What is needed to become a good surgeon?

This lecture has been delivered as a part of the RBSS-BAST symposium ‘What does it need to become a good surgeon’. The lecture relates to the evolution that has taken place over the last decades in relation to the training in surgery. It also gives some hints to younger colleagues how to make a successful career in surgery.     

How to advise a patient who wants a tattoo?

Tattooing and permanent make-up have become mainstream procedures. Many factors play a role in the final outcome of a tattoo and the satisfaction of the customer. The technical and artistic skills of the tattooist will determine the esthetic result and will help to guide the customers in their decision and choice of the tattoo. Although tattooing is by many considered as safe one should be are aware of the risks of complications related to this body modification technique. Some customers have a medical problem and some doubt about the safety of the procedure. People with increased risk of adverse events often seek medical advice prior to decide to get a tattoo or PMU. Physicians should not only be informed about the medical history of their patients but also have some basic knowledge of the practice of tattooing and the effects this procedure can exert on the skin and on the health condition of the patient. Contraindications and special precautions with regard to skin diseases and specific systemic conditions will be addressed in this article.     

How Young Is Too Young to Be a Living Donor?

Assessing people in adolescence and early adulthood who wish to become living organ donors (LDs) provides unique challenges. In several Canadian provinces, 16‐year‐old can legally consent to living organ donation. While the World Health Organization states that adolescence corresponds roughly to the ages of 10–19 years, parts of the brain associated with judgment continue to develop into the mid‐20s. Therefore, it is legally possible for some young people to donate organs before their capacity to judge the benefits and risks of surgery has fully matured. Potential young living donors (YLDs) may be financially and/or psychologically dependent on their recipients (e.g. parents), which can make it difficult to determine if the YLD's donation is voluntary. This paper suggests ways to manage three ethical challenges in the use of young people as LDs: (1) determining the YLD's ability to appreciate the consequences of living organ donation, (2) determining whether the YLD's donation is voluntary and (3) evaluating the unique risks and benefits to the YLD. We conclude that there are compelling ethical reasons to offer the opportunity of living donation to selected young people. A thorough and fair evaluation process can address social, emotional and developmental issues associated with YLDs.     

Is YouTube a good resource for patients to better understand kidney cancer?

ObjectiveTo assesses the complexity, reliability, and quality of the most popular kidney cancer videos on YouTube.MethodsWe searched YouTube using phrases relevant to kidney cancer and grouped videos based on publishing channel type. Video parameters along with complexity, reliability, and quality scores were recorded. Video complexity was determined using the SMOG index. SMOG scores greater than 6.4 equate to content that is too complex for the general public. Video quality and reliability was scored by 5 reviewers using the Global Quality Scale and a modified DISCERN criteria. All categorical and numerical variables were analyzed via independent t-test and 1-way analysis of variance using SPSS.ResultsOne hundred twenty-one videos were analyzed. The most popular publishing channel types are professional development (n = 65), medical institutions (n = 27), student education (n = 9), and nonprofit organization (n = 4).Professional development videos are significantly more complex than medical institution videos (mean SMOG score of 11.1 vs. 9.4, P = 0.004), and nonprofit organization videos (11.1 vs. 7.8, P = 0.003). Compared to medical institution videos, professional development videos have fewer mean total views (876 views vs. 17,554, P = 0.016), mean views per month (14.92 views vs. 351.7, P = 0.007), and mean comments (1 comment vs. 18, P = 0.038). Both professional development videos and medical institution videos are more reliable than student education videos (mean DISCERN score of 3.9 vs. 2.9, P < 0.001).ConclusionThere is a lack of understandable and reliable kidney cancer videos on YouTube. Moreover, the majority of kidney cancer videos are intended for medical professionals and may be too complex for the general public. The medical community has the opportunity to make an active effort to provide better resources for patients on YouTube.