Why did I have to have a general anaesthetic?

[Dilbertian]

I've been watching Dr Pimple Popper, and she removes massive lipomas under LA. Which reminds me that I have always wondered why I had mine removed under GA.

A few years ago I had a 3cm lipoma removed from my shoulder. I was having pain in my arm and neck, especially when the lipoma was pressed by a bra strap or shoulder bag.

I was referred to a GP who did minor surgery. He was going to remove it under local anaesthetic. He warned me that, if the tumour was too close to the major nerve or blood vessel, he would have to close me up again and refer me to a specialist surgeon (orthopaedics IIRC). I refused the surgery and asked to be referred there and then.

The specialist decided to remove the lipoma in hospital. Ultrasound scan had shown that the lipoma was unlikely to involve any important tissues, though this was not guaranteed. This time I felt I was in expert, safe hands, and was not worried.

On the morning of the surgery, when the surgeon came to say hello and draw all over my shoulder with permanent marker, he told me I was going to have GA (I had been told to fast beforehand, in any case). I asked if I could have the surgery under LA, explaining that I was not anxious about it. Surgeon was quite firm that it had to be GA. I accepted this, and the surgery went ahead with no problems.

Thing is, GA always messes with my head, and I'm loopy for up to a week after it. So I do not know whether my question was ever answered: why did the specialist insist on a GA?

I'm not an anesthetist but I guess his comment Ultrasound scan had shown that the lipoma was unlikely to involve any important tissues, though this was not guaranteed meant that there was a chance that they'd have to do more involved surgery . They have to cover all the bases .

If you'd been awake , and then the surgeon had to do more extensive work, it would make the situation more complicated. A wakeful patient can move without meaning to, which could cause pretty bad problems when a surgeon is working on nerves, blood vessels etc. I think it's always best to accept that the surgeon and the anesthetist know what is needed.

Mine was done under GA. Small one on my chest.

I had a lipoma removed under GA too.
I would trust that the surgeons had experience and used what was best. They never use GA unless it's absolutely necessary.

Oh I did trust them. I felt much safer under the hands of someone who specialised in knowing their way around a shoulder, and who had checked what there was to be concerned about within that shoulder, rather than a generalist who essentially said that he didn't know but he would open me up and have a try!

I expect Starrynight is right, and they were being extra cautious as they maybe didn't have as much info from the scan as they would have liked.

I am horrified at the lipoma surgery Dr PP undertakes under local!

To me it shouts 'insufficient insurance'.

I perform MR scans on what are almost always lipomas. But now and then one isn't, and will therefore need deep excision.

I doubt for a second many of her patients had a MR prior to their excisions!