Civil medical liability in general surgery: A systematic review

Civil medical liability is an important issue in modern surgical practice, affecting both medical practice and the doctor-patient relationship, and contributing to the increasing use of defensive medicine. General surgery, as a predominantly invasive specialty with a wide range of emergency and elective procedures, is at increased risk of legal claims. The purpose of this systematic review was to investigate the international literature on the civil medical liability of general surgeons, with an emphasis on the types of procedures involved, the causes of lawsuits, and the reported compensation amounts. A systematic search of PubMed and Scopus was performed according to PRISMA guidelines, without geographical restrictions, and included only English-language studies. After removing duplicates and evaluating the titles, abstracts, and full texts, 41 studies were included in the final analysis. Legal claims in general surgery typically involve common procedures such as cholecystectomy, hernia repair, thyroidectomy, and bariatric surgery. Compensation varies widely by country, with the highest amounts linked to permanent injury or death. The main causes include surgical errors, delayed diagnosis or treatment, missed postoperative complications, and poor patient consent documentation. The findings suggest that medical liability in general surgery is a multifactorial issue, in which the management of complications and patient communication play roles as important as surgical technique. A systematic understanding of the factors leading to legal claims may contribute to improving patient safety, reducing defensive medicine, and enhancing the quality of surgical care.