Surgery: Operations and Surgical Procedures

Introduction

Surgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, and sometimes for religious reasons. An act of performing surgery may be called a surgical procedure, operation, or simply surgery.

Main Document

A surgeon is a person who performs operations on patients. In rare cases, surgeons may operate on themselves. Persons described as surgeons are commonly medical practitioners, but the term is also applied to physicians, podiatric physicians, dentists (or known as oral and maxillofacial surgeon) and veterinarians.

Every year, more than 15 million people in the United States have surgery. There are many reasons to have surgery performed. Some operations can relieve or prevent pain, while others can reduce a symptom of a condition or improve a body function. Some exploratory surgeries are done to find a problem. Today, some surgeries are done with lasers. Some operations that once needed large incisions - cuts in the body - can now be done using much smaller incisions.

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Types of Surgery Include

Elective Surgery

Elective surgery is surgery that is scheduled in advance, and does not involve a medical emergency. Essentially, there are two types of elective surgery: surgery for nonmedical reasons (e.g., cosmetic surgery), and surgery that is necessary for medical reasons, but which is not yet urgent in nature.

Emergency Surgery

A surgery which must be done quickly to save life, limb, or functional capacity. Emergency Medicine encompasses a large amount of general medicine and surgery, including the surgical sub-specialties.

Amputation

Involves cutting off a body part, usually a limb or digit. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems. A special case is the congenital amputation, a congenital disorder, where fetal limbs have been cut off by constrictive bands.

Excision

Cutting out of an organ, tissue, or other body part from a patient. Excisional biopsy is essentially the same as incision biopsy, except the entire lesion or tumor is included. This is the ideal method of diagnosis of small melanomas (when performed as an excision). Ideally, an entire melanoma should be submitted for diagnosis if it can be done safely and cosmetically.

Exploratory Surgery

Exploratory surgery is a diagnostic method used by doctors when trying to find a diagnosis for an ailment. Sometimes, cancer is located in a place where standard tests cannot detect it. In this case, doctors must go into surgery and look at the cancerous mass manually. This procedure, which is what is commonly associated with exploratory surgery, is not used for treatment at all.[citation needed] Instead, it is used chiefly to identify the location of the tumor and the extent of its damage. If a tumor is found, a biopsy is performed and tests are run to see what type of cancer was found.

Gamma Knife Radiosurgery

A type of radiation therapy used to treat tumors and other abnormalities in the brain. The precision of gamma-knife radiosurgery results in minimal damage to healthy tissues surrounding the target and, in some cases, a lower risk of side effects compared with other types of radiation therapy. Gamma-knife radiosurgery doesn't involve surgical incisions, so it's generally less risky than traditional neurosurgery, where you can have problems with anesthesia, bleeding, and infection.

Laser Surgery

Involves surgery using a laser to cut tissue instead of a scalpel. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content. Laser resurfacing is a technique in which molecular bonds of a material are dissolved by a laser. Laser surgery is commonly used on the eye. Techniques used include LASIK, which is used to correct near- and far-sightedness in vision, and photorefractive keratectomy, a procedure which permanently reshapes the cornea using an excimer laser to remove a small amount of tissue. Green laser surgery is used for the treatment/reduction of enlarged prostates. The laser is very superficial, which results in a much reduced recovery time for the patient.

Microsurgery

A general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves, which have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Although microsurgery is used mostly in plastic surgery, microsurgical techniques are utilized by all specialties today, especially those involved in reconstructive surgery such as general surgery, ophthalmology, orthopedic surgery, gynecological surgery, otolaryngology, neurosurgery, maxillofacial surgery, and pediatric surgery.

Minimally Invasive Surgery

A minimally invasive procedure typically involves use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device, and are carried out through the skin or through a body cavity or anatomical opening. This may result in shorter hospital stays, or allow outpatient treatment.

Plastic and Cosmetic Surgery

Cosmetic breast, face, and body surgeries strive to minimize the amount of visible scarring while maximizing the positive benefits. From breast implants to tummy tucks to nose jobs, cosmetic surgeons add to, remove, or adjust existing physical structures to achieve the look that the patient wants. Key factors to keep in mind include cost, physical feasibility, and longevity of results.

