This scenario presents a professional challenge due to the inherent difficulty in objectively assessing cognitive function, particularly in the context of surgical competence. Surgeons operate under immense pressure, and subtle cognitive changes can have profound patient safety implications. The American Osteopathic Board of Surgery (AOBS) certification process, like other medical credentialing bodies, has a vested interest in ensuring that all certified surgeons maintain the cognitive capacity necessary to practice safely and effectively. This requires a balanced approach that respects physician autonomy while prioritizing patient well-being and public trust. The best approach involves a structured, multi-faceted evaluation that leverages objective data and expert opinion. This includes a comprehensive review of the surgeon’s practice history, patient outcomes, and any available peer review or incident reports. Crucially, it necessitates a formal cognitive assessment conducted by qualified specialists, such as neurologists or neuropsychologists, using validated instruments. This objective data, combined with input from peers and supervisors who have direct knowledge of the surgeon’s performance, provides the most reliable basis for determining fitness to practice. This aligns with ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as the AOBS’s responsibility to uphold professional standards and protect the public. An approach that relies solely on anecdotal observations or informal discussions among colleagues, without objective testing, is professionally unacceptable. This method is prone to bias, subjectivity, and may not capture subtle but significant cognitive impairments. It fails to meet the standard of due diligence required for credentialing and can lead to either the unwarranted disqualification of a competent surgeon or, more dangerously, the certification of a surgeon whose cognitive abilities are compromised, thereby jeopardizing patient safety. Another professionally unacceptable approach is to dismiss concerns based on the surgeon’s past achievements or reputation alone. While a strong track record is important, it does not guarantee continued cognitive fitness. Cognitive abilities can change over time due to age, medical conditions, or other factors. Ignoring current concerns based on past performance is a failure to address potential risks and violates the principle of ongoing professional accountability. Finally, an approach that focuses exclusively on the surgeon’s subjective report of their own cognitive status, without independent verification, is insufficient. While a surgeon’s self-awareness is valuable, it is not a substitute for objective assessment. Individuals experiencing cognitive decline may lack insight into their own limitations. Relying solely on self-reporting would abdicate the responsibility of the certifying board to ensure objective standards are met. The professional reasoning process for such situations should involve a systematic evaluation of concerns. This begins with gathering all available information, both objective and subjective. If concerns persist, a formal, objective assessment should be initiated. Decisions should be based on the totality of the evidence, with a clear emphasis on patient safety and adherence to established professional standards and guidelines. Transparency and fairness to the surgeon throughout the process are also paramount.

Scenario Analysis: This scenario presents a common challenge in orthopedic surgery where a patient’s desire for a specific, potentially unproven, surgical technique conflicts with established evidence-based practices and the surgeon’s professional judgment. The challenge lies in balancing patient autonomy with the surgeon’s ethical and legal obligations to provide care that is safe, effective, and aligns with professional standards. Navigating this requires careful communication, thorough patient education, and a commitment to evidence-based medicine. Correct Approach Analysis: The best professional practice involves a comprehensive discussion with the patient about the risks, benefits, and alternatives to the requested procedure, grounded in current scientific literature and established surgical consensus. This approach prioritizes informed consent, ensuring the patient understands why the requested technique may not be suitable or evidence-based, and presenting well-supported, alternative treatment options. This aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as the legal requirement for informed consent, which mandates that patients receive sufficient information to make autonomous decisions about their care. It also upholds the surgeon’s responsibility to practice within the scope of accepted medical knowledge and standards. Incorrect Approaches Analysis: Proceeding with the patient’s requested technique without a thorough discussion of alternatives and evidence, despite reservations, would be ethically problematic. It risks performing a procedure that may be ineffective or even harmful, violating the principle of beneficence and potentially leading to patient dissatisfaction or adverse outcomes. This approach fails to adequately inform the patient and could be seen as a deviation from the standard of care. Refusing to discuss the requested technique altogether and solely offering standard treatments without acknowledging the patient’s inquiry would undermine patient autonomy and the collaborative nature of shared decision-making. While the surgeon has a duty to recommend evidence-based care, dismissing a patient’s expressed interest without explanation can damage the patient-physician relationship and may lead to the patient seeking care elsewhere, potentially from less qualified practitioners. Agreeing to the requested technique solely to satisfy the patient’s request, without a robust assessment of its safety and efficacy, and without thoroughly exploring evidence-based alternatives, is a significant ethical and professional failing. This prioritizes patient satisfaction over patient well-being and could expose both the patient and the surgeon to undue risk, potentially violating professional guidelines and legal standards for medical practice. Professional Reasoning: Professionals should approach such situations by first actively listening to and understanding the patient’s desires and concerns. This should be followed by a transparent and evidence-based discussion of all viable treatment options, including the risks, benefits, and expected outcomes of each. The surgeon must clearly articulate their professional recommendation, explaining the rationale based on scientific evidence and clinical experience. The decision-making process should be a shared one, where the patient’s values and preferences are respected, but ultimately, the recommended course of action must be medically sound and ethically justifiable. If a patient insists on a treatment that the surgeon deems inappropriate or unsafe, the surgeon has an ethical obligation to explain their reasoning clearly and offer to refer the patient to another physician who may be willing to consider the patient’s preferred approach, provided such an approach is not inherently harmful.

