GENERAL SURGERY DIAGNOSIS PREPARATION
Category: General Surgery
Abstract : General surgery is the treatment of injury, deformity, and disease using
operative procedures.
Purpose General surgery is frequently performed to alleviate suffering
when a cure is unlikely through medication alone. It can be used for such
routine procedures performed in a physician’s office, as vasectomy, or for more
complicated operations requiring a medical team in a hospital
General surgery is the treatment of injury, deformity, and disease using
operative procedures.
Purpose
General surgery is frequently performed to alleviate suffering
when a cure is unlikely through medication alone.
It can be used for such
routine procedures performed in a physician’s office, as vasectomy, or for more
complicated operations requiring a medical team in a hospital setting, such as
laparoscopic cholecystectomy (removal of the gallbladder). Areas of the body
treated by general surgery include the stomach, liver, intestines, appendix,
breasts, thyroid gland, salivary glands, some arteries and veins, and the skin.
The brain, heart, lungs, eyes, feet, kidneys, bladder, and reproductive organs,
to name only a few, are areas that require specialized surgical repair.
New methods and techniques are less invasive than older practices, permitting
procedures that were considered impossible in the past. For example,
microsurgery has been used in reattaching severed body parts by successfully
reconnecting small blood vessels and nerves. Laparoscopic techniques are more
efficient, promote more rapid healing, leave smaller scars, and have lower
postoperative infection rates.
Demographics
All surgeons receive similar training in the first two years
of their residency (post-medical school) training. General surgeons are the
surgical equivalent of family practitioners. General surgeons typically differ
from other surgical specialties in the operations that they perform. This
difference is most easily understood by exclusion. For example, procedures
involving nerves or the brain are usually performed by neurosurgeons. Surgeons
having specialized training during the final three years of their residency
period similarly focus on other regions of the body. General surgeons may
perform such procedures in the absence of other surgeons with specialized
training. Such procedures are the exception, however, rather than the rule.
In the United States, there are approximately 700,000 physicians licensed to
practice medicine and surgery. Experts estimate that fewer than 5% of these
physicians (approximately 35,000) restrict their practices to general
surgery.
Description
In earlier times, surgery was a dangerous and dirty practice.
Through the middle of the nineteenth century, the number of people who died from
surgery approximately equaled the number of those who were cured. With the
discovery and development of general anesthesia in the mid-nineteenth century,
surgery became more humane. As knowledge about infections grew and sterile
practices were introduced into the operating room, surgery became more
successful. The last 50 years have brought continued advancements.
General surgery experienced major advances with the introduction of the
endoscope. This is an instrument for visualizing the interior of a body canal or
a hollow organ. Endoscopic surgery relies on this pencil-thin instrument,
equipped with its own lighting system and small video camera. The endoscope is
inserted through tiny incisions called portals. While viewing the procedure on a
video screen, the surgeon then operates with various other small precise
instruments inserted through one or more of the portals. The specific area of
the body to be treated determines the type of endoscopic surgery performed. For
example, colonoscopy uses an endoscope, which can be equipped with a device for
obtaining tissue samples for visual examination of the colon. Gastroscopy uses
an endoscope inserted through the mouth to examine the interior of the stomach.
Arthroscopy refers to joint surgery. Abdominal procedures are called
laparoscopies.
Endoscopy is frequently used in both treatment and diagnosis especially
involving the digestive and female reproductive systems. Endoscopy has
advantages over many other surgical procedures, resulting in a quicker recovery
and shorter hospital stays. This noninvasive technique is being used for
appendectomies, gallbladder surgery, hysterectomies, and the repair of shoulder
and knee ligaments. However, endoscopy has such limitations as complications and
high operating expense. Also, endoscopy does not offer advantages over
conventional surgery in all procedures. Some literature states that, as general
surgeons become more experienced in their prospective fields, additional
noninvasive surgical procedures will become more common options.
One-day surgery is also termed same-day or outpatient surgery. Surgical
procedures in this category usually require two hours or less and involve
minimal blood loss and a short recovery time. In the majority of surgical cases,
oral medications control postoperative pain. Cataract removal, laparoscopy,
tonsillectomy, repair of broken bones, hernia repair, and a wide range of
cosmetic procedures are common same-day surgical procedures. Many individuals
prefer the convenience and atmosphere of one-day surgery centers, as there is
less competition for attention with more serious surgical cases. These centers
are accredited by the Joint Commission on Accreditation of Healthcare
Organizations or the Accreditation Association for Ambulatory Health Care.
Diagnosis/Preparation
The preparation of persons for surgery has advanced
significantly with improved diagnostic techniques and procedures. Before
surgery, a candidate may be asked to undergo a series of tests, including blood
and urine studies, x rays, and specific heart studies if the person’s past
medical history or physical examination warrants this testing. Before any
surgical procedure, the physician will explain the nature of the surgery needed,
the reason for the procedure, and the anticipated outcome. The risks involved
will be discussed, along with the types of anesthesia to be utilized. The
expected length of recovery and limitations imposed during the recovery period
are also explained in detail before any surgical procedure.
Surgical procedures most often require some type of anesthetic. Some
procedures require only local anesthesia, produced by injecting the anesthetic
agent into the skin near the site of the operation. The person remains awake
with this form of medication. Injecting anesthetic agents near a primary nerve
located adjacent to the surgical site produces block anesthesia (also known as
regional anesthesia), which is a more extensive local anesthesia. The person
remains conscious, but is usually sedated. General anesthesia involves injecting
anesthetic agents into the blood stream or inhaling medicines through a mask
placed over the person’s face. During general anesthesia, an individual is
asleep and an airway tube is usually placed into the windpipe (trachea) to help
keep the airway open. As part of the preoperative preparation, surgical patients
will receive printed educational material and may be asked to review audio or
videotapes. They will be instructed to shower or bathe the evening before or
morning of surgery and may be asked to scrub the operative site with a special
antibacterial soap. Instructions will also be given to eat or drink nothing by
mouth for a determined period of time prior to the surgical procedure.
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