Surgery
Overview
Surgery is an ancient medical specialty
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 that uses operative manual and instrumental techniques on a patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

 to investigate and/or treat a pathological condition such as disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 or injury
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...

, or to help improve bodily function or appearance.

An act of performing surgery may be called a surgical procedure, operation, or simply surgery. In this context, the verb operate means to perform surgery.
Encyclopedia
Surgery is an ancient medical specialty
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 that uses operative manual and instrumental techniques on a patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....

 to investigate and/or treat a pathological condition such as disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

 or injury
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...

, or to help improve bodily function or appearance.

An act of performing surgery may be called a surgical procedure, operation, or simply surgery. In this context, the verb operate means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments
Surgical instruments
A surgical instrument is a specially designed tool or device for performing specific actions of carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of surgical instruments and tools...

 or surgical nurse. The patient or subject on which the surgery is performed can be a person or an animal. A surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

 is a person who performs operations on patients. In rare cases, surgeons may operate on themselves
Self-surgery
Self-surgery is the act of performing a surgical procedure on oneself. It can be a rare manifestation of a psychological disorder, an attempt to avoid embarrassment or legal action, or an act taken in extreme circumstances out of necessity.- Genital :...

. Persons described as surgeons are commonly physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

s, but the term is also applied to podiatrists
Podiatry
Podiatry is a branch of medicine devoted to the study, diagnosis, and treatment of disorders of the foot, ankle, and lower leg. The term podiatry came into use first in the early 20th century United States, where it now denotes a Doctor of Podiatric Medicine , a specialist who is qualified by their...

, dentist
Dentist
A dentist, also known as a 'dental surgeon', is a doctor that specializes in the diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aides in providing oral health services...

s (known as oral and maxillofacial surgeons) and veterinarian
Veterinarian
A veterinary physician, colloquially called a vet, shortened from veterinarian or veterinary surgeon , is a professional who treats disease, disorder and injury in animals....

s. A surgery can last from minutes to hours, but is typically not an ongoing or periodic type of treatment. The term surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentist, or veterinarian.

Definitions of surgery

Surgery is a technology consisting of a physical intervention on tissues.

As a general rule, a procedure is considered surgical when it involves cutting of a patient's tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty
Angioplasty
Angioplasty is the technique of mechanically widening a narrowed or obstructed blood vessel, the latter typically being a result of atherosclerosis. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size...

 or endoscopy
Endoscopy
Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...

, may be considered surgery if they involve "common" surgical procedure or settings, such as use of a sterile environment, anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

, antiseptic
Antiseptic
Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction...

 conditions, typical surgical instruments
Surgical instruments
A surgical instrument is a specially designed tool or device for performing specific actions of carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of surgical instruments and tools...

, and suturing or stapling
Surgical staple
Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. A more recent development, from the 1990s, uses clips instead of staples for some applications; this does not require the staple to penetrate.Stapling...

. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being excised (e.g. laser ablation of the cornea) or to a radiosurgical procedure (e.g. irradiation of a tumor).

Types of surgery

Surgical procedures are the commonly categorized by urgency, type of procedure, body system involved, degree of invasiveness, and special instrumentation.
  • Based on timing: Elective surgery
    Elective surgery
    Elective surgery is surgery that is scheduled in advance because it does not involve a medical emergency...

     is done to correct a non-life-threatening condition, and is carried out at the patient's request, subject to the surgeon's and the surgical facility's availability. Emergency surgery
    Emergency medicine
    Emergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...

     is surgery which must be done promptly to save life, limb, or functional capacity. A semi-elective surgery is one that must be done to avoid permanent disability or death, but can be postponed for a short time.
  • Based on purpose: Exploratory surgery
    Exploratory surgery
    Exploratory surgery is a diagnostic method used by doctors when trying to find a diagnosis for an ailment. It can be performed in both humans and animals, but it is far more common in animals...

     is performed to aid or confirm a diagnosis. Therapeutic surgery treats a previously diagnosed condition.
  • By type of procedure: Amputation
    Amputation
    Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. 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...

     involves cutting off a body part, usually a limb or digit; castration is also an example. Replantation
    Replantation
    Replantation is the surgical reattachment of a body part by microsurgical means, most commonly a finger, hand or arm, that has been completely cut from a person's body...

     involves reattaching a severed body part. Reconstructive surgery
    Reconstructive surgery
    Reconstructive surgery is, in its broadest sense, the use of surgery to restore the form and function of the body, although Maxillo-Facial Surgeons, Plastic Surgeons and Otolaryngologists do reconstructive surgery on faces after trauma and to reconstruct the head and neck after cancer.Other...

     involves reconstruction of an injured, mutilated, or deformed part of the body. Cosmetic surgery is done to improve the appearance of an otherwise normal structure. Excision is the cutting out or removal of an organ, tissue, or other body part from the patient. Transplant
    Organ transplant
    Organ transplantation is the moving of an organ from one body to another or from a donor site on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be...

     surgery is the replacement of an organ or body part by insertion of another from 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.
  • By body part: When surgery is performed on one organ system or structure, it may be classed by the organ, organ system or tissue involved. Examples include cardiac surgery (performed on the heart), gastrointestinal surgery (performed within the digestive tract and its accessory organs), and orthopedic surgery (performed on bones and/or muscles).
  • By degree of invasiveness
    Invasiveness of surgical procedures
    There are three main categories which describe the invasiveness of surgical procedures. These are: non-invasive procedures, minimally invasive procedures, and invasive procedures ....

    : Minimally invasive surgery involves smaller outer incision(s) to insert miniaturized instruments within a body cavity or structure, as in laparoscopic surgery
    Laparoscopic surgery
    Laparoscopic surgery, also called minimally invasive surgery , bandaid surgery, or keyhole surgery, is a modern surgical technique in which operations in the abdomen are performed through small incisions as opposed to the larger incisions needed in laparotomy.Keyhole surgery makes use of images...

     or angioplasty
    Angioplasty
    Angioplasty is the technique of mechanically widening a narrowed or obstructed blood vessel, the latter typically being a result of atherosclerosis. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size...

