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Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

In pursuit of surgical success

Ensuring a safe operation for every patient is not straightforward. Surgical patients range from the gravely ill with a slim chance of survival to the perfectly healthy who are seeking enhancement. Given this highly variable mix, surgical safety can be problematic to define, difficult to implement and harder to measure. As the population ages and technological advances feed public expectations, surgeons may feel at risk of finding themselves in the situation described over a century ago by then professor of surgery at the University of Edinburgh, John Chiene: “The operation was a complete success, but the patient died of something else”.

As several commentators in this issue indicate, there has recently been renewed focus on this enduring surgical dilemma. In an overview of the expanding field of perioperative care (doi: 10.5694/mja13.10383), Waxman describes the ideal scenario, in which elective patients benefit from multidisciplinary preoperative assessment and an “enhanced recovery after surgery” pathway. Preoperative planning and a “preflight” checklist in the operating theatre pay dividends for patients in their postoperative journey, even in emergency surgery.

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