David Aughton, MD, a general surgeon, joined the medical staff at Charlotte Hungerford Hospital in fall 2020. As a general surgeon, he performs a variety of surgical procedures. His particular areas of focus include laparoscopic surgery, abdominal surgery, and hernia repairs. He has extensive training in minimally invasive surgical techniques.
His addition as the fourth surgeon in the practice provides greater resources for the hospital to meet the needs of patients in the Northwest corner. Dr. Aughton explains that he currently maintains three to four office days per week, where he performs initial surgical consultations, minor procedures such as biopsies, and follow-up visits. He performs surgery one to two days each week. He also sees patients at the Winsted office a half day a week (currently Thursday afternoons) and patients needing chronic wound management at the CHH Wound Care & Hyperbaric Medicine Center on Friday mornings. He is on-call for surgical emergencies one out of every four days.
Dr. Aughton did not start out pursuing a career in medicine, although he had an idea of what it meant to be a doctor and specifically a surgeon because his father was a maxillofacial surgeon. He grew up in Southwest Florida where he attended the University of Central Florida with a major in aerospace engineering. He was close to graduating when he realized aerospace engineering was not what he really wanted to do. He recalls feeling like he was just learning harder and harder course work such as advance calculus but couldn’t see how these courses were relevant to what he would actually be doing in the profession.
He liked the idea of being able to help people, and after some long discussions with his father, Dr. Aughton made the switch to pre-med. He says once he made the switch, everything kind of clicked. He could immediately see how his coursework would be applicable to what he would be doing. He is very happy he made the change.
He specifically likes being a surgeon, “because you can go in and actually change someone’s health for the better right away. I’m glad that I’m able to do that for people.” This is in contrast with other medical subspecialties that deal with more chronic diseases. In those situations, he explains, a physician may provide a treatment such as a new medicine, but it may take weeks to months to fully see the results.
After graduating from the University of Central Florida, Dr. Aughton completed medical school at The American University of the Caribbean Medical School in Coral Gables, Florida. During his third and fourth years of medical school, he spent some time in Long Island, New York completing clinical rotations. It was there that he met his now wife.
He found that he liked the Northeast and included the region when he was considering options for his surgical residency. After completing his five-year surgical residency at Waterbury Hospital, he and his wife chose to stay in Connecticut. They have a two-and-a-half-year-old son. When he is not working, Dr. Aughton enjoys spending family time at home or enjoying the outdoors. He says he really enjoys experiencing the four seasons in Connecticut, although he admits that if the winter is bad, he does have the opportunity to visit family back in Florida!
Dr. Aughton gained extensive experience in performing robotic surgery during his residency. He explains that there is a plan for Charlotte Hungerford Hospital to offer robotic general surgery using a Da Vinci robot within the next year or so. (The hospital currently offers robotic spinal surgery but that is performed by spine surgeons rather than general surgeons.)
Dr. Aughton wants to assure patients that when people talk about robotic surgery, it does not mean that a robot is performing the surgery. The surgeon, like Dr. Aughton, is in the operating room the entire time. Rather than standing over the patient on the operating table however, he is off to the side sitting at a console where he controls all the movements of the robot.
The Da Vinci robot has four arms. These are attached to the patient, and surgical instruments are introduced through the abdominal or chest wall via a surgical tool called a trocar.
This part of the process is similar to what is done during current laparoscopic surgery. However, using a robot during surgery offers several advantages:
Improved Visualization: The robot uses two offset very high definition cameras so the surgeon has a three-dimensional view of the operating field. (Current laparoscopic procedures have a single camera.)
Improved Mobility: In current laparoscopic procedures, the instruments have only one degree of motion, meaning that they can only open or close. The robotic arms possess seven degrees of motion, so they function more like a surgeon’s wrist in their ability to maneuver.
Patient Recovery: Compared to open surgical procedures (where a surgeon makes a large cut in the abdomen or chest to gain access to body organs), robotically-assisted surgery generally results in a shorter recovery time, shorter length of hospital stay, and lower need for pain medications, all of which improve a patient’s post-surgical experience.
ne downside to robotic surgery is the cost of the initial investment for the hospital to purchase the robot. Dr. Aughton points out that this one-time cost is offset by the savings obtained by shorter lengths of stay. Still, this does not mean that every surgical procedure will automatically become a robotic surgery. Every case needs to be considered individually. Dr. Aughton meets with his patients to discuss all the options for surgery, including the potential risks and benefits of each option. Ultimately, it is the patient’s decision as to which type of surgery they want to undergo, but Dr. Aughton guides them through the decision process.
Given the current news reports regarding the ongoing opioid epidemic, some patients express concern at receiving opiates for pain management after surgery. Dr. Aughton can work with patients who have this concern. He thinks it is first important to set realistic expectations for a patient as to what level of discomfort they may experience after surgery. It is unrealistic to expect there will be no discomfort. Even with current laparoscopic procedures and the anticipation of robotically-assisted surgical procedures to come, a surgery is still a big disruption to the body.
Dr. Aughton notes he had an enlightening experience regarding pain management during his residency. In his third year, he spent two weeks in Liberia, West Africa performing surgeries. The country has very limited healthcare resources including for pain management. The surgical team brought bottles of naproxen sodium (brand name Aleve) with them and relied heavily on that for pain management. He states, “We successfully controlled almost everyone’s pain this way.”
After a major surgery Dr. Aughton explains it is his usual practice to prescribe an opiate pain reliever for the first two to three days. After that, patients can usually be switched to another class of pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (which include prescription and over-the-counter medicine options). There are non-drug pain therapy options that can be used too. Pain management options are part of the discussion Dr. Aughton has with patients during the planning process.
When asked if there were any myths about surgery he would want to dispel, Dr. Aughton replied, “Surgery is very different nowadays. If you know someone who had gallbladder surgery thirty years ago, it required them to be in the hospital for a week. Now, it is an outpatient surgery.” He recommends discussing any questions or concerns you may have about a possible surgery with your surgeon.
Margaret M. Burke, Pharm.D., BCPPS, is a freelance medical writer with more than 25 years of clinical pharmacy experience, including board certification as a pediatric pharmacotherapy specialist. She lives in Manchester.
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