    . By contrast, an open surgical procedure or laparotomy
    Laparotomy
    A laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy.- Terminology :...

     requires a large incision to access the area of interest.
  • By equipment used: Laser surgery
    Laser surgery
    Laser surgery is 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...

     involves use of a laser
    Laser
    A laser is a device that emits light through a process of optical amplification based on the stimulated emission of photons. The term "laser" originated as an acronym for Light Amplification by Stimulated Emission of Radiation...

     for cutting tissue instead of a scalpel
    Scalpel
    A scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, and various arts and crafts . Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have attached, resharpenable blades or, more commonly, non-attached, replaceable...

     or similar surgical instruments. Microsurgery
    Microsurgery
    Microsurgery is 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...

     involves the use of an operating microscope
    Microscope
    A microscope is an instrument used to see objects that are too small for the naked eye. The science of investigating small objects using such an instrument is called microscopy...

     for the surgeon to see small structures. Robotic surgery
    Robotic surgery
    Robotic surgery, computer-assisted surgery, and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in surgical procedures....

     makes use of a surgical robot
    Robot
    A robot is a mechanical or virtual intelligent agent that can perform tasks automatically or with guidance, typically by remote control. In practice a robot is usually an electro-mechanical machine that is guided by computer and electronic programming. Robots can be autonomous, semi-autonomous or...

    , such as the Da Vinci
    Da Vinci Surgical System
    The Da Vinci Surgical System is a robotic surgical system made by Intuitive Surgical and designed to facilitate complex surgery using a minimally invasive approach...

     or the Zeus surgical systems, to control the instrumentation under the direction of the surgeon.

Terminology

  • Excision surgery names often start with a name for the organ to be excised (cut out) and end in -ectomy.
  • Procedures involving cutting into an organ or tissue end in -otomy. A surgical procedure cutting through the abdominal wall to gain access to the abdominal cavity
    Abdominal cavity
    The abdominal cavity is the body cavity of the human body that holds the bulk of the viscera. It is located below the thoracic cavity, and above the pelvic cavity. Its dome-shaped roof is the thoracic diaphragm , and its oblique floor is the pelvic inlet...

     is a laparotomy
    Laparotomy
    A laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy.- Terminology :...

    .
  • Minimally invasive procedures involving small incisions through which an endoscope is inserted end in -oscopy. For example, such surgery in the abdominal cavity is called laparoscopy
    Laparoscopy
    Laparoscopy is an operation performed in the abdomen or pelvis through small incisions with the aid of a camera...

    .
  • Procedures for formation of a permanent or semi-permanent opening called a stoma
    Stoma (medicine)
    A stoma is an opening , either natural or surgically created, which connects a portion of the body cavity to the outside environment...

     in the body end in -ostomy.
  • Reconstruction, plastic or cosmetic surgery of a body part starts with a name for the body part to be reconstructed and ends in -oplasty. Rhino is used as a prefix for "nose", so rhinoplasty
    Rhinoplasty
    Rhinoplasty , also nose job, is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the nose, by resolving nasal trauma , congenital defect, respiratory impediment, and a failed primary rhinoplasty...

    is basically reconstructive or cosmetic surgery for the nose.
  • Reparation of damaged or congenital abnormal structure ends in -rraphy. Herniorraphy
    Herniorraphy
    Hernia repair refers to a surgical operation for the correction of a hernia . Hernias can occur in many places, including the abdomen, groin, diaphragm, brain, and at the site of a previous operation...

     is the reparation of a hernia, while perineorraphy is the reparation of perineum
    Perineum
    In human anatomy, the perineum is a region of the body including the perineal body and surrounding structures...

    .

Description of surgical procedure

At a hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....

, modern surgery is often done in an operating theater using surgical instruments, an operating table
Operating table
An operating table, sometimes called operating room table, is the table on which the patient lies during a surgical operation. This surgical equipment is usually found inside the surgery room of a hospital. An improvised suitable operating table can be composed of two kitchen tables that are...

 for the patient, and other equipment. The environment and procedures used in surgery are governed by the principles of aseptic technique
Aseptic technique
Aseptic technique refers to a procedure that is performed under sterile conditions. This includes medical and laboratory techniques, such as with microbiological cultures. It includes techniques like flame sterilization...

: the strict separation of "sterile" (free of microorganisms) things from "unsterile" or "contaminated" things. All surgical instruments must be sterilized
Sterilization (microbiology)
Sterilization is a term referring to any process that eliminates or kills all forms of microbial life, including transmissible agents present on a surface, contained in a fluid, in medication, or in a compound such as biological culture media...

, and an instrument must be replaced or re-sterilized if it becomes contaminated (i.e. handled in an unsterile manner, or allowed to touch an unsterile surface). Operating room staff must wear sterile attire (scrubs
Scrubs (clothing)
Scrubs are the shirts and trousers or gowns worn by nurses , surgeons, and other operating room personnel when "scrubbing in" for surgery. In the United Kingdom, they are sometimes known as Theatre Blues. They are designed to be simple with minimal places for dirt to hide, easy to launder, and...

, a scrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask), and they must scrub hands and arms with an approved disinfectant agent before each procedure.

Prior to surgery, the patient is given a medical examination, certain pre-operative tests, and their physical status
Physical fitness
Physical fitness comprises two related concepts: general fitness , and specific fitness...

 is rated according to the ASA physical status classification system. If these results are satisfactory, the patient signs a consent form and is given a surgical clearance. If the procedure is expected to result in significant blood loss, an autologous blood donation
Blood donation
A blood donation occurs when a person voluntarily has blood drawn and used for transfusions or made into medications by a process called fractionation....

 may be made some weeks prior to surgery. If the surgery involves the digestive system, the patient may be instructed to perform a bowel prep
Whole bowel irrigation
Whole bowel irrigation is a medical process involving the rapid administration of large volumes of an osmotically balanced polyethylene glycol solution , either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract.-History:Whole bowel irrigation was originally developed...

 by drinking a solution of polyethylene glycol
Polyethylene glycol
Polyethylene glycol is a polyether compound with many applications from industrial manufacturing to medicine. It has also been known as polyethylene oxide or polyoxyethylene , depending on its molecular weight, and under the tradename Carbowax.-Available forms:PEG, PEO, or POE refers to an...

 the night before the procedure. Patients are also instructed to abstain from food or drink (an NPO order
Nil per os
Nil per os is a medical instruction meaning to withhold oral food and fluids from a patient for various reasons. It is a Latin phrase which translates as "nothing through the mouth". In the United Kingdom it is translated as nil by mouth .Typical reasons for NPO instructions are the prevention...

 after midnight on the night before the procedure, to minimize the effect of stomach contents on pre-operative medications and reduce the risk of aspiration if the patient vomits during or after the procedure.