The risk matrix shows a scenario where a surgeon is faced with a patient presenting with complex physiological symptoms that could indicate multiple underlying conditions, each requiring a different surgical approach. This is professionally challenging because the surgeon must accurately diagnose the primary issue and select the most appropriate and least invasive intervention, balancing potential benefits against significant risks, all while adhering to the principles of patient autonomy and beneficence. The urgency of the situation, coupled with the potential for rapid deterioration, necessitates swift yet thorough clinical reasoning. The best approach involves a comprehensive, multi-modal diagnostic strategy that prioritizes non-invasive or minimally invasive investigations to confirm the suspected diagnosis before committing to a specific surgical intervention. This includes detailed patient history, thorough physical examination, and judicious use of advanced imaging (e.g., CT, MRI) and laboratory tests to elucidate the precise pathophysiology. This approach aligns with the ethical principle of non-maleficence by minimizing unnecessary surgical risks and the principle of beneficence by ensuring the treatment directly addresses the confirmed pathology. It also respects patient autonomy by allowing for informed consent based on a clear understanding of the diagnosis and proposed treatment. An incorrect approach would be to proceed with a broad surgical exploration based on initial suspicions without definitive diagnostic confirmation. This carries a significant risk of iatrogenic injury, unnecessary patient morbidity, and potential for misdiagnosis, violating the principle of non-maleficence. Another incorrect approach is to delay definitive surgical intervention indefinitely due to diagnostic uncertainty, which could lead to irreversible damage or a worse prognosis, failing the principle of beneficence. Finally, opting for a surgical procedure that is technically simpler for the surgeon but not necessarily the most physiologically appropriate or least invasive for the patient, without clear justification, would be ethically questionable and potentially harmful. Professionals should employ a systematic decision-making process that begins with a thorough assessment of the patient’s physiological status and potential diagnoses. This should be followed by a critical evaluation of available diagnostic tools, prioritizing those that offer the most information with the least risk. Once a diagnosis is reasonably certain, the surgeon must consider all available treatment options, weighing their physiological implications, risks, benefits, and alternatives, in consultation with the patient. This iterative process ensures that the chosen intervention is the most appropriate for the patient’s specific condition and overall well-being.

