Maybe I'm wrong.
Any surgeons out there who might know if a burn scar stays visible on the liver?

I think the real question is a hypothetical, let's say the doctor carved in a copyright image, like the M$oft logo, would my liver now belong to microsoft? Because if you think I abused it prior, I would abuse the hell out of it if it was running Windows 8.0, just out of sheer anger.

Of course it would then crash, and/or forget where its start menu is…

badgerprints
As I understand it, the liver is one of the fastest healing tissues. It continuously recycles it's cells due to the fact that it has to process so much.

I'm surprised that a scar would remain on the liver for very long.
Maybe I'm wrong.
Any surgeons out there who might know if a burn scar stays visible on the liver?

Cirrhosis is long-term scarring of the liver that impedes its function. I think that scar tissue does not get regenerated but I am not a surgeon.

webedoomed
reply to post by eletheia

 

Branding in no way helps to "perform the miracle". This is science. They are supposed to be held to strict, ethical standards, and the consequences of deviating from these standards are too high to allow.

You can't allow this, period.

It's absolutely unnecessary for the branding to be done.

The whole point is that this was without consent, and a clear breach of ethics.

If a doc told me he could save my life but really wanted to put a sig on his work, I'd say no. If he said that's cool, I'd chuckle and say go ahead.

This isn't about what you or I would do, it's about a doctor gone rogue and breaching ethical practice. He did this without consent. You might be okay with that, but I'd end the guy if he did it without my consent.

Branding may not in any way help to perform the miracle ... neither does it detract

from the end results. I bet there is more than that one person with an autographed

organ walking around and they don't even know it!! Small change in the bigger

picture!





@ BADGERPRINTS I believe you are correct in your assumptions. The liver is the only

organ that can regenerate itself ........

reply to post by eletheia


From inflammation, not scarring.

You don't heal cirrhosis, or scarring of the liver.

If it would be healed so easily, you nor I would be having this conversation.

I agree that the moral question is is the imperative here
It's not right to graffiti someone's organs.
"Floyd was here" does not belong on somebody's spleen.

I'm just wondering if the liver actually would hold those marks.

I have seen some crazy justifications for all manner of #e over the years including those for going to war/invading/peacekeeping/regime change etc. in Iraq, Afghanistan and the odd Caribbean country, but the sheer lunacy of one or two postings on here has me wondering where ATS is headed as the year ends?

Individuals reasoning to justify their comments about the actions of a surgeon who has disgraced his profession and hippocratic oath or was it hypocritical oath, are worthy of the best of reality tv or tabloid reporting.

A great pity there is not a negative censure facility available as has been suggested elsewhere.

I await the expected shower of bile in return.

Has anyone missed the part where surgery is NOT a solo act?

Depending on the surgery, what it was for, and how complicated it might be, there could very well be half a dozen if not more present for any one single surgery.

Not only that, surgeries are usually recorded these days as well. This recording is typically done by the surgeon for teaching purposes, but, not necessarily so.
The medical campus could very well require recording of procedures for their records in consideration entire procedures can fit uninterrupted on a $50 memory card and stored in a patient's file.

Whatever the case, at the very least, this physician didn't perform the surgery alone.
There was someone in charge of anesthesia.
There was at least one nurse/surgical technician if not two.
Generally there's an assisting physician.

Surgery is not a solo act.
Other people are there.

My question then goes with who was assisting with the surgery and how could they have missed him branding his initials onto someone's liver?

It's not like "Oh look, who let snoopy riding a unicycle into the operating theater?" *brands liver while everyone is distracted*
The guy would have to brand the liver, and then, on top of that, go through the process of closing.
I'm fairly certain the patient didn't have a zipper installed such that closing would be any kind of quick and easy.

reply to post by AliceBleachWhite


You make an excellent point, My first thought was may have been some kind of coincedental scarring of sorts why would a surgeon do that to someone in the first place as risky as it is to the patients health. The guy has been doing surgery it says for more then 10 years he must be good at his job to stay on for so long and like his work as he has been there for so long.

Also I wonder what a routine operation involving ones liver might be

The initials were reportedly found by a colleague during a routine operation.

From source in OP

Mr Simon R Bramhall
Mr Simon R Bramhall, Consultant Hepatobiliary and Transplant Surgeon

Qualified from the University of Birmingham in 1988. Studied the molecular aspects of pancreatic cancer for MD, awarded 1997. Widely published on HPB and liver transplant surgery.