In the pre-operative holding area, the patient changes out of his or her street clothes and is asked to confirm the details of his or her surgery. A set of vital signs are recorded, a peripheral IV line
Intravenous therapy
Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...

 is placed, and pre-operative medications (antibiotics, sedatives, etc.) are given. When the patient enters the operating room, the skin surface to be operated on, called the operating field, is cleaned and prepared by applying an antiseptic
Antiseptic
Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction...

 such as chlorhexidine gluconate
Chlorhexidine gluconate
Chlorhexidine is a chemical antiseptic. It is effective on both Gram-positive and Gram-negative bacteria, although it is less effective with some Gram-negative bacteria. It has both bactericidal and bacteriostatic mechanisms of action, the mechanism of action being membrane disruption, not ATPase...

 or povidone-iodine to reduce the possibility of infection. If hair is present at the surgical site, it is clipped off prior to prep application. The patient is assisted by an anesthesiologist or resident to make a specific surgical position
Surgical positions
Surgical positioning is to facilitate the surgeon's technical approach while balancing risk factors. Surgical techniques have been expanded by the flexibility provided by anesthesia methodology, so that new areas of the body have become accessible and new positions have been developed...

, then sterile drapes are used to cover all of the patient's body except for the head and the surgical site or at least a wide area surrounding the operating field; the drapes are clipped to a pair of poles near the head of the bed to form an "ether screen", which separates the anesthetist/anesthesiologist
Anesthesiologist
An anesthesiologist or anaesthetist is a physician trained in anesthesia and peri-operative medicine....

's working area (unsterile) from the surgical site (sterile).

Anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

 is administered to prevent pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...

 from incision, tissue manipulation and suturing. Based on the procedure, anesthesia may be provided locally
Local anesthesia
Local anesthesia is any technique to induce the absence of sensation in part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with...

 or as general anesthesia. Spinal anesthesia may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia, the surgical site is anesthetized, but the patient can remain conscious or minimally sedated. In contrast, general anesthesia renders the patient unconscious and paralyzed during surgery. The patient is intubated
Intubation
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic or rubber tube into the trachea to maintain an open airway or to serve as a conduit through which to administer certain drugs...

 and is placed on a mechanical ventilator, and anesthesia is produced by a combination of injected and inhaled agents.

An incision is made to access the surgical site. Blood vessel
Blood vessel
The blood vessels are the part of the circulatory system that transports blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and...

s may be clamped to prevent bleeding, and retractors may be used to expose the site or keep the incision open. The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then peritoneum. In certain cases, bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...

 may be cut to further access the interior of the body; for example, cutting the skull
Human skull
The human skull is a bony structure, skeleton, that is in the human head and which supports the structures of the face and forms a cavity for the brain.In humans, the adult skull is normally made up of 22 bones...

 for brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

 surgery or cutting the sternum for thoracic (chest) surgery
Thoracic surgery
Thoracic surgery is the field of medicine involved in the surgical treatment of diseases affecting organs inside the thorax . Generally treatment of conditions of the lungs, chest wall, and diaphragm....

 to open up the rib cage
Rib cage
The rib cage is an arrangement of bones in the thorax of animals. It is formed by the vertebral column, ribs and sternum and encloses the heart and lungs....

.

Work to correct the problem in body then proceeds. This work may involve:
  • excision - cutting out an organ, tumor, or other tissue.
  • resection
    Segmental resection
    Segmental resection is a surgical procedure to remove part of an organ or gland. It may also be used to remove a tumor and normal tissue around it. In lung cancer surgery, segmental resection refers to removing a section of a lobe of the lung.- External links :* entry in the public domain NCI...

     - partial removal of an organ or other bodily structure.
  • reconnection of organs, tissues, etc., particularly if severed. Resection of organs such as intestines involves reconnection. Internal suturing or stapling may be used. Surgical connection between blood vessels or other tubular or hollow structures such as loops of intestine is called anastomosis
    Anastomosis
    An anastomosis is the reconnection of two streams that previously branched out, such as blood vessels or leaf veins. The term is used in medicine, biology, mycology and geology....

    .
  • Reduction - the movement or realignment of a body part to its normal position. e.g. Reduction of a broken nose involves the physical manipulation of the bone and/or cartilage from their displaced state back to their original position to restore normal airflow and aesthetics.
  • ligation
    Ligation
    Ligation may refer to:* In molecular biology, the covalent linking of two ends of DNA molecules using DNA ligase* In medicine, the making of a ligature * Chemical ligation, the production of peptides from amino acids...

     - tying off blood vessels, ducts, or "tubes".
  • grafts
    Medical grafting
    Grafting refers to a surgical procedure to move tissue from one site to another on the body, or from another person, without bringing its own blood supply with it. Instead, a new blood supply grows in after it is placed. A similar technique where tissue is transferred with the blood supply intact...

     - may be severed pieces of tissue cut from the same (or different) body or flaps of tissue still partly connected to the body but resewn for rearranging or restructuring of the area of the body in question. Although grafting is often used in cosmetic surgery, it is also used in other surgery. Grafts may be taken from one area of the patient's body and inserted to another area of the body. An example is bypass surgery
    Coronary artery bypass surgery
    Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease...

    , where clogged blood vessels are bypassed with a graft from another part of the body. Alternatively, grafts may be from other persons, cadavers, or animals.
  • insertion of prosthetic
    Prosthesis
    In medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...

     parts when needed. Pins or screws to set and hold bones may be used. Sections of bone may be replaced with prosthetic rods or other parts. Sometime a plate is inserted to replace a damaged area of skull. Artificial hip replacement has become more common. Heart pacemakers or valves
    Heart valve
    A heart valve normally allows blood flow in only one direction through the heart. The four valves commonly represented in a mammalian heart determine the pathway of blood flow through the heart...

     may be inserted. Many other types of prostheses
    Prosthesis
    In medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...

     are used.
  • creation of a stoma
    Stoma (medicine)
    A stoma is an opening , either natural or surgically created, which connects a portion of the body cavity to the outside environment...