Scenario Analysis: This scenario presents a common challenge in surgical practice: ensuring patient safety through effective sterilization of reusable surgical instruments. The professional challenge lies in balancing efficiency with the absolute imperative of preventing surgical site infections, which can lead to significant patient morbidity, increased healthcare costs, and reputational damage. A surgeon’s judgment is critical in selecting and verifying the most appropriate sterilization method based on instrument type, manufacturer’s instructions, and regulatory standards. Correct Approach Analysis: The best professional practice involves a multi-faceted approach that prioritizes manufacturer’s instructions for use (IFU) for each specific instrument, coupled with adherence to established guidelines from regulatory bodies like the Association for the Advancement of Medical Instrumentation (AAMI) and the Centers for Disease Control and Prevention (CDC). This approach ensures that the chosen sterilization method is validated for the specific materials and design of the instruments, thereby guaranteeing efficacy and patient safety. The IFU provides critical information on compatible sterilization cycles, temperature, pressure, and time, while regulatory guidelines offer a framework for best practices in sterilization processes, monitoring, and documentation. This comprehensive strategy minimizes the risk of instrument contamination and subsequent infection. Incorrect Approaches Analysis: One incorrect approach involves relying solely on a single, generalized sterilization method for all instruments, irrespective of their material composition or manufacturer’s recommendations. This fails to account for the fact that different materials (e.g., plastics, delicate optics, complex lumens) may be damaged by certain sterilization methods or may not be effectively sterilized by others. This oversight can lead to instrument damage, compromised sterilization efficacy, and potential patient harm, violating the principle of providing safe and effective patient care. Another unacceptable approach is to bypass the verification of sterilization parameters, such as spore testing or chemical indicator results, assuming the process is functioning correctly. This disregard for monitoring and validation directly contravenes regulatory requirements for quality assurance in sterilization. Failure to verify can result in the release of improperly sterilized instruments, posing a direct risk of infection to patients. This demonstrates a lack of due diligence and a failure to uphold professional responsibility for patient safety. A further flawed approach is to prioritize speed and convenience over established protocols, such as using a shorter cycle than recommended or skipping necessary pre-cleaning steps. This can lead to incomplete sterilization, as microorganisms may not be adequately killed or removed. Such shortcuts undermine the integrity of the sterilization process and expose patients to preventable risks, violating ethical obligations to provide care that meets established standards. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with understanding the specific needs of each surgical procedure and the instruments involved. This includes meticulously reviewing the IFU for all reusable instruments. Subsequently, they must consult and adhere to relevant national and professional guidelines (e.g., AAMI ST standards, CDC guidelines) for sterilization. A robust system for monitoring, documenting, and verifying the effectiveness of the chosen sterilization method is essential. Regular training and competency assessment for all staff involved in instrument processing are also critical components of a safe and compliant sterilization program.

Scenario Analysis: This scenario is professionally challenging because it requires a surgeon to balance the immediate need for surgical intervention with the patient’s long-term well-being and autonomy, particularly when faced with a patient who may not fully grasp the implications of their condition or treatment. The surgeon must navigate ethical obligations to provide care while respecting patient rights and ensuring informed consent, all within the framework of established medical practice and potential legal ramifications. Correct Approach Analysis: The best professional practice involves a comprehensive, multi-faceted risk assessment that prioritizes patient understanding and shared decision-making. This approach begins with a thorough evaluation of the patient’s cognitive capacity and understanding of their condition, the proposed surgery, and alternative treatments. It necessitates clear, jargon-free communication, allowing ample time for questions and addressing any concerns. Crucially, it involves engaging the patient’s designated healthcare proxy or family members, with the patient’s consent, to ensure a robust support system and to gather additional insights into the patient’s values and preferences. This aligns with ethical principles of beneficence, non-maleficence, and respect for autonomy, and is supported by professional guidelines emphasizing informed consent and patient-centered care. Incorrect Approaches Analysis: One incorrect approach involves proceeding with surgery based solely on the surgeon’s clinical judgment of necessity, without adequately confirming the patient’s comprehension or exploring their values. This fails to uphold the principle of patient autonomy and informed consent, potentially leading to a patient undergoing a procedure they do not fully understand or desire, which is ethically and legally problematic. Another incorrect approach is to defer all decision-making to the patient’s family or healthcare proxy without a thorough assessment of the patient’s own capacity and wishes. While family involvement is important, the patient’s voice and preferences, to the extent they can be ascertained, must remain central to the decision-making process, respecting their inherent right to self-determination. A third incorrect approach is to delay necessary surgery indefinitely due to perceived communication barriers, without actively seeking strategies to improve understanding or involving specialists who can assist in assessing capacity or facilitating communication. This can be detrimental to the patient’s health and well-being, potentially violating the duty of beneficence. Professional Reasoning: Professionals should employ a structured approach to risk assessment in such situations. This begins with a clear understanding of the patient’s medical condition and the associated risks and benefits of intervention versus non-intervention. Simultaneously, an assessment of the patient’s capacity to understand this information and make a reasoned decision is paramount. If capacity is questionable, a systematic process for evaluating and supporting decision-making should be initiated, which may involve consulting with ethics committees, social workers, or neuropsychologists. Open and empathetic communication, tailored to the patient’s level of understanding, is essential throughout. Documenting all discussions, assessments, and decisions is critical for accountability and continuity of care.

