tumor during intervention

[marc]

a surgeon during operating an ER appendicitis find that the patient has an ovary tumor...could he make a biopsy of that tumor without the permission of the patient????
thanks a lot for your help.

[md90]

a surgeon during operating an ER appendicitis find that the patient has an ovary tumor...could he make a biopsy of that tumor without the permission of the patient???? thanks a lot for your help.

Yes, he can get a biopsy of the tumor, but that is all he can do. I had this same question on qbank; the female came with lower right pain, diagnosed with appendix, but when she was opened... it was found that the appendix was normal, but there was an ovarian tumor; I thought since she was already in the OR... the surgeon could ask her husband for the permission; But it's not an emergency such as an ectopic pregnancy, and the female is alert and oriented once she is removed and recovers from anesthesia; It's okay to biopsy, and see the type of tumor, then talk about options with patient. She only gave permission for the appendix being removed.

[marc]

ok so thats mean that you can perform "only" a biopsy...is the permission of the husband necessary for performing biopsy???
thanks a lot md90 for your help.
best wishes.

[tRmedic21]

It's not unusual for this topic to be covered with the patient in advance of performing such a surgery, and to inform the patient and obtain consent to extend the procedure should it become necessary.

[rafi]

exactly that's true...but what are the limit of extensions??????, you can not perform an ovariectomy for example...without the patient permission...am i true??? in my opinion the only thing that you can do is only biopsy the lesion." without any permission"
please correct me....;-)
best wishes.

[gazpacho]

ovariectomy
please correct me....;-)

oophorectomy :) you asked.

[md90]

is the permission of the husband necessary for performing biopsy???
do not need the permission of the husband... but it's important to be upfront with the husband when you speak to him after the surgery.. If we change the case, and say the surgeon finds an ectopic pregnancy, then s/he can remove without a consent, why? It's an emergency.. there are grave consequences that can occur which can be life-threatening if left...

It's not unusual for this topic to be covered with the patient in advance of performing such a surgery, and to inform the patient and obtain consent to extend the procedure should it become necessary.
this is more difficult to do in my opinion because of the prediction factor.. symptoms can lead to many other diagnoses; Also in this case, let's say that the woman is young and of childbearing age... and having a child in the future.. It's best to do the biopsy, and give the information to the woman, then let them make the BEST decision for THEM.

[tRmedic21]

Unilateral oophorectomy doesn't have much of an impact on future childbearing potential, IIRC. However, I agree that ideally you should discuss the possibility of something like this with the patient if at all possible. It's impossible to forsee all complications.