    , a permanent or semi-permanent opening in the body
  • in transplant
    Organ transplant
    Organ transplantation is the moving of an organ from one body to another or from a donor site on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be...

     surgery, the donor organ (taken out of the donor's body) is inserted into the recipient's body and reconnected to the recipient in all necessary ways (blood vessels, ducts, etc.).
  • arthrodesis
    Arthrodesis
    Arthrodesis, also known as artificial ankylosis or syndesis, is the artificial induction of joint ossification between two bones via surgery. This is done to relieve intractable pain in a joint which cannot be managed by pain medication, splints, or other normally-indicated treatments. The typical...

     - surgical connection of adjacent bones so the bones can grow together into one. Spinal fusion
    Spinal fusion
    Spinal fusion, also known as spondylodesis or spondylosyndesis, is a surgical technique used to join two or more vertebrae. Supplementary bone tissue, either from the patient or a donor , is used in conjunction with the body's natural bone growth processes to fuse the vertebrae.Fusing of the...

     is an example of adjacent vertebrae connected allowing them to grow together into one piece.
  • modifying the digestive tract in bariatric surgery for weight loss
    Weight loss
    Weight loss, in the context of medicine, health or physical fitness, is a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon and other connective tissue...

    .
  • repair of a fistula
    Fistula
    In medicine, a fistula is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.-Locations:Fistulas can develop in various parts of the...

    , hernia
    Hernia
    A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....

    , or prolapse
    Prolapse
    Prolapse literally means "to fall out of place", from the Latin prolabi meaning "to fall out". In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is used for organs protruding through the vagina or the rectum or for the misalignment of the...

  • other procedures, including:
  • clearing clogged ducts, blood or other vessels
  • removal of calculi (stones)
  • draining of accumulated fluids
  • debridement
    Debridement
    Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue...

    - removal of dead, damaged, or diseased tissue
  • Surgery has also been conducted to separate conjoined twins
    Conjoined twins
    Conjoined twins are identical twins whose bodies are joined in utero. A rare phenomenon, the occurrence is estimated to range from 1 in 50,000 births to 1 in 100,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn, and a smaller fraction of...

    .
  • Sex change operations


Blood
Blood transfusion
Blood transfusion is the process of receiving blood products into one's circulation intravenously. Transfusions are used in a variety of medical conditions to replace lost components of the blood...

 or blood expanders may be administered to compensate for blood lost during surgery. Once the procedure is complete, sutures or staples
Surgical staple
Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. A more recent development, from the 1990s, uses clips instead of staples for some applications; this does not require the staple to penetrate.Stapling...

 are used to close the incision. Once the incision is closed, the anesthetic agents are stopped and/or reversed, and the patient is taken off ventilation and extubated (if general anesthesia was administered).

After completion of surgery, the patient is transferred to the post anesthesia care unit
Post anesthesia care unit
A post-anesthesia care unit, often abbreviated PACU and sometimes referred to as post-anesthesia recovery or PAR, is a vital part of hospitals, ambulatory care centers, and other medical facilities...

 and closely monitored. When the patient is judged to have recovered from the anesthesia, he/she is either transferred to a surgical ward elsewhere in the hospital or discharged home. During the post-operative period, the patient's general function is assessed, the outcome of the procedure is assessed, and the surgical site is checked for signs of infection. There are several risk factors associated with post operative complications, such as immune deficienty and obesity. Obesity has long been considered a risk factor for adverse post-surgical outcomes. It has been linked to many disorders such as obesity hypoventilation syndrome, atelectasis and pulmonary embolism, adverse cardiovascular affects, and wound healing complications. If removable skin closures are used, they are removed after 7 to 10 days post-operatively, or after healing of the incision is well under way.

Post-operative therapy may include adjuvant treatment such as chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

, radiation therapy
Radiation therapy
Radiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...

, or administration of medication
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...

 such as anti-rejection medication for transplants. Other follow-up studies or rehabilitation may be prescribed during and after the recovery period.

Elderly people

Older adults have widely varying physical health. Frail elderly
Frailty syndrome
The frailty syndrome is a collection of symptoms or markers, primarily due to the aging-related loss and dysfunction of skeletal muscle and bone, that place older adults at increased risk of adverse events such as death, disability, and institutionalization.-Sarcopenia:Sarcopenia, refers to loss...

 people are at significant risk of post-surgical complications and the need for extended care. Assessment of older patients before elective surgeries can accurately predict the patients' recovery trajectories. One frailty scale uses five items: unintentional weight loss, muscle weakness
Muscle weakness
Muscle weakness or myasthenia is a lack of muscle strength. The causes are many and can be divided into conditions that have true or perceived muscle weakness...

, exhaustion, low physical activity, and slowed walking speed. A healthy person scores 0; a very frail person scores 5. Compared to non-frail elderly people, people with intermediate frailty scores (2 or 3) are twice as likely to have post-surgical complications, spend 50% more time in the hospital, and are three times as likely to be discharged to a skilled nursing facility instead of to their own homes. Frail elderly patients (score of 4 or 5) have even worse outcomes, with the risk of being discharged to a fraternity rising to twenty times the rate for non-frail elderly people.

History

The earliest known compendium on Surgery were penned down by ancient Indians. Sushruta was an in ancient Indian sage who had extensively described about various surgeries in Sushruta Samhita
Sushruta Samhita
The Sushruta Samhita is a Sanskrit text, attributed to one Sushruta, foundational to Ayurvedic medicine , with innovative chapters on surgery....

 ranging from rhinoplasties, labioplasties and ceasarians.
At least two prehistoric cultures had developed forms of surgery. The oldest for which there is evidence is trepanation
Trepanation
Trepanning, also known as trephination, trephining or making a burr hole, is a surgical intervention in which a hole is drilled or scraped into the human skull, exposing the dura mater in order to treat health problems related to intracranial diseases. It may also refer to any "burr" hole created...