This scenario presents a professional challenge due to the inherent conflict between a surgeon’s duty to their patient and the potential for financial gain or professional advancement through research. Navigating this requires a deep understanding of ethical principles governing patient care and research, as well as legal frameworks designed to protect patient autonomy and prevent conflicts of interest. The core tension lies in ensuring that patient decisions are based solely on their medical needs and informed consent, not influenced by the surgeon’s personal or institutional interests. The best approach involves prioritizing the patient’s informed consent and well-being above all else, while adhering to strict ethical guidelines for research participation. This means clearly and comprehensively explaining the investigational nature of the device, its potential risks and benefits, and the patient’s absolute right to refuse participation without compromising their standard care. The surgeon must also ensure that the research protocol is approved by an Institutional Review Board (IRB) and that all data collection and reporting are conducted with integrity and transparency, in accordance with federal regulations such as the Common Rule (45 CFR Part 46) and FDA regulations concerning clinical investigations (21 CFR Parts 50, 56, and 812). This approach upholds the ethical principles of beneficence, non-maleficence, autonomy, and justice, and ensures compliance with legal mandates for human subjects research. An approach that involves subtly encouraging participation by highlighting potential future benefits to the patient or downplaying the investigational status of the device is ethically flawed. This constitutes a form of undue influence, undermining the principle of autonomous decision-making. It also violates the ethical obligation to provide complete and unbiased information during the informed consent process. Furthermore, failing to disclose the surgeon’s financial interest in the device to the patient and the IRB creates a significant conflict of interest, violating principles of transparency and integrity in research. Another unacceptable approach would be to proceed with using the investigational device without obtaining explicit informed consent for its use in a research context, or without IRB approval. This is a direct violation of federal regulations governing human subjects research and constitutes a serious ethical breach. It disregards the patient’s right to know what interventions they are receiving and why, and bypasses the essential oversight mechanism designed to protect research participants. Finally, an approach that focuses solely on the potential for publication or career advancement without adequately addressing the patient’s best interests or the rigorous ethical and regulatory requirements for research is professionally irresponsible. While research is vital for medical progress, it must always be conducted within a framework that prioritizes patient safety and autonomy. Professionals should employ a decision-making process that begins with identifying potential conflicts of interest. They must then consult relevant ethical codes and regulatory guidelines. Open and honest communication with the patient, ensuring their understanding and voluntary participation, is paramount. Seeking guidance from institutional ethics committees or IRBs is crucial when navigating complex research scenarios. The ultimate goal is to balance the pursuit of scientific knowledge with the unwavering commitment to patient welfare and ethical conduct.

Scenario Analysis: This scenario presents a professional challenge due to the inherent variability in anatomical presentation and the critical need for accurate surgical planning. Misinterpreting anatomical landmarks or failing to account for individual patient variations can lead to suboptimal surgical outcomes, increased operative time, potential complications, and patient dissatisfaction. The surgeon must exercise meticulous judgment to ensure the chosen approach is both safe and effective for the specific patient. Correct Approach Analysis: The best professional practice involves a comprehensive pre-operative assessment that integrates multiple imaging modalities to create a detailed, three-dimensional understanding of the patient’s unique anatomy. This approach allows for the identification of critical structures, potential anomalies, and the precise planning of surgical corridors. This is correct because it aligns with the ethical imperative to provide patient-centered care, minimizing risks and maximizing benefits through thorough preparation. It also reflects the professional standard of care, which mandates the use of all available diagnostic tools to ensure surgical safety and efficacy. Incorrect Approaches Analysis: One incorrect approach involves relying solely on standard anatomical textbooks and general surgical experience without specific pre-operative imaging. This fails to acknowledge and address individual anatomical variations, potentially leading to unexpected intraoperative findings and increased risk. Ethically, this approach falls short of the duty of care by not adequately preparing for the specific patient’s condition. Another incorrect approach is to proceed with surgery based on a single, limited imaging view that does not provide a complete anatomical picture. This can result in overlooking crucial anatomical details or relationships, thereby compromising surgical precision and safety. This is professionally unacceptable as it deviates from the standard of care that requires a holistic understanding of the surgical field. A further incorrect approach is to make significant intraoperative anatomical assumptions based on perceived similarities to previous cases, without confirming with intraoperative imaging or tactile feedback. This approach is dangerous as it bypasses the critical step of verifying anatomical relationships in real-time, increasing the likelihood of inadvertent injury to vital structures. This is ethically unsound due to the potential for patient harm. Professional Reasoning: Professionals should employ a systematic decision-making process that prioritizes patient safety and optimal outcomes. This involves a thorough pre-operative evaluation, including a detailed review of patient history, physical examination, and appropriate diagnostic imaging. The surgeon should then formulate a surgical plan that accounts for the patient’s specific anatomy and potential challenges. Intraoperatively, continuous assessment and adaptation based on direct visualization and, if necessary, intraoperative imaging are crucial. This iterative process ensures that the surgical intervention remains aligned with the pre-operative plan while responding to the dynamic intraoperative environment.

