The main focus is on the psychological and physiological preparation of the patient and the management of special diseases, in order to reduce intraoperative and postoperative complications. The patient’s imaging data has been seen many times before surgery and should be well known to the surgeon, so the purpose of reading it again is to emphasize and remind. Take kidney cancer as an example, the first thing to look at is whether the diagnosis is correct or not, some people may say that if the diagnosis is not correct, why should we go into the operating room? And I emphasize that it is never too late until the surgery is opened! The relationship between the area to be resected and the surrounding organs, such as the location and adjacency of duodenum, ascending colon, inferior vena cava, etc.; the presence of enlarged lymph nodes around the renal artery and veins, and the presence of inflammatory reactions, are directly related to the ease of surgery and the safety of ligating the renal hilum during surgery and the prevention of paid injuries. The CT or MRI film is already on the light of the resident (this is their job), and the surgeon in charge checks the film to see if it matches the patient’s side anyway. It’s not uncommon to cut the wrong organ, especially with the left and right kidney. Like a murderer who is shot, there is no chance to correct the mistake, and the same is true for a surgeon who cuts the wrong organ. Observe the correct placement of the surgical position (sometimes by hand) The placement of the surgical position must not only facilitate the surgical operation, but must also respond to the important respiratory and circulatory functions. Proper and reasonable surgical positioning is an important factor in the success of surgery. Inappropriate surgical positions can cause nerve damage, and in severe cases can affect respiration and circulation, resulting in respiratory and circulatory failure and disability and death. For example, in bladder electrosurgery stone position, the distance between the patient’s hip and the edge of the bed is very important for tumors at the twelve points of the bladder neck or the anterior wall, and the distance is far from the bedside obstruction when pressing down on the mirror, which makes electrosurgery very difficult, and may be difficult or insufficiently understood by the resident or operating room nurse. Another example is whether the patient is firmly fixed during laparoscopic surgery. Because intraoperatively, to avoid intra-abdominal organ interference, multiple positions may have to be changed by rocking the bed, tilting from side to side, head side low, tail side low, etc. The surgeon is undoubtedly the main body of the operation, and the surgeon is the commander of the battle. Just as the commander should know all the soldiers of his group, the surgeon should also know the level of anesthesiologists, nurses, and assistants, and the surgeon often works with anesthesiologists, so it is better to know their character, habits, and technical level. etc., the proficiency of instruments and traveling nurses to do such surgical cooperation, or at least should maintain a good cooperative relationship with anesthesiologists and nurses. Understand the surgical level of the assistant, there is a saying that the operator will do everything and know nothing, while the assistant knows everything but will do nothing, has your assistant reached this level? If not what should you do? Be prepared, but don’t worry. After the surgery is completed, recall the incision suture is usually the assistant’s business, then quickly recall the procedure, is the key area ligated or sutured securely? Were there any gauzes that compressed the hemostasis that were not removed? Were there any regrets left from the surgery? Is there anything to add? At this point, the problem is found when the sheep is not dead but the prison has been mended. Specimen handling and surgical treatment The surgery is the surgeon’s business, and the cut specimens belong to the pathologist, so for the convenience of the pathologist, the specimens should not be cut open indiscriminately for their own understanding or because they do not understand. There was a patient with renal abscess combined with renal cancer, and after the doctor removed the specimen, the specimen was cut in three places, and the pathology report was renal abscess, the operator was anxious. In fact, the pathologist did not find the foci of cancer. It is better for the operator to mark out the parts to be understood with a line, and to bottle the specimens that are smaller, such as the specimens after lymph node dissection, and fill out the pathology report form carefully and in detail, which is only a matter of a few minutes, and it is convenient for others, right? After the specimen is removed, the family will see the specimen and then soak and bag it. When you show the specimen to the family, you should not just do anything, first of all, explain whether the operation was successful or not, it is better to tell them the general scope of the operation, what are the specimens removed, briefly explain the problems encountered during the operation, how they were solved, and what we should pay attention to after the operation. And so on. Because of the limited time, we will talk about the detailed problems immediately after returning to the ward, which may reduce many unnecessary troubles. These are tedious but by no means trivial matters!