A week in theatre
A week in the operating theatre with visiting orthopaedic surgeon Dr Willem Pretorius, who came down from Rockhampton. The work took place at Mater Springfield Hospital.
We worked through the week's scheduled cases together and compared views on each. A full week is long enough to cover a reasonable range of cases rather than a single day's list, which makes the visit considerably more useful.
Regional practice and why surgeons travel for it
A surgeon working in a regional centre such as Rockhampton generally covers a broader range of orthopaedic work than a surgeon in a capital city, where practices tend to narrow to one or two joints. That breadth is what a regional community needs, but it means the number of any one procedure performed in a year is lower, and techniques that are changing quickly are harder to keep up with from a distance.
Spending a week in a unit that concentrates on a single joint is one answer to that. It is the same principle as a fellowship, compressed: rather than reading about a technique, the visiting surgeon sees it set up, performed and then reviewed in clinic afterwards, several times over. The benefit runs back the other way too, since a surgeon who manages a wide case mix with fewer resources tends to have practical solutions that a well equipped city theatre never had to find.
What a week of cases covers
A week's operating list in a shoulder practice will usually include rotator cuff repairs, stabilisation procedures for shoulders that keep dislocating, decompressions for impingement, releases for frozen shoulder and joint replacements. Working through them together allows the conversation to move past technique to the decisions either side of it: which patients were offered surgery and which were not, why a particular implant or fixation was chosen for this shoulder, and what the rehabilitation plan will be.
Those surrounding decisions are usually where practice differs most between surgeons, and they are rarely written down in any detail. Individual results vary.
Related information
- The shoulder surgery page covers the procedures discussed.
- The rotator cuff repair page.
- The shoulder instability page.
- The shoulder fellowship page explains the longer training programme.