Surgery Section

SURGERIES - YOU MAY BE BETTER OFF WITHOUT

►Before you have these invasive procedures, check out safer alternatives

Here are a dozen invasive procedures that may be overperformed,plus the safer or more effective alternatives you should at least consider.

» Too many heart procedures

Blockage of the arteries feeding the heart can lead to a heart attack. But procedures to detect or treat such blockage may be overused. One such procedure is angiography,in which cardiologists inject dye into the coronary arteries to make them visible on an X-ray. The test can lead physicians to find clinically insignificant obstructions, which they may then treat aggressively.

Such treatment often involves angioplasty, in which cardiologists snake a tiny balloon up into a narrowed coronary artery and then inflate it to crush the blockage, then they insert a cylinder called a stent to prop the vessel open. But in 1995 researchers determined that nearly one-third of those procedures were performed when medication and lifestyle changes alone would suffice or, less often when bypass surgery was the better choice.

»Women’s choice

Two of the most frequently performed major operation on women are hysterectomy, or surgical removal of the uterus and often the ovaries, and caesarean section. In both cases research suggests that most physicians fail to follow treatment guide-lines.Episiotomy, a less invasive but even more dubious procedure in which physicians make a short incision to widen the vaginal opening during childbirth, is another overdone one.

»For Males Only

Studies suggest that prostate problems − including cancer and benign enlargement− are often treated by invasive procedures without adequate discussion of the alternatives. But the best approach for both may sometimes be no treatment or watchful waiting. When completely informed about alternatives prostate treatments, men tend to choose less-aggressive options. But male patients have no say about another extremely common and medically unnecessary procedure: circumcision.