Surgery is part of the practice of medicine and is used to structurally alter the human body through incision or destruction of tissues. Surgery is also defined as the diagnosis or treatment of conditions or disease processes using any instrument that causes localised alteration or transportation of live human tissue, such as lasers, ultrasound, ionising radiation, scalpels, probes, and needles.
Some examples of surgery include the removal of a tumor, the opening of a blockage in your intestine, or the attachment of a blood vessel in a new location to help blood flow to a part of your body. Mostly hemostatic forceps and other grasping tools are used in above mentioned surgeries.
- Emergency Surgery: A life-threatening problem, such as a burst artery, is treated immediately by emergency surgery.
- Urgent Surgery: Urgent surgery, such as the removal of an inflamed appendix, treats a serious problem within hours.
- Elective Surgery: Elective surgery addresses a problem that can wait until you’re ready to address it, such as replacing a knee joint or removing wrinkles from your face to improve your appearance (cosmetic surgery).
Major and minor surgeries are terms used by doctors to describe procedures.
Major Surgery:
Doctors usually cut into your belly, chest, or head during major surgery. While you are unconscious, a team of doctors performs this surgery in a hospital operating room. Following that, you’ll usually spend one or more nights in the hospital.
Minor Surgery:
Minor surgery does not require the opening of a large part of your body and usually does not affect your major organs. This surgery may be performed by a single doctor rather than a team in a hospital or other setting (such as a doctor’s office). Normally, you return home the same day.
Laparoscopy (Keyhole Surgery)
Laparoscopy is a surgical procedure that allows a surgeon to see inside the abdomen (tummy) and pelvis without making large incisions in the skin.
This is also referred to as keyhole surgery or minimally invasive surgery.
The surgery is performed by doctors using a tiny video camera, lights, and surgical instruments inserted through small cuts in your body. When compared to traditional surgery, keyhole surgery has several advantages, including:
- Less tissue damage
- Reduced hospital stay
- Return to work faster
- Less Pain
Keyhole surgery does have some drawbacks, including:
- Surgery takes more time.
- It is more difficult for surgeons.
- The pain from surgery may be worse than you expect.
When laparoscopy is used:
Laparoscopy can be used to help diagnose a variety of conditions that arise within the abdomen or pelvis. It can also be used to perform surgical procedures such as removing a diseased or damaged organ or removing a tissue sample for further testing (biopsy).
Laparoscopy is most commonly used in the following procedures:
- Gynaecology is the study and treatment of female reproductive system disorders.
- Gastroenterology – the study and treatment of digestive system disorders.
- Urology is the study and treatment of urinary system disorders.
How is pain controlled during surgery?
An anaesthetic is a substance that prevents you from feeling pain or renders you unconscious. Analgesics are pain-relieving medications. Anesthesia will be administered by a doctor or nurse practitioner prior to surgery to keep you from feeling pain during the procedure.
Types of Anaesthesia:
Local Anaesthesia: local anaesthesia numbs a specific area; for example, before removing a skin growth, a doctor may inject lidocaine into the skin on your arm.
Regional Anaesthesia: Because the medicine is injected into one or more nerves, regional anaesthesia numbs a specific area of your body—for example, an epidural during childbirth.
General Anaesthesia: This anaesthesia renders you unconscious by administering medication into your bloodstream—during surgery, the doctor administering anaesthesia will monitor your breathing, heart rate, and blood pressure, and you may require a breathing tube or ventilator.
Prevention of surgical infections
Standard precautions are the minimum infection prevention practices that apply to all patient care, regardless of whether the patient has a suspected or confirmed infection status, in any setting where healthcare is provided.
Standard precautions include the following:
- Hand hygiene is important.
- Personal protective equipment should be worn (e.g., gloves, masks and eyewear).
- Cough etiquette / respiratory hygiene
- Sharps protection (engineering and work practice controls).
- Injection safety procedures (i.e., aseptic technique for parenteral medications).
- Instruments and devices that are sterile.
- Surfaces in the environment should be clean and disinfected.
Instruments used in general surgery
Surgical instruments can vary greatly depending on the field of surgery in which they are used. In general, instruments are classified into five types based on their function:
Cutting and dissecting tools
- Scalpels, scissors, and saws are the most common cutting and dissecting tools.
- Elevators can be cutting as well as lifting/retracting.
- Despite the broad definition of dissection, energy devices such as diathermy/cautery are frequently used as more modern alternatives.
Grasping or holding a musical instrument:
- Traditionally, this included primarily forceps and clamps.
- Forceps are classified as traumatic (tissue crushing) or atraumatic (tissue preserving, such as Debakey’s).
Hemostatic instruments:
- These are instruments used to stop bleeding. Artery foreceps are a classic example of how bleeding can be stopped by directly clamping a vessel.
- Sutures are frequently used, with the assistance of a needle holder.
- Cautery and related instruments are being used more frequently in high-resource countries.
Retractors:
- Surgery is frequently thought to be primarily about exposure. A variety of retractors are available to assist in exposing the body’s cavities accessed during surgery.
- These are typically hand-held (often by a junior assistant) or self-retaining.
- Elevators can be cutting as well as lifting/retracting.
