Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
London NW3 2QG, UK

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New "Easy Load" Universal Knot Pusher developed at the Royal Free - click here.

A new website for gynaecologists interested in the surgical management of fibroids is now on line.

Surgical aphorisms and sayings

An aphorism can be defined as a concise statement of a principle. You may find the following aphorisms and words of wisdom relating to surgery amusing and in some cases even useful in every day clinical practice. They have been taken from an excellent book "Aphorisms & Surgical Quotations for the Surgeon" edited by Moshe Schein (published by tfm Publishing Limited, Shrewsbury, UK; SIBN 978 1 903378 11 3).

It is safer to look and see than to wait and see.
Sidney Cuthbert Wallace, ~1907

The flat abdomen is a good abdomen.
George G.A. Decker

Abdominal wall closure: if it looks all right, it's too tight – if it looks too loose, it's all right.
Matt Oliver

Better to have a piece of peritoneum on the bowel than a piece of bowel on the peritoneum.

It is a simple system here: if you do not agree with the style or requirements of the man above you, leave.
John C. Goligher, 1912-1998

Two things surgeons fear the most are God and Peritonitis.
Henri Mondor, 1885-1962

The general rule can be laid down that the majority of severe abdominal pains which ensue in patients who have been previously fairly well, and which last as long as six hours, are caused by conditions of surgical import.
Zachary Cope, 1881-1974

Severe, acute abdominal pain always requires a surgical consultation.
Clifton K. Meador

An acute surgical abdomen is when a good surgeon says it is an acute surgical abdomen.
Clifton K, Meador

Never let the skin stand between you and the diagnosis.

The aim is to operate only when necessary but not to delay a necessary operation.
Moshe Schein

Who learns his anatomy from books should operate on books only.

The advent of anaesthesia has made it so that any idiot can become a surgeon.
William Stewart Halsted, 1852-1922

A surgeon is someone who likes to operate; an anaesthetist is someone who doesn't like to give anaesthetics.
David M. Dent

He is not even fit for a haircut under local anaesthesia.

Blood brain barrier (BBB): the screen between the surgeons and anaesthetists.

There is an inverse relationship between the surgeon's ability and the frequency he asks for more muscle relaxants.

The patient who can't be intubated should be intubated.

Surgery is not a trade or an art but a way of life.
Alexander A. Artemiev

Surgery is not an art; it is a personality disorder.

Have plenty of assistance, but not many assistants.
Augustus Charles Bernays, 1854-1907

A good assistant does not always become a good chief, but a bad assistant never does. A good chief has always been a good assistant.
Charles F.M. Saint, 1886-1973

A surgeon operates as good as his assistant permits.

The harder you pull, the more you learn.

The surgical resident is like a mushroom: kept in the dark, fed shit, and expected to grow.

Poor surgeons can improve but poor assistants never become good surgeons.
Moshe Schein

Haemorrhage can be stopped in four ways: by pressure exerted upon the vessel until the blood coagulates in the mouth of the opening; by cooling of the part in which the wound is located; by actual or potential cautery; by ligature and torsion of the vein and artery.
Jean Yperman, 1260-1310

All bleeding eventually ceases.
Guy de Chauliac, 1300-1368

The surgeon never suffers greater anxiety than when he is called upon to suppress a violent haemorrhage; and on no occasion is the reputation of his art so much at stake.
J.F.D. Jones, ~1811

The only weapon with which the unconscious patient can immediately retaliate upon the incompetent surgeon is haemorrhage.
William Stewart Halstead, 1852-1922

Whenever you encounter massive bleeding, the first thing to remember is that it is not your blood.
Raphael Adar

There are four degrees of intra-operative haemorrhage: 1. "Why did I get involved in this operation?" 2. "Why did I become a surgeon?" 3. "Why did I study to become a doctor?" 4. "Why was I born?".
Alexander A. Artemiev

Blood bank is the surgeon's gas station.

You have to ligate the artery if the tip of the diathermy fits into its end.

The most common cause of post-operative coagulopathy: poor haemostasis.

Operative atlases never bleed.

It is not the blood loss you can see that will get you, it's the blood loss you can't see.

The most important clotting factor is the surgeon.
Moshe Schein

In men nine out of ten abdominal tumours are malignant; in women nine out of ten abdominal swellings are the pregnant uterus.
Rutherford Morris, 1853-1939

More will be added to this collection in due course!


Doctors are the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you too.

Anton Checkhov (1860-1904)