ABSTRACT
The control of a large disease lesion is the same principle as the control of a small one. Operating with a large surgical team under the leadership in the context of a complex operation should not be conceptually different from performing minor operations with local anaesthesia. To ensure optimal surgical outcomes, it is necessary to strengthen all surgical modalities to minimize the effects of disease processes. Intra-operative factors include ergonomics, setting up the case, patient position, the appropriate use of arm boards, patient warming blankets, anti-thrombotic calf-compression boots and tissue retractors. Extra-operative factors include the patient’s resuscitation status, and if there was a need for pre-operative or post-operative medications such as adjuvant and neo-adjuvant radiotherapy or chemotherapy. Indirect surgical tactics are an eternal mainstay of treatment. Simulation in surgery postulates perfect discipline, simulated fear postulates surgical safety, and simulated weakness postulates surgical preparedness.