, in which a hole is drill
Drill
A drill or drill motor is a tool fitted with a cutting tool attachment or driving tool attachment, usually a drill bit or driver bit, used for drilling holes in various materials or fastening various materials together with the use of fasteners. The attachment is gripped by a chuck at one end of...

ed or scraped into the skull
Human skull
The human skull is a bony structure, skeleton, that is in the human head and which supports the structures of the face and forms a cavity for the brain.In humans, the adult skull is normally made up of 22 bones...

, thus exposing the dura mater
Dura mater
The dura mater , or dura, is the outermost of the three layers of the meninges surrounding the brain and spinal cord. It is derived from Mesoderm. The other two meningeal layers are the pia mater and the arachnoid mater. The dura surrounds the brain and the spinal cord and is responsible for...

 in order to treat health problems related to intra cranial pressure and other diseases. Evidence has been found in prehistoric human remains from Neolithic
Neolithic
The Neolithic Age, Era, or Period, or New Stone Age, was a period in the development of human technology, beginning about 9500 BC in some parts of the Middle East, and later in other parts of the world. It is traditionally considered as the last part of the Stone Age...

 times, in cave painting
Cave painting
Cave paintings are paintings on cave walls and ceilings, and the term is used especially for those dating to prehistoric times. The earliest European cave paintings date to the Aurignacian, some 32,000 years ago. The purpose of the paleolithic cave paintings is not known...

s, and the procedure continued in use well into recorded history
Recorded history
Recorded history is the period in history of the world after prehistory. It has been written down using language, or recorded using other means of communication. It starts around the 4th millennium BC, with the invention of writing.-Historical accounts:...

. Surprisingly, many prehistoric and premodern patients had signs of their skull structure healing; suggesting that many survived the operation. Remains from the early Harappan periods of the Indus Valley Civilization
Indus Valley Civilization
The Indus Valley Civilization was a Bronze Age civilization that was located in the northwestern region of the Indian subcontinent, consisting of what is now mainly modern-day Pakistan and northwest India...

 (c. 3300 BCE) show evidence of teeth having been drilled dating back 9,000 years. A final candidate for prehistoric surgical techniques is Ancient Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...

, where a mandible dated to approximately 2650 BCE shows two perforations just below the root of the first molar
Molar (tooth)
Molars are the rearmost and most complicated kind of tooth in most mammals. In many mammals they grind food; hence the Latin name mola, "millstone"....

, indicating the draining of an abscessed tooth
Tooth abscess
A tooth abscess or root abscess is pus enclosed in the tissues of the jaw bone at the apex of an infected tooth's root. Usually the abscess originates from a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth. This can be caused by untreated tooth decay, cracked...

.
The oldest known surgical texts date back to ancient Egypt about 3500 years ago. Surgical operations were performed by priests, specialized in medical treatments similar to today. The procedures were documented on papyrus and were the first to describe patient case files; the Edwin Smith Papyrus
Edwin Smith papyrus
The Edwin Smith Papyrus is an Ancient Egyptian medical text and the oldest known surgical treatise on trauma. It dates to Dynasties 16-17 of the Second Intermediate Period in Ancient Egypt, ca. 1500 BCE. The Edwin Smith papyrus is unique among the four principal medical papyri in existencethat...

 (held in the New York Academy of Medicine
New York Academy of Medicine
The New York Academy of Medicine was founded in 1847 by a group of leading New York City metropolitan area physicians as a voice for the medical profession in medical practice and public health reform...

) documents surgical procedures based on anatomy and physiology, while the Ebers Papyrus
Ebers papyrus
The Ebers Papyrus, also known as Papyrus Ebers, is an Egyptian medical papyrus dating to circa 1550 BC. Among the oldest and most important medical papyri of ancient Egypt, it was purchased at Luxor, in the winter of 1873–74 by Georg Ebers...

 describes healing based on magic
Magic (paranormal)
Magic is the claimed art of manipulating aspects of reality either by supernatural means or through knowledge of occult laws unknown to science. It is in contrast to science, in that science does not accept anything not subject to either direct or indirect observation, and subject to logical...

. Their medical expertise was later documented by Herodotus: "The practice of medicine is very specialized among them. Each physician treats just one disease. The country is full of physicians, some treat the eye, some the teeth, some of what belongs to the abdomen, and others internal diseases."

In ancient Greece
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...

, temples dedicated to the healer-god Asclepius
Asclepius
Asclepius is the God of Medicine and Healing in ancient Greek religion. Asclepius represents the healing aspect of the medical arts; his daughters are Hygieia , Iaso , Aceso , Aglæa/Ægle , and Panacea...

, known as Asclepieia , functioned as centers of medical advice, prognosis, and healing. At these shrines, patients would enter a dream-like state of induced sleep known as "enkoimesis" not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery. In the Asclepieion of Epidaurus
Epidaurus
Epidaurus was a small city in ancient Greece, at the Saronic Gulf. Two modern towns bear the name Epidavros : Palaia Epidavros and Nea Epidavros. Since 2010 they belong to the new municipality of Epidavros, part of the peripheral unit of Argolis...

, three large marble boards dated to 350 BCE preserve the names, case histories, complaints, and cures of about 70 patients who came to the temple with a problem and shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium.
The Greek Galen
Galen
Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...

 was one of the greatest surgeons of the ancient world and performed many audacious operations — including brain and eye surgery — that were not tried again for almost two millennia.

In China, Hua Tuo
Hua Tuo
Hua Tuo was an ancient Chinese physician who lived during the late Han Dynasty and Three Kingdoms era of Chinese history. The Records of Three Kingdoms and Book of Later Han record Hua as the first person in China to use anesthesia during surgery. He used a general anesthetic combining wine with a...

 was a famous Chinese physician during the Eastern Han and Three Kingdoms era who performed surgery with the aid of anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

.

In the Middle Ages
Middle Ages
The Middle Ages is a periodization of European history from the 5th century to the 15th century. The Middle Ages follows the fall of the Western Roman Empire in 476 and precedes the Early Modern Era. It is the middle period of a three-period division of Western history: Classic, Medieval and Modern...

, surgery was developed to a high degree in the Islamic world
Islamic Golden Age
During the Islamic Golden Age philosophers, scientists and engineers of the Islamic world contributed enormously to technology and culture, both by preserving earlier traditions and by adding their own inventions and innovations...

