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- Surgical Precision Beyond Technical Skill
- Mindfulness Enhances Routine Procedures
- Patient Education Prevents Complications
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Surgical Precision Beyond Technical Skill
Dr. Cheryl TwuOBGYNWellness OBGYNEarly in my robotic surgery training, I had a patient whose fibroid removal went flawlessly from a technical standpoint--clean margins, minimal blood loss, textbook closure. However, she developed significant adhesions during recovery that affected her fertility goals. The imaging looked perfect, but I hadn't adequately discussed her timeline for trying to conceive or adjusted my suturing technique accordingly.
That case taught me that "minimally invasive" isn't just about incision size--it's about tissue handling at a microscopic level. Now, before any myomectomy, I spend real time mapping out each patient's reproductive timeline and adjust my approach based on whether they're trying to conceive in 6 months versus 2 years. I switched to using barbed sutures in specific scenarios and changed how I handle the peritoneum to reduce adhesion risk.
My osteopathic training already emphasized whole-person care, but this experience pushed me to integrate future functional goals into my surgical planning. I started asking different questions in consultations: "What does your body need to do six months from now?" instead of just "What symptoms are bothering you today?" That shift alone changed outcomes for patients who needed their bodies to perform specific functions post-surgery.
Mindfulness Enhances Routine Procedures
Even with all the care and experience in the world, complications can happen in surgery. One that stands out is a posterior capsule rupture during cataract surgery—a known but rare risk when implanting the intraocular lens. It's not always preventable, but it does remind us that even routine cases require full presence and patience.
For me, it reinforced the importance of never rushing, no matter how many times you've performed the procedure. Every patient deserves the same attention as the first one of the day. I take every complication personally—not in a negative way, but as an opportunity to learn and improve.
Since then, I've made mindfulness a conscious part of my surgical process. I slow down, double-check positioning, and ensure I'm focused before each case starts. It's a small change that helps with consistency, safety, and trust—and ultimately better outcomes for my patients.
Patient Education Prevents Complications
I'm a PA-C specializing in men's health, not a surgeon--but I've encountered plenty of complications from procedures like intracavernosal injections and PRP treatments that have taught me critical lessons about patient communication and tissue handling.
Early in my practice at MetroWest Urology, I had a patient develop significant bruising after a penile injection because I didn't spend enough time explaining proper pressure application post-procedure. He panicked, thought something was seriously wrong, and lost trust in the treatment. That taught me that half of preventing complications is obsessive pre-procedure education--now I physically demonstrate every aftercare step and have patients repeat it back to me before they leave.
The bigger lesson was documentation. When we started doing Peyronie's injections at CMH-RI, I began photographing curvature angles and recording exact injection sites in detailed notes. One patient claimed his curvature worsened after treatment, but my photos showed he'd actually improved by 15 degrees--he just had unrealistic expectations we hadn't fully addressed. Now I use visual aids during consultations and set milestone expectations at 6 weeks, 12 weeks, and 6 months.
The takeaway: in any procedure-based practice, your pre-op conversation is as important as your technique. Manage expectations obsessively, document everything, and teach patients to be active participants in their recovery.