Source

The importance of routine liver biopsy in diagnosing nonalcoholic steatohepatitis in bariatric patients.
Shalhub S, Parsee A, Gallagher SF, Haines KL, Willkomm C, Brantley SG, Pinkas H, Saff-Koche L, Murr MM.
Author information
Abstract
BACKGROUND:
Nonalcoholic Steatohepatitis (NASH) commonly occurs in obese patients and predisposes to cirrhosis. Prevalence of NASH in bariatric patients is unknown. Our aim was to determine the role of routine liver biopsy in managing bariatric patients.
METHODS:
Prospective data on patients undergoing Roux-en-Y gastric bypass (RYGBP) was analyzed. One pathologist graded all liver biopsies as mild, moderate or severe steatohepatitis. NASH was defined as steatohepatitis without alcoholic or viral hepatitis. Consecutive liver biopsies were compared to those liver biopsies selected because of grossly fatty livers.
RESULTS:
242 patients underwent open and laparoscopic RYGBP from 1998-2001. Routine liver biopsies (68 consecutive patients) and selective liver biopsies (additional 86/174, 49%) were obtained. Findings of cirrhosis on frozen section changed the operation from a distal to a proximal RYGBP. The two groups were similar in age, gender, and BMI. The group with the routine liver biopsies showed a statistically significant larger preponderance of NASH (37% vs 32%). Both groups had a similar prevalence of cirrhosis. Neither BMI nor liver enzymes predicted the presence or severity of NASH.
CONCLUSIONS:
Routine liver biopsy documented significant liver abnormalities in a larger group of patients compared with selective liver biopsies, thereby suggesting that liver appearance is not predictive of NASH. Liver biopsy remains the gold-standard for diagnosing NASH. We recommend routine liver biopsy during bariatric operations to determine the prevalence and natural history of NASH, which will have important implications in directing future therapeutics for obese patients with NASH and for patients undergoing bariatric procedures.
PMID: 14980034 [PubMed - indexed for MEDLINE]

Source

I would imagine more then likely this is what the Colleague was doing. It is only my guess, trying to answer my own questions of what is considered routine Liver surgery.

webedoomed
reply to post by eletheia

 

From inflammation, not scarring.

You don't heal cirrhosis, or scarring of the liver.

If it would be healed so easily, you nor I would be having this conversation.

Please show me where I said, or implied anything about cirrhosis or scarring??


Regeneration of the liver >>>

The liver has a remarkable capacity to regenerate and to adjust its size to match

its host.

A week after partial hepatectomy up to 2/3 of removal of the liver, heptic mass is

back to what it was prior to surgery.

If God, or whatever, really wanted you to talk through your rectums or the top of your heads he (or she) would have made sure that was where your mouths were put.

What a bunch of Muppets are crawling out of the ether and showing their true colours? It surprises me, not, that so few views to the contrary appear.

Time for me to review the T&C and see if I remain as a contributor, should this be my last post, I wish the vast majority of ATS all the best, and to those of you alone at this time of the year, an apology if I don't come back to offer comfort tomorrow.

reply to post by AliceBleachWhite

Has anyone missed the part where surgery is NOT a solo act?

Depending on the surgery, what it was for, and how complicated it might be, there could very well be half a dozen if not more present for any one single surgery.

Actually, I had thought of that as my first thing. Unfortunately, my wife isn't blessed by the same allergy to television that I've developed and loves those medical shows. Not Doogie Howser medical shows.... 'Stories of the ER' as a warm-up and then the full procedural shows as something...umm.. she enjoys watching? Anyway...

I've caught a little of that, and they always have plenty of people around them. Multiple surgeons on the big stuff...but consider..if it's not a major and complex surgery? How many actually are in a position to see inside the body cavity with real detail vs. close enough to hand the Doc a tool or bring suction in as ordered?

I sure like your idea about flat, straight out and mandatory filming. Just mount a camera in the corner of the operating room if nothing else and as a bare min.. I'm thinking of other things too where anesthesiologists get mysteriously lost and something going wrong is all that catches it or the horror stories of patients waking mid operation and being told later it never happened or something.

reply to post by PhoenixOD


Why is anybody angry about a craftsman marking his work?

It doesn't harm the patient. It actually assists him and others in remembering what has been done previously.

reply to post by Wrabbit2000


Hey Wabbit,

this may shed some light on how many may be present if in fact the routine procedure was a liver biopsy which I have no doubt considering the specialty of the surgeon in question versus the "routine Procedure" that supposedly made the discovery and how they found the alleged initials. Scroll down to the during the procedure section

Here Wabbit

I also wanted to mention the part of radiograph in the link and the definition of surgery

sur·ger·y (sûrj-r)
n. pl. sur·ger·ies
1. The branch of medicine that deals with the diagnosis and treatment of injury, deformity, and disease by manual and instrumental means.
2. A surgical operation or procedure, especially one involving the removal or replacement of a diseased organ or tissue.
3. An operating room or a laboratory of a surgeon or of a hospital's surgical staff.
4. The skill or work of a surgeon.
5. Chiefly British
a. A physician's, dentist's, or veterinarian's office.
b. The period during which a physician, dentist, or veterinarian consults with or treats patients in the office.

Source

Number 1 and especially number 5B for some reason is of note to me, how exactly did this guy discover initials on liver?

Reviewed T&C and also a previous thread from some years ago related to What does the ATS motto Deny Ignorance mean to you?
With sound bites such as;
...promote intelligent posting & productive debate
...inspires intelligent content & meaningful debate
...intelligent exchange of ideas
I remain a contributor & will leave policing of ATS to the mods

BBC News reports of the scandal refer to a subsequent operation discovering the disgrace, whatever the reason for that subsequent op. is irrelevant...

No doubt as this unfolds further more surprises will come to light.

Perhaps I have misread the situation and the whole thing is merely a precursor to advertising on donated organs when, in the UK, you will soon be presumed by omission I.e. by not saying no, you have given presumed consent for the donation of your organs. As I understand the situation those organs could end up being sold to a patient in the private medical sector as opposed to someone unable to buy them. Organ farming? Another topic that.

Quite simply any mark left is essentially damage no matter how small. There is now way anyone can justify damaging someone else on an egotistical whim. The surgeon should be struck off and then put in jail for Actual Bodily Harm (ABH) or assault at the very least.