ABSTRACT
In the practical art of surgery, the best thing to do is to manage the complete disease process where possible. The highest form of medical leadership is to achieve disease eradication; the next best is disease prevention; the next best is to treat disease directly through surgery or medical pharmaco-therapy; and the most unfortunate scenario is where disease prognosis cannot be changed so that supportive and palliative measures must be engaged to optimize quality of life. The preparation of airway tools, ventilation machines, anti-bedsore mattresses, anaesthetic pharmacotherapies, nursing and medical staff requires significant time and energy, and more importantly represents an increased likelihood of protracted patient recovery time. Adopting a staged approach of applying surgical therapy only when lower-risk non-surgical strategies have been applied and shown not to be adequately effcacious is the method to apply surgery.