Scenario Analysis: This scenario presents a common yet critical challenge in surgical practice: managing a complex wound with potential for complications. The surgeon must balance immediate patient needs with long-term functional and aesthetic outcomes, while adhering to established best practices and ethical considerations. The choice of closure technique directly impacts healing, infection risk, scar formation, and patient satisfaction, making careful judgment paramount. Correct Approach Analysis: The optimal approach involves a layered closure technique, utilizing absorbable sutures for deep tissue approximation and non-absorbable or absorbable sutures for skin closure, tailored to the wound’s depth and location. This method promotes eversion of wound edges, minimizes tension on the skin, and facilitates optimal healing by supporting tissue regeneration from the base upwards. This aligns with the fundamental principles of wound management taught and expected within surgical training and practice, emphasizing biomechanical principles for scar minimization and functional recovery. Adherence to these established techniques ensures the highest standard of care, minimizing complications and maximizing patient outcomes, which is an implicit ethical and professional obligation. Incorrect Approaches Analysis: Simply closing the skin with a single layer of sutures without addressing deeper tissue layers fails to provide adequate support, leading to increased tension on the skin closure. This can result in wound dehiscence, poor scar formation, and a higher risk of infection due to compromised tissue integrity. It neglects the biomechanical principles of wound healing and can be considered substandard care. Utilizing only non-absorbable sutures for all layers of the wound, including deep tissues, can lead to foreign body reactions, chronic inflammation, and potential sinus tract formation as the body attempts to extrude the suture material. This is contrary to best practices for deep tissue closure, which favor absorbable materials to minimize long-term complications. Employing a technique that excessively tightens the skin sutures without considering the underlying tissue support can cause strangulation of the skin edges, leading to ischemia, necrosis, and a widened, hypertrophic scar. This demonstrates a lack of understanding of tension management in wound closure and can negatively impact both functional and aesthetic results. Professional Reasoning: Professionals should approach wound closure by first thoroughly assessing the wound characteristics, including depth, location, tension, and contamination. They should then consider the patient’s individual factors, such as age, comorbidities, and potential for scarring. The decision-making process should prioritize techniques that promote optimal tissue healing, minimize complications, and achieve the best functional and aesthetic outcome, guided by established surgical principles and evidence-based practice. This involves a systematic evaluation of available closure methods and selecting the one that best addresses the specific wound and patient needs.