. Abulcasis (Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi), an Andalusian-Arab
Al-Andalus
Al-Andalus was the Arabic name given to a nation and territorial region also commonly referred to as Moorish Iberia. The name describes parts of the Iberian Peninsula and Septimania governed by Muslims , at various times in the period between 711 and 1492, although the territorial boundaries...

 physician and scientist who practised in the Zahra suburb of Córdoba
Córdoba, Spain
-History:The first trace of human presence in the area are remains of a Neanderthal Man, dating to c. 32,000 BC. In the 8th century BC, during the ancient Tartessos period, a pre-urban settlement existed. The population gradually learned copper and silver metallurgy...

, wrote medical texts that shaped European surgical procedures up until the Renaissance.

In Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

, the demand grew for surgeons to formally study for many years before practicing; universities such as Montpellier
University of Montpellier
The University of Montpellier was a French university in Montpellier in the Languedoc-Roussillon région of the south of France. Its present-day successor universities are the University of Montpellier 1, Montpellier 2 University and Paul Valéry University, Montpellier III.-History:The university...

, Padua
University of Padua
The University of Padua is a premier Italian university located in the city of Padua, Italy. The University of Padua was founded in 1222 as a school of law and was one of the most prominent universities in early modern Europe. It is among the earliest universities of the world and the second...

 and Bologna
University of Bologna
The Alma Mater Studiorum - University of Bologna is the oldest continually operating university in the world, the word 'universitas' being first used by this institution at its foundation. The true date of its founding is uncertain, but believed by most accounts to have been 1088...

 were particularly renowned. According to Peter Elmer and Ole Peter Grell, "Guy de Chauliac
Guy de Chauliac
Guy de Chauliac or Guigonis de Caulhaco was a French physician and surgeon who wrote a lengthy and influential treatise on surgery in Latin, titled Chirurgia Magna...

 (1298-1368) was one of the most eminent surgeons of the Middle Ages. His Chirurgia Magna or Great Surgery (1363) was a standard text for surgeons until well into the seventeenth century." By the fifteenth century at the latest, surgery had split away from physic
Physic
Physic may also refer to:*Physics, the study of matter, motion, and energy*Medicine, the science of healing*A type of Herb garden used for remedial purposes.*A professorship at either Cambridge or Dublin...

 as its own subject, of a lesser status than pure medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

, and initially took the form of a craft tradition until Rogerius Salernitanus
Rogerius (physician)
Rogerius , also called Rogerius Salernitanus, Roger Frugard, Roger Frugardi, Roggerio Frugardo, Rüdiger Frutgard and Roggerio dei Frugardi, was a Salernitan surgeon who wrote a work on medicine entitled Practica Chirurgiae around 1180...

 composed his Chirurgia, laying the foundation for modern Western surgical manuals up to the modern time. Late in the nineteenth century, Bachelor of Surgery degrees (usually ChB) began to be awarded with the (MB)
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...

, and the mastership became a higher degree, usually abbreviated ChM or MS
Master of Surgery
The Master of Surgery is an advanced qualification in surgery. It is most commonly abbreviated Ch.M. or M.S., as well as M.Ch. and M.Chir. from its Latin name, Magister Chirurgiae or the English form of Master of Surgery....

 in London, where the first degree was MB, BS.

Barber-surgeons
Barber surgeon
The barber surgeon was one of the most common medical practitioners of medieval Europe - generally charged with looking after soldiers during or after a battle...

 generally had a bad reputation that was not to improve until the development of academic surgery as a specialty of medicine, rather than an accessory field. Basic surgical principles for asepsis etc., are known as Halsteads principles

Modern surgery

Modern surgery developed rapidly with the scientific era. Ambroise Paré
Ambroise Paré
Ambroise Paré was a French surgeon. He was the great official royal surgeon for kings Henry II, Francis II, Charles IX and Henry III and is considered as one of the fathers of surgery and modern forensic pathology. He was a leader in surgical techniques and battlefield medicine, especially the...

 (sometimes spelled "Ambrose") pioneered the treatment of gunshot wounds, and the first modern surgeons were battlefield doctors in the Napoleonic Wars
Napoleonic Wars
The Napoleonic Wars were a series of wars declared against Napoleon's French Empire by opposing coalitions that ran from 1803 to 1815. As a continuation of the wars sparked by the French Revolution of 1789, they revolutionised European armies and played out on an unprecedented scale, mainly due to...

. Naval surgeons were often barber surgeon
Barber surgeon
The barber surgeon was one of the most common medical practitioners of medieval Europe - generally charged with looking after soldiers during or after a battle...

s, who combined surgery with their main jobs as barbers. Three main developments permitted the transition to modern surgical approaches - control of bleeding
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...

, control of infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

 and control of pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...

 (anaesthesia).
Bleeding: Before modern surgical developments, there was a very real threat that a patient would bleed to death before treatment, or during the operation. Cauterization
Cauterization
The medical practice or technique of cauterization is the burning of part of a body to remove or close off a part of it in a process called cautery, which destroys some tissue, in an attempt to mitigate damage, remove an undesired growth, or minimize other potential medical harmful possibilities...

 (fusing a wound closed with extreme heat) was successful but limited - it was destructive, painful and in the long term had very poor outcomes. Ligatures
Ligature (medicine)
In surgery or medical procedure, a ligature consists of a piece of thread tied around an anatomical structure, usually a blood vessel or another hollow structure to shut it off. With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat,...

, or material used to tie off severed blood vessels, originated as early as ancient Rome
Ancient Rome
Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

, and were improved by Ambroise Paré
Ambroise Paré
Ambroise Paré was a French surgeon. He was the great official royal surgeon for kings Henry II, Francis II, Charles IX and Henry III and is considered as one of the fathers of surgery and modern forensic pathology. He was a leader in surgical techniques and battlefield medicine, especially the...

 in the 16th century. Though this method was a significant improvement over the method of cauterization, it was still dangerous until infection risk was brought under control - at the time of its discovery, the concept of infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

 was not fully understood. Finally, early 20th century research into blood groups
Human blood group systems
The International Society of Blood Transfusion currently recognises 30 major blood group systems . Thus, in addition to the ABO antigens and Rhesus antigens, many other antigens are expressed on the red blood cell surface membrane...

 allowed the first effective blood transfusions.
Pain: Modern pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...

 control through anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

 was discovered by Crawford Long
Crawford Long
Crawford Williamson Long was an American surgeon and pharmacist best known for his first use of inhaled diethyl ether as an anesthetic...

