INTRAOPERATIVE AND POSTOPERATIVE EVALUATION
Reynaldo O. Joson, MD, DPBS
There should always be a preoperative impression or diagnosis prior to an operation. During the operation, there should be an intraoperative evaluation. The intraoperative evaluation may either confirm or correct the preoperative impression or diagnosis. The intraoperative evaluation may make an uncertain preoperative impression or diagnosis more certain.
The intraoperative evaluation can be done through inspection, palpation, smelling, or microscopic examination of tissues taken from the operative field. The intraoperative evaluation should lead to an intraoperative diagnosis and which in turn should guide the surgeon in deciding what surgical procedures or operative techniques to utilize.
Just like the preoperative diagnosis, the intraoperative diagnosis may be uncertain, quite certain, and almost certain depending on the situation. Intraoperative diagnosis may be based on gross examination by the surgeon or by the rapid microscopic examination (so-called frozen section) by a pathologist. Whether the diagnosis is by gross evaluation or by microscopic examination, it may be definite or it may not be depending on the circumstances.
The postoperative diagnosis may be the intraoperative diagnosis if the latter is certain. If there is a tissue taken for microscopic study, then the histopathologic report may constitute in part or in whole the postoperative diagnosis. Again, the postoperative diagnosis may be the final definitive diagnosis or it may not be depending on the circumstances.
Postoperatively, beside evaluating for the diagnosis, the surgeon also evaluates for possible complications that may result from his surgical procedures. If a postoperative complication occurs, he then manages it accordingly.
ROJoson Writing in 1999