The Pelvic Surgeon

Abstract

Journal of Gynecologic SurgeryVol. 39, No. 3 EditorialFree AccessThe Pelvic SurgeonMitchel S. HoffmanMitchel S. Hoffman—Mitchel S. Hoffman, MD, Editor-in-Chief Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.MCC GYN Program, Moffitt Cancer Center, Tampa, Florida, USA.Search for more papers by this authorPublished Online:1 Jun 2023https://doi.org/10.1089/gyn.2023.0035AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail At the turn of the 20th century, a number of advances made surgery much safer for patients. These were: antisepsis; anesthesia; and eventual introduction of antibiotics and blood banking. Formal surgical training in the United States began in the early part of that century. Expertise in gynecologic surgery in the United States also arose from and in tandem with general surgery. The American Board of Obstetrics and Gynecology was established in 1930 as departments of obstetrics and gynecology continued to develop and expand their training programs. Eventually, training in gynecologic surgery became distinct from that of general surgery. Surgical specialization (including gynecologic) followed, a trend that continues in parallel with advances in medical knowledge and complexity.The pelvis is a confined space where portions of the urinary, genital, and intestinal tracts become intimately associated. For that reason, diseases and other abnormalities in the pelvis may involve multiple organ systems and other neurovascular structures. Therefore, urology, gynecology, and colorectal surgery may all be involved in procedures within the confines of the pelvis. As pelvic diseases and abnormalities cross organ systems and disciplines, so must their surgical management.There are ranges of expertise within each pelvic surgical discipline and, while a multidisciplinary approach may be required at times, the gynecologic surgeon must be able to manage the treatment of extended pelvic disease or related pelvic disorders. In some instances, the various surgical disciplines have developed specialty-specific methodology for managing similar conditions. For the reasons described, pelvic surgery by its very nature is multidisciplinary.Two articles in the current issue address gynecologic surgical management of disease extension or related disorders. Drs. Simone Fertel (MD) and Katie Propst (MD), from the University of South Florida Morsani College of Medicine, in Tampa, FL, USA, discuss the historical background of assessment and management of fecal incontinence and the surgical treatment options for patients who suffer with this condition. The Mayo Clinic's (Rochester, MN, USA) gynecologic oncology division investigated specific procedures that might be associated with postoperative complications occurring with ovarian cancer cytoreductive surgery, and identified the contribution of some nongynecologic procedures. Most importantly, surgery must always be done by appropriately trained and skilled individuals. There is a critical consequence arising from the issues that face surgical training competency, particularly as it affects general gynecologic surgery. General gynecologic surgery especially is in danger of becoming boxed into an increasingly narrower scope of capability. Our specialty must train individuals to be pelvic surgeons. I would be most interested in hearing from you, the readers of this journal, regarding your thoughts on the future of general gynecologic surgery. The best format for doing this would be a Letter to the Editor.FiguresReferencesRelatedDetails Volume 39Issue 3Jun 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Mitchel S. Hoffman.The Pelvic Surgeon.Journal of Gynecologic Surgery.Jun 2023.107-107.http://doi.org/10.1089/gyn.2023.0035Published in Volume: 39 Issue 3: June 1, 2023PDF download