. Before the advent of anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

, surgery was a traumatically painful procedure and surgeons were encouraged to be as swift as possible to minimize patient suffering
Suffering
Suffering, or pain in a broad sense, is an individual's basic affective experience of unpleasantness and aversion associated with harm or threat of harm. Suffering may be qualified as physical or mental. It may come in all degrees of intensity, from mild to intolerable. Factors of duration and...

. This also meant that operations were largely restricted to amputation
Amputation
Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. 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...

s and external growth removals. Beginning in the 1840s, surgery began to change dramatically in character with the discovery of effective and practical anaesthetic chemicals such as ether
Diethyl ether
Diethyl ether, also known as ethyl ether, simply ether, or ethoxyethane, is an organic compound in the ether class with the formula . It is a colorless, highly volatile flammable liquid with a characteristic odor...

 and chloroform
Chloroform
Chloroform is an organic compound with formula CHCl3. It is one of the four chloromethanes. The colorless, sweet-smelling, dense liquid is a trihalomethane, and is considered somewhat hazardous...

, discovered by James Young Simpson
James Young Simpson
Sir James Young Simpson was a Scottish doctor and an important figure in the history of medicine. Simpson discovered the anaesthetic properties of chloroform and successfully introduced it for general medical use....

 and later pioneered in Britain by John Snow
John Snow (physician)
John Snow was an English physician and a leader in the adoption of anaesthesia and medical hygiene. He is considered to be one of the fathers of epidemiology, because of his work in tracing the source of a cholera outbreak in Soho, England, in 1854.-Early life and education:Snow was born 15 March...

. In addition to relieving patient suffering, anaesthesia allowed more intricate operations in the internal regions of the human body. In addition, the discovery of muscle relaxant
Muscle relaxant
A muscle relaxant is a drug which affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term "muscle relaxant" is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics...

s such as curare
Curare
Curare is a common name for various arrow poisons originating from South America. The three main types of curare are:* tubocurare...

 allowed for safer applications.
Infection: Unfortunately, the introduction of anesthetics encouraged more surgery, which inadvertently caused more dangerous patient post-operative infections. The concept of infection was unknown until relatively modern times. The first progress in combating infection was made in 1847 by the Hungarian doctor Ignaz Semmelweis
Ignaz Semmelweis
Ignaz Philipp Semmelweis was a Hungarian physician now known as an early pioneer of antiseptic procedures. Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics...

 who noticed that medical students fresh from the dissecting room were causing excess maternal death compared to midwives. Semmelweis, despite ridicule and opposition, introduced compulsory handwashing for everyone entering the maternal wards and was rewarded with a plunge in maternal and fetal deaths, however the Royal Society
Royal Society
The Royal Society of London for Improving Natural Knowledge, known simply as the Royal Society, is a learned society for science, and is possibly the oldest such society in existence. Founded in November 1660, it was granted a Royal Charter by King Charles II as the "Royal Society of London"...

 in the UK still dismissed his advice. Significant progress came following the work of Louis Pasteur
Louis Pasteur
Louis Pasteur was a French chemist and microbiologist born in Dole. He is remembered for his remarkable breakthroughs in the causes and preventions of diseases. His discoveries reduced mortality from puerperal fever, and he created the first vaccine for rabies and anthrax. His experiments...

 and his advances in microbiology
Microbiology
Microbiology is the study of microorganisms, which are defined as any microscopic organism that comprises either a single cell , cell clusters or no cell at all . This includes eukaryotes, such as fungi and protists, and prokaryotes...

, when the British surgeon Joseph Lister
Joseph Lister, 1st Baron Lister
Joseph Lister, 1st Baron Lister OM, FRS, PC , known as Sir Joseph Lister, Bt., between 1883 and 1897, was a British surgeon and a pioneer of antiseptic surgery, who promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary...

 began experimenting with using phenol during surgery to prevent infections. Lister was able to quickly reduce infection rates, a reduction that was further helped by his subsequent introduction of the techniques of Robert Koch
Robert Koch
Heinrich Hermann Robert Koch was a German physician. He became famous for isolating Bacillus anthracis , the Tuberculosis bacillus and the Vibrio cholerae and for his development of Koch's postulates....

 (such as the Steam Steriliser, which proved more successful than the carbolic acid spray that Lister had been using previously) to sterilize
Sterilization (microbiology)
Sterilization is a term referring to any process that eliminates or kills all forms of microbial life, including transmissible agents present on a surface, contained in a fluid, in medication, or in a compound such as biological culture media...

 equipment, have rigorous hand washing and a later implementation of rubber gloves. Lister published his work as a series of articles in The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...

 (March 1867) under the title Antiseptic Principle of the Practice of Surgery
Antiseptic Principle of the Practice of Surgery
"Antiseptic Principle of the Practice of Surgery" is a paper regarding antiseptics written by Joseph Lister in 1867.- External links :* * —Internet Archive...

. The work was groundbreaking and laid the foundations for a rapid advance in infection control that saw modern aseptic operating theatres widely used within 50 years (Lister himself went on to make further strides in antisepsis and asepsis throughout his lifetime).

Surgical specialties and sub-specialties

  • General surgery
    General surgery
    General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...

    • Cardiothoracic surgery
      Cardiothoracic Surgery
      Cardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affecting organs inside the thorax —generally treatment of conditions of the heart and lungs .-Cardiac / Thoracic:...

    • Vascular surgery
      Vascular surgery
      Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery...

    • Plastic surgery
      Plastic surgery
      Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...

    • Paediatric surgery
      Pediatric surgery
      Pediatric surgery or paediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults...

    • Colorectal surgery
    • Transplant surgery
    • Surgical oncology
      Surgical oncology
      Surgical oncology is the branch of surgery which focuses on the surgical management of cancer.The specialty of surgical oncology has evolved in steps similar to medical oncology, which grew out of hematology, and radiation oncology, which grew out of radiology...

