He’s Seen A Superior Shift In Surgery
February 05, 2018
Less time in the hospital. Less invasive. Less morphine. More movement.
Surgery has changed drastically in the past 30 years and Larry Stevens, M.D., has been there to see it all. The medical director of surgery at IU Health Methodist Hospital started his career here in 1991.
Recently, he revealed the three biggest changes he’s seen in surgery in the past three decades
Less invasive, fewer days in the hospital
“Whatever the field, more and more procedures are being done in a more minimally-invasive fashion,” Dr. Stevens says. “Smaller incisions, little punctures -- all done under X-ray guidance.”
Pain management. It’s always been a tricky
"Back in the day, you’d give patients more morphine, more morphine, more morphine,” he says. “Now, it’s multimodal pain control — non-steroidal anti-inflammatories, local anesthetics, a regional block and then some narcotics.”
The theory is very much like chemotherapy for cancer, Dr. Stevens says.
"If you use one drug, you have to use a lot of it and you have a lot of toxicity and a lot of side effects,” he says. “If you use multiple drugs, you attack the cancer or, in this case, pain from different pathways. It allows us to use less of each drug while getting better pain control and having fewer side effects.”
Up and at it…
“There’s just been a change in the philosophy of rehabilitation,” Dr. Stevens says. “Used to if you had, say, bladder surgery you would lay in bed for a week. Now, it’s get up and get moving. You actually recover better. Early mobilization and early activity promotes better healing.”