Diagnostic process

The initial surgical process is complete when a diagnosis has been obtained by history, examination and imaging, supported by pathology. Experience enables correct weighting to be placed on each aspect of this process to define the correct treatment. All pieces of the jigsaw must fit together, and when they do not, great care must be exercised. Surgical

conditions tend to follow a logic based on anatomy, physiology and pathology (Fig. 1.13); if that logic is transgressed, mistakes are made, and the patient may be wrongly treated.

Before submitting a patient to surgery, the diagnosis should be exact, the patient’s condition carefully assessed and physiological variables corrected as far as possible. Any addi­tional risks should be taken into account and allowance made for them in the surgical process.