    • Trauma surgery
      Trauma surgery
      Trauma surgery is a surgical specialty involved in the invasive treatment of physical injuries, typically in an emergency setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care...

    • Endocrine surgery
      Endocrine surgery
      Endocrine surgery is a specialized surgical field where procedures are performed on endocrine glands to achieve a hormonal or anti-hormonal effect in the body...

    • Breast surgery
      Breast surgery
      Breast surgery is a form of surgery performed on the breast.Types include:*Breast reduction surgery*Augmentation mammoplasty*Mastectomy*Lumpectomy*Breast-conserving surgery, a less radical cancer surgery than mastectomy...

    • Skin surgery
  • Otolaryngology
    Otolaryngology
    Otolaryngology or ENT is the branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders....

  • Gynaecology
    Gynaecology
    Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system . Literally, outside medicine, it means "the science of women"...

  • Oral and maxillofacial surgery
    Oral and maxillofacial surgery
    Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is an internationally recognized surgical specialty...

  • Dental Surgery
    Dental surgery
    Dental surgery is any of a number of medical procedures that involve artificially modifying dentition, in other words surgery of the teeth and jaw bones.-Types:Some of the more common are:...

  • Orthopaedic surgery
  • Neurosurgery
    Neurosurgery
    Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...

  • Ophthalmology
    Ophthalmology
    Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

  • Podiatric surgery
  • Urology
    Urology
    Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological...



Some other specialties involve some forms of surgical intervention, especially gynaecology
Gynaecology
Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system . Literally, outside medicine, it means "the science of women"...

. Also, some people consider invasive methods of treatment/diagnosis, such as cardiac catheterization, endoscopy, and placing of chest tubes or central lines "surgery". In most parts of the medical field, this view is not shared.

Patronage

The patron saints
Patron saints of occupations and activities
-A:*Adrian of Nicomedia - arms dealers, butchers, guards, soldiers*Agatha - nurses, bellmaking*Albertus Magnus - natural scientists*Alexander of Comana - charcoal-burners*Alexius - nurses*Aloysius Gonzaga - children, Catholic students, Jesuit Scholastics...

 for surgeons are Saint Luke the Evangelist the physician and disciple of Christ
Christ
Christ is the English term for the Greek meaning "the anointed one". It is a translation of the Hebrew , usually transliterated into English as Messiah or Mashiach...

, Saints Cosmas and Damian
Saints Cosmas and Damian
Saints Cosmas and Damian were twin brothers, physicians, and early Christian martyrs born in Cilicia, part of today's Turkey. They practiced their profession in the seaport of Ayas, Adana, then in the Roman province of Syria...

 (3rd century physicians from Syria
Syria
Syria , officially the Syrian Arab Republic , is a country in Western Asia, bordering Lebanon and the Mediterranean Sea to the West, Turkey to the north, Iraq to the east, Jordan to the south, and Israel to the southwest....

), Saint Quentin
Saint Quentin
Saint Quentin , Quintinus in Latin, also known as Quentin of Amiens, is an early Christian saint. No real details are known of his life.-Martyrdom:...

 (3rd century saint from France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

), Saint Foillan (7th century saint from Ireland
Ireland
Ireland is an island to the northwest of continental Europe. It is the third-largest island in Europe and the twentieth-largest island on Earth...

), and Saint Roch (14th century saint from France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

).

See also

  • Anesthesia
    Anesthesia
    Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

  • ASA physical status classification system or pre-operative physical fitness
  • Biomaterial
    Biomaterial
    A biomaterial is any matter, surface, or construct that interacts with biological systems. The development of biomaterials, as a science, is about fifty years old. The study of biomaterials is called biomaterials science. It has experienced steady and strong growth over its history, with many...

  • Cardiac surgery
    Cardiac surgery
    Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...

  • Surgical drain
    Drain (surgery)
    A surgical drain is a tube used to remove pus, blood or other fluids from a wound. Drains inserted after surgery do not result in faster wound healing or prevent infection but are sometimes necessary to drain body fluid which may accumulate and in itself become a focus of infection...

  • Endoscopy
    Endoscopy
    Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...

  • Hypnosurgery
    Hypnosurgery
    Hypnosurgery is the term given to an operation where the patient is sedated using hypnotherapy rather than traditional anaesthetics. It is still in its experimental stages, and not often used....

  • Jet ventilation
  • List of surgical procedures
  • Minimally invasive procedure
  • Operative report
    Operative report
    An Operative report is a report written to document the details of a surgery. In most American states and in many other jurisdictions patients have a right to receive a copy of their medical records, including the operative report...

  • Perioperative mortality
    Perioperative mortality
    Perioperative mortality is mortality in relation to surgery, often defined as death within two weeks of a surgical procedure. An important consideration in the decision to perform any surgical procedure is to weigh the benefits against the risks...

  • Robotic surgery
    Robotic surgery
    Robotic surgery, computer-assisted surgery, and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in surgical procedures....

  • Surgical Outcomes Analysis and Research
    Surgical Outcomes Analysis and Research
    Surgical Outcomes Analysis & Research, SOAR, is a research laboratory of the Department of Surgery at the University of Massachusetts Medical School with expertise in outcomes research. SOAR investigates surgical diseases and perioperative outcomes. The group focuses on pancreatic cancer as well...

  • Surgical Sieve
    Surgical Sieve
    The surgical sieve is a thought process in medicine. It is a typical example of how to organise a structured examination answer for medical students and doctors when they are challenged with a question. It is also a way of constructing answers to questions from patients and their relatives in a...

  • Trauma surgery
    Trauma surgery
    Trauma surgery is a surgical specialty involved in the invasive treatment of physical injuries, typically in an emergency setting. Trauma surgeons generally complete residency training in general surgery and often fellowship training in trauma or surgical critical care...

  • Reconstructive surgery
    Reconstructive surgery
    Reconstructive surgery is, in its broadest sense, the use of surgery to restore the form and function of the body, although Maxillo-Facial Surgeons, Plastic Surgeons and Otolaryngologists do reconstructive surgery on faces after trauma and to reconstruct the head and neck after cancer.Other...

  • Complications of surgery

Governing bodies

  • American College of Surgeons
    American College of Surgeons
    The American College of Surgeons is an educational