[Placebo, an underestimated ally]

Patients' views and patient-oriented outcomes are increasingly acknowledged, including beliefs about pain and illness, and expectations of treatment. Indeed, how far patient expectations influence outcomes has developed into an important area of research, and all the more so as the impact of expectations on subjective outcome is related to the placebo effects; indeed, expectations can both mediate and modulate these effects. Surgery has been suggested as conveying a placebo effect related to the ceremony of surgical preparation, the use of sophisticated techniques and the need for hospitalization possibly leading to increased pain management, more active sympathy and disease recognition.