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American Morning
Avoiding Surgery
Aired April 23, 2003 - 08:43 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
HEIDI COLLINS, CNN ANCHOR: Just say no to surgery. New research suggests that a variety of common surgical procedures might not be necessary after all. So we're paging Dr. Sanjay Gupta at CNN Center to find out more.
Hey, if I don't have to have an operation, I'm happy about it.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Yeah. Most people would be, Heidi, no question. But I don't know that everyone is ready to say no to surgery for everyone. But there has definitely been a change, especially the last five years in the way that surgeries are done. the way that operations are performed, less invasiveness, less time in the hospital and less costs. That's become the mantra for patients, doctors and insurance companies, all of them alike.
And also less surgery may be more is also the result of a couple of studies that people have recently published as well.
One study came out of Johns Hopkins, actually looked at back pain and leg pain, really common ailments, people who have herniated disks, and they found that about 3/4 of those patients actually recovered on their own, never needing the knife, and they also looked at arthritis of the knees, and they found that arthroscopic surgery did not fare any better than placebo surgery.
So obviously some gray areas in there. But the best option for all patients really to talk to the doctor about specific individual cases, but surgery, as hard this is for a surgeon to say, surgery may not always be the answer -- Heidi.
COLLINS: Sanjay, you already said reasons for this might include less invasive surgeries, but also better tools, better instruments and better antibiotics. What about early detection? Isn't that helping out with this, too?
GUPTA: Yes, absolutely, all of the things that you said, early detection. I mean, there has just been an entire paradigm shift in the way that patients are approached. You mentioned the better tools. But you know, people used talked about something known as exploratory surgery, but now you can see these sorts of images that you see there on the screen, CAT scans, MRIs, things like that, really offer a better way to look inside somebody's body without having to do an operation and look inside actually. Better antibiotics, sinus surgery, a really big deal, tonsillectomies. You don't hear about those operations as much anymore.
Certainly they're still performed, but with good antibiotics, they're not as necessary.
And finally, as you mentioned as well, Heidi, less invasive surgeries, laparoscopic surgery. You can do operations using little cameras inside of the body instead of making bigger incisions.
This all leads to those three things again -- less invasiveness, less time in the hospital and less costs, and that does make everyone happy -- Heidi.
COLLINS: I'm wondering how insurance might be affecting these surgeries and the number of them being done as well. Surgery is expensive, and insurance is not covering as many traditional surgeries as in the past.
GUPTA: That's right, and you know, the insurance companies are chanting this mantra as well. It does reduce costs in the long run as well. A lot of these technologies are expensive, sort of as up-front costs, getting new CAT scanners, getting new operating room technologies can be expensive.
But what a lot of the insurance companies are finding out, the same thing doctors have been finding out, is that in the long run, it probably cut costs, because the patients aren't spending as much time in hospitals, they may be spending no time in an intensive care unit, whereas they used to before, and in the long run, that's going to cut costs for everybody.
COLLINS: So, Sanjay, you're a neurosurgeon. Tell us, what is the future of these surgeries?
GUPTA: Well, that's a good question. A couple of points about that, Heidi. I think that, first of all, there's going to be some operations that are still going to always need to be done. And patients need not take the message home today that surgery is always a no. People have appendicitis, an operation can be a life-saving procedure, and they should not wait for things like that.
But there are a lot of areas of surgery that are gray areas, operations that are done for pain. A lot of times, as we found out from the Johns Hopkins study, with back and leg pain, 75 percent of those patients got better on their own. If waiting is an option, it may not be a bad option for individual patients.
So the best advice still I think for you, Heidi, for anybody really, is to talk to your doctor about your individual case. There may be something you don't know, something you may be missing, but there are all sorts of different options out there.
COLLINS: Absolutely. All right, Paging Dr. Gupta. Dr. Sanjay Gupta, thanks so much.
GUPTA: Thank you.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired April 23, 2003 - 08:43 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
HEIDI COLLINS, CNN ANCHOR: Just say no to surgery. New research suggests that a variety of common surgical procedures might not be necessary after all. So we're paging Dr. Sanjay Gupta at CNN Center to find out more.
Hey, if I don't have to have an operation, I'm happy about it.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Yeah. Most people would be, Heidi, no question. But I don't know that everyone is ready to say no to surgery for everyone. But there has definitely been a change, especially the last five years in the way that surgeries are done. the way that operations are performed, less invasiveness, less time in the hospital and less costs. That's become the mantra for patients, doctors and insurance companies, all of them alike.
And also less surgery may be more is also the result of a couple of studies that people have recently published as well.
One study came out of Johns Hopkins, actually looked at back pain and leg pain, really common ailments, people who have herniated disks, and they found that about 3/4 of those patients actually recovered on their own, never needing the knife, and they also looked at arthritis of the knees, and they found that arthroscopic surgery did not fare any better than placebo surgery.
So obviously some gray areas in there. But the best option for all patients really to talk to the doctor about specific individual cases, but surgery, as hard this is for a surgeon to say, surgery may not always be the answer -- Heidi.
COLLINS: Sanjay, you already said reasons for this might include less invasive surgeries, but also better tools, better instruments and better antibiotics. What about early detection? Isn't that helping out with this, too?
GUPTA: Yes, absolutely, all of the things that you said, early detection. I mean, there has just been an entire paradigm shift in the way that patients are approached. You mentioned the better tools. But you know, people used talked about something known as exploratory surgery, but now you can see these sorts of images that you see there on the screen, CAT scans, MRIs, things like that, really offer a better way to look inside somebody's body without having to do an operation and look inside actually. Better antibiotics, sinus surgery, a really big deal, tonsillectomies. You don't hear about those operations as much anymore.
Certainly they're still performed, but with good antibiotics, they're not as necessary.
And finally, as you mentioned as well, Heidi, less invasive surgeries, laparoscopic surgery. You can do operations using little cameras inside of the body instead of making bigger incisions.
This all leads to those three things again -- less invasiveness, less time in the hospital and less costs, and that does make everyone happy -- Heidi.
COLLINS: I'm wondering how insurance might be affecting these surgeries and the number of them being done as well. Surgery is expensive, and insurance is not covering as many traditional surgeries as in the past.
GUPTA: That's right, and you know, the insurance companies are chanting this mantra as well. It does reduce costs in the long run as well. A lot of these technologies are expensive, sort of as up-front costs, getting new CAT scanners, getting new operating room technologies can be expensive.
But what a lot of the insurance companies are finding out, the same thing doctors have been finding out, is that in the long run, it probably cut costs, because the patients aren't spending as much time in hospitals, they may be spending no time in an intensive care unit, whereas they used to before, and in the long run, that's going to cut costs for everybody.
COLLINS: So, Sanjay, you're a neurosurgeon. Tell us, what is the future of these surgeries?
GUPTA: Well, that's a good question. A couple of points about that, Heidi. I think that, first of all, there's going to be some operations that are still going to always need to be done. And patients need not take the message home today that surgery is always a no. People have appendicitis, an operation can be a life-saving procedure, and they should not wait for things like that.
But there are a lot of areas of surgery that are gray areas, operations that are done for pain. A lot of times, as we found out from the Johns Hopkins study, with back and leg pain, 75 percent of those patients got better on their own. If waiting is an option, it may not be a bad option for individual patients.
So the best advice still I think for you, Heidi, for anybody really, is to talk to your doctor about your individual case. There may be something you don't know, something you may be missing, but there are all sorts of different options out there.
COLLINS: Absolutely. All right, Paging Dr. Gupta. Dr. Sanjay Gupta, thanks so much.
GUPTA: Thank you.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
