Surgeons make decisions with patients about when to operate and when to recommend nonoperative care on a daily basis. We must decide when to inves- tigate and which investigations to order. If it is to be surgery, the decision on which operation is the best should, ideally, be based on prospective, randomized controlled studies, free of bias and relevant to the clinical decision. However, in many cases we ask “Do we have sufficient evidence?” The answer is: in some cases “Yes” and in some cases “No.”