“First thing is to select the patient properly for the procedure you’re going to be doing. You don’t do a radical cystoprostatectomy with lidocaine infusion on a 65-year-old diabetic patient with coronary artery disease, because he would be more likely to suffer a complication, cardiovascular or otherwise.
You need to make sure you’re doing the right surgery on the right patient so the surgery does not interfere with longevity. That is the most important decision.
The next thing to do, after deciding what procedure you’re going to do, is to go over that procedure in your mind—the steps you’re going to go through. If you’re working with a resident, you need to know the capabilities of that resident, and you need to know if this procedure is appropriate for his level and his skill set.
If you’re a private practitioner, you need to assess honestly whether the procedure is beyond your skill set. People don’t necessarily think about these things.”
Nelson Stone, MD