The therapy of factitious disorders is a challenge for the treating su
rgeon. Only a clear understanding of the underlying causes and a good
doctor-patient relationship make a successful outcome possible. Discus
sion about a confrontation of the patient with the diagnosis and the b
est made of treatment is still in progress. Early diagnosis and the co
operation between surgeons and psychiatrists are the most important pa
rts of dealing with factitious disorders. This article gives an overvi
ew of symptoms and therapies. Six case reports demonstrate possibiliti
es of the disorder's appearance.