Reconstructive Surgery

Involves reconstruction of an injured, mutilated, or deformed part of the body. The common feature is that the operation attempts to restore the anatomy or the function of the body part to normal.

Re-plantation

The surgical reattachment of a body part, most commonly a finger, hand or arm, that has been completely cut from a person's body. Re-plantation of amputated parts has been performed on fingers, hands, forearms, arms, toes, feet, legs, ears, avulsed scalp injuries, a face, lips, penis, and a tongue.

Robotic Surgery

Makes use of a surgical robot, such as the Da Vinci or the Zeus surgical systems, to control the instrumentation under the direction of the surgeon. Robotic surgery, computer-assisted surgery, and robot-assisted surgery are all terms for various technological developments that currently are developed to support a range of surgical procedures. Robot-assisted surgery was developed to overcome limitations of minimally invasive surgery, Instead of directly moving the instruments the surgeon uses a computer console to manipulate the instruments attached to multiple robot arms. The computer translates the surgeon's movements, which are then carried out on the patient by the robot.

Transplant Surgery

The replacement of an organ or body part by insertion of another from a different human (or animal) into the patient. Removing an organ or body part from a live human or animal for use in transplant is also a type of surgery. Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, and veins. Worldwide, the kidneys are the most commonly transplanted organs, while musculoskeletal transplants outnumber them by more than tenfold.

Other Surgeries

• Cardiac surgery (performed on the heart)
• Gastrointestinal surgery (performed within the digestive tract and its accessory organs)
• Orthopedic surgery (performed on bones or muscles)

Before Surgery

Some questions to ask when about to undergo surgery are:

• When you can go back to work
• How long you will be in the hospital
• When it is ok to start exercising again
• Are they any other restrictions in your activities
• What kind of supplies, equipment, and help you might need when you go home

After Surgery

After surgery there can be a risk of complications, including infection, too much bleeding, reaction to anesthesia, or accidental injury. There is almost always some pain with surgery. There may also be swelling and soreness around the area that the surgeon cut.

Your surgeon can tell you how you might feel and what you will be able to do, or not do, the first few days, weeks, or months after surgery. Following your surgeon's advice can help you recover as soon as possible.

Surgery Facts and Statistics

• Surgical treatments date back to the prehistoric era.
• The oldest known surgical texts date back to Ancient Egypt about 3500 years ago.
• The discipline of surgery was put on a sound, scientific footing during the Age of Enlightenment in Europe.
• Reconstruction, plastic or cosmetic surgery of a body part, starts with a name for the body part to be reconstructed and ends in -oplasty.
• Some operations that once needed large incisions (cuts in the body) can now be done using much smaller cuts. This is called laparoscopic surgery.
• Procedures for formation of a permanent or semi-permanent opening called a stoma in the body end in -ostomy.
• Surgery on children requires considerations which are not common in adult surgery.
• Excision surgery names often start with a name for the organ to be excised (cut out) and end in -ectomy.
• Anesthesiologists report that anesthesia awareness - being conscious during surgery - affects less than 1% of U.S. patients given general anesthesia.
• After completion of surgery, the patient is transferred to the post anesthesia care unit and closely monitored.
• Elective surgery generally refers to a surgical procedure that can be scheduled in advance because it does not involve a medical emergency.
• Repair of damaged or congenital abnormal structure ends in -rraphy.
• Minimally invasive procedures involving small incisions through which an endoscope is inserted end in -oscopy.
• Frail elderly people are at significant risk of post-surgical complications and the need for extended care.
• For hospital stays in 2012 in the United States, private insurance had the highest percentage of surgical expenditure.
• In total, there were over 15 million operating room procedures performed in U.S. hospitals in 2011. The overall number of procedures remained stable from 2001-2011.
• Of the 38.6 million hospital stays that occurred in U.S. hospitals in 2011, 29% included at least one operating room procedure. These stays accounted for 48% of the total $387 billion in hospital costs.
• A study of data from 2003-2011 showed that U.S. hospital costs were highest for the surgical service line; the surgical service line costs were $17,600 in 2003 and projected to be $22,500 in 2013.

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