Surgery is medical treatment performed to treat a health problem. It may involve removing or changing tissues or organs, making or confirming a diagnosis, repairing damage or an injury, redirecting blood vessels and other procedures.
Many surgeries that once required large cuts now can be done with minimally invasive techniques, such as laparoscopy. These involve inserting a tube with a camera lens (laparoscope) into the belly cavity and using tiny tools to perform surgery. Contact Copper Mountain Surgical now!
For centuries, surgery was an experimental art whose practitioners struggled with three principal obstacles: bleeding, pain and infection. The twin emergence of anesthesia and antiseptic procedures in the 19th Century paved the way for the advanced surgical techniques we see today.
A 16th century Flemish man named Andreas Vesalius revolutionized the practice of surgery by separating it from medicine. He believed that medical students should be taught anatomy through a two step process: first, professors would read anatomical texts, many of which were built on Galen’s inaccurate ideas; then they would dissect animals and human bodies.
While surgeons were not as well-liked as physicians, their status slowly rose during the Renaissance thanks to advancements like increasing the success rate of Caesarean operations. The rise of the barber surgeon was a factor because many were trained in the trade and had a variety of sharp tools at their disposal, which they could use for everything from bloodletting to cutting off limbs.
Surgeons also benefited from innovations by others, such as French microbiologist Louis Pasteur who understood the relationship between bacteria and infectious disease; and British surgeon Joseph Lister who developed antiseptic, which greatly reduced the number of patients who died from wound infections after an operation. In addition, physicist Wilhelm Röntgen invented X-rays, which allowed surgeons to visualize bone structures within the body. Throughout history, countless surgeons have made significant contributions to the field.
Procedures
Surgical procedures involve cutting or stitching tissue to treat disease, injury or deformity. These may be elective or emergency, and they may be performed for treatment, improvement of quality of life, cosmetic reasons, or research purposes. New medical technology in surgery often takes the form of drugs, devices or techniques of care. Surgeons and medical institutions must carefully consider using a particular technology because it has the potential to reenliven professional vitality, enhance a surgeon’s or institution’s image and gain a competitive advantage, but it can also sully reputations, waste resources and injure patients when it is inappropriately used.
A surgical procedure is usually divided into three phases: preoperative, operative and postoperative. The preoperative phase includes testing and examination to determine whether the person is a good candidate for surgery, and it may include diagnostic imaging such as an X-ray or ultrasound.
Once a person is determined to need surgery, an extensive discussion with the surgeon will be held, during which the reasons for and benefits of the operation are explained. The risks and recovery time are also explained, and alternatives to surgery are discussed. In many cases, less invasive procedures are available that can offer better outcomes and faster recovery times. This approach is called minimally invasive surgery. It uses multiple smaller incisions or natural openings, and it requires the surgeon to use different surgical tools. It’s important to keep in mind that surgery can be very invasive, and not everyone will benefit from it.
Techniques
Surgery requires an excellent understanding of anatomy and a good level of hand-eye coordination. Problem-solving skills are also important, as surgeons must be able to assess clues from patients about their medical histories and determine the best course of action for treating the condition. Surgeons must also be able to handle delicate tools in sensitive areas of the body with precision. The twin developments of anesthesia and antiseptic techniques in the 19th century marked the start of modern surgical procedures.
There are many different types of instruments used in surgery, and trainees need to learn the names of all of them. Typically, basic surgical sets contain the most common tools required for performing a procedure such as a laparotomy or removal of a mole. Other trays may be used for more complicated operations. For example, it is essential to know the name and function of all basic forceps (tissue-holding forceps, haemostatic clamps and retractors) as well as more sophisticated instruments such as tissue dissectors and needle holders.
It is also essential to understand that surgeons have their own individual idiosyncrasies when it comes to the way they use their tools. As a result, it is very likely that each hospital and scrub team will have their own unique language and terminology. Understanding this will help to demystify the working environment in the operating theatre and enable you to participate more effectively as a surgical assistant.
Instruments
A surgeon relies on a multitude of tools to perform surgical procedures. These instruments can be made of different materials, but most are made of steel for durability and ease of sterilization. They have a variety of uses during surgery, and their lifecycle is complex, from the initial use to their return to the operating room for future cases. Instruments are kept in special trays to protect them from accidental damage and to keep them organized, and a sterile processing technician uses enzymatic pretreatment on used instruments before they’re sterilized and sent back out for further use.
Grasping and Holding
Many instruments have specialized designs to help surgeons with tissue or organ access, and to enhance precision and control. For example, a dilator expands the size of an orifice or cavity such as the cervical os or urethra, and retractors hold and retract tissues to allow better visibility and maneuverability. Retractors come in a variety of shapes, sizes and designs, such as Richardson retractors or Army-Navy retractors that are held manually, or Gelpi retractors that have a ratcheting mechanism to keep the blades closed without continuous manual holding.
Forceps are similar to tweezers that have two opposing arms joined at a pivot point and handles for control. They have many names and sizes, including rat toothed forceps, Littlewood forceps, or Adson bipolar forceps. During surgery, they’re usually used to grasp hard tissues such as fascia or bone.
Anesthetics
Before modern anesthetics, surgery was painful, dangerous and sometimes fatal. People searched for pain relief using a variety of substances, including mind-altering plants and recreational drugs. Medications, called anesthetics, block the transmission of nerve impulses to reduce or eliminate pain during surgery and other medical procedures. Different types of anesthetics produce different effects, from numbing only one part of the body to making a person unconscious.
The type of anesthesia used depends on the surgery you are having, your health and the doctor’s preference. You may have general, regional or local anesthesia. General anesthesia puts you into a deep sleep-like state during the procedure. You won’t feel any pain and you probably won’t remember the operation. Doctors use general anesthesia for most major surgeries and some minor ones.
Anesthesia can be administered through a vein (intravenous, or IV) or inhaled through a tube inserted into the throat. A nurse or anesthesiologist can monitor your heart rate, blood pressure, breathing and oxygen levels during the surgery.
Anesthesia can affect your memory, concentration and reflexes for a day or two after the operation. You may not be able to drive or sign legal documents and you’ll need someone to stay with you for 24 hours or more after the operation, especially if you have general anesthesia. Anesthetics are safe, but they do have risks and you should discuss these with your anesthesiologist before the procedure.
Recovery
The recovery process after surgery can be very different depending on the type of procedure. After your surgery, you will be taken to a recovery room, where nurses will monitor your vital signs and keep you comfortable until the effects of anesthesia wear off. Once you are medically stable, you will be either released home — if it was an outpatient procedure — or moved to your hospital room if you will be staying overnight.
During this time, it is important to follow your care team’s instructions regarding activity level, diet and wound care. Your surgeon may also prescribe medication for pain management, and you should be sure to take it as directed. If you experience any side effects from your medication, please contact your doctor as soon as possible, as they may be able to change the dosage or provide an alternative.
In general, patients consider themselves to be fully recovered when they return to the habits and routines that they had before their surgical procedure. For example, many patients cite returning to their preoperative physical exercise as an indicator of full recovery. Patients also value being able to return to their normal eating and drinking patterns. In addition, some patients consider that they are only truly “recovered” if they can resume their prior social activities and responsibilities.1