Scenario Analysis: This scenario presents a professional challenge related to maintaining surgical proficiency and ensuring patient safety through adherence to established standards for knot tying. The challenge lies in balancing the need for continuous skill development with the practical constraints of a busy surgical schedule and the potential for complacency. It requires a surgeon to proactively assess their own skills and seek appropriate methods for maintenance and improvement, rather than relying solely on routine practice. Correct Approach Analysis: The best professional practice involves a structured and documented approach to maintaining knot-tying proficiency. This includes regular participation in simulation-based training sessions specifically designed to hone surgical skills, including knot tying, and documenting these sessions. Such an approach aligns with the principles of continuous professional development and patient safety, as it ensures that surgical skills are not only maintained but also refined according to current best practices and evidence-based techniques. This proactive engagement with skill maintenance demonstrates a commitment to the highest standards of surgical care, which is implicitly expected by regulatory bodies and professional organizations overseeing surgical practice. Incorrect Approaches Analysis: Relying solely on the frequency of surgical procedures to maintain knot-tying proficiency is professionally unacceptable. While experience is valuable, it does not guarantee the maintenance of optimal technique, especially for skills that may be less frequently utilized in every procedure. This approach lacks a systematic evaluation and can lead to the perpetuation of suboptimal techniques without awareness. Similarly, assuming that current knot-tying skills are adequate without any form of periodic assessment or formal retraining fails to acknowledge the dynamic nature of surgical techniques and the potential for skill degradation over time. This passive stance is contrary to the proactive commitment required for maintaining surgical competence. Finally, focusing only on the aesthetic appearance of a knot without considering its functional integrity and security is a critical oversight. A knot’s primary purpose is to provide secure and lasting closure, and its visual appeal is secondary to its mechanical performance. This approach prioritizes superficial aspects over the fundamental requirements of surgical efficacy and patient safety. Professional Reasoning: Professionals should adopt a framework that prioritizes proactive skill assessment and maintenance. This involves regularly evaluating one’s own competencies, identifying areas for improvement, and actively engaging in structured training and simulation. Documentation of these efforts provides evidence of commitment to professional development and patient safety. When faced with a need to maintain a specific surgical skill like knot tying, professionals should seek out validated training methods and integrate them into their ongoing practice, rather than relying on assumptions or infrequent, unstructured experience.

Scenario Analysis: This scenario presents a professional challenge due to the inherent risks associated with endocrine surgery, particularly the potential for significant morbidity if complications arise. The patient’s pre-existing conditions, including obesity and a history of deep vein thrombosis (DVT), introduce additional layers of complexity, increasing the risk of surgical complications such as wound dehiscence, infection, and thromboembolic events. The surgeon must balance the potential benefits of the surgery against these elevated risks, requiring meticulous pre-operative assessment, careful surgical planning, and comprehensive post-operative management. The ethical imperative to act in the patient’s best interest, while respecting their autonomy, necessitates a thorough risk-benefit analysis and clear communication. Correct Approach Analysis: The best professional practice involves a comprehensive pre-operative risk assessment that specifically addresses the patient’s comorbidities. This includes a detailed review of their medical history, current medications, and any previous adverse events. For this patient, the obesity necessitates evaluation for potential airway difficulties and increased surgical stress, while the DVT history mandates aggressive prophylactic measures against further thromboembolic events. This approach ensures that all potential risks are identified and mitigated to the greatest extent possible before proceeding with surgery. It aligns with the fundamental ethical principle of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm) by proactively addressing known risk factors. Regulatory guidelines for surgical practice emphasize thorough patient evaluation and risk stratification as a cornerstone of safe and effective care. Incorrect Approaches Analysis: Proceeding with surgery without a thorough pre-operative risk assessment that specifically addresses the patient’s obesity and DVT history is professionally unacceptable. This failure to identify and plan for known risk factors directly contravenes the principles of beneficence and non-maleficence, potentially leading to preventable complications and patient harm. It also falls short of regulatory expectations for due diligence in surgical patient management. Recommending surgery solely based on the patient’s desire for the procedure, without a robust assessment of their individual risk profile, neglects the surgeon’s professional responsibility to ensure patient safety. This approach prioritizes patient autonomy over the surgeon’s duty to provide safe and appropriate medical care, potentially exposing the patient to undue risks. Delaying the surgical decision until after the procedure has commenced, without adequate pre-operative planning for the identified comorbidities, represents a significant lapse in professional judgment. This reactive approach increases the likelihood of intra-operative or post-operative complications that could have been anticipated and managed with proper pre-operative preparation. It demonstrates a failure to adhere to established standards of surgical care and risk management. Professional Reasoning: Professionals should employ a systematic risk assessment framework that begins with a thorough patient history and physical examination, focusing on identifying any factors that may increase surgical risk. This should be followed by a review of relevant diagnostic tests and consultations with other specialists if indicated. The surgeon must then conduct a detailed risk-benefit analysis, considering both the potential benefits of the intervention and the likelihood and severity of potential complications. This analysis should be clearly communicated to the patient, enabling them to make an informed decision about their care. In situations with elevated risks, the decision-making process should involve exploring alternative treatment options, optimizing the patient’s condition prior to surgery, and developing a comprehensive management plan for potential complications.