Postoperative Guidelines

When helping a colleague with an iatrogenic injury, one should be gracious and never accusatory - in the operating room, in the operative dictation, in conversation with the family, and in casual talk with fellow urologists. One should talk with the family immediately after the case, even as a consulting surgeon. Whenever possible it is best to have the surgeon of record alongside you when talking with the family so that a uniform explanation of the circumstances surrounding the injury can be presented. Nothing is gained in the operative dictation by using words such as "error", "iatrogenic", or "mistake." Rather, one should describe the situation in passive terms, without introducing bias, i.e., "I was called into the room to examine and repair a transected ureter" rather than "Due to the large amount of blood in the field and poor visibility the ureter had been mistakenly injured. I was asked to repair this iatrogenic injury." The former gives the necessary information without introducing an unsolicited opinion about the factors leading to the event, whereas the latter is fodder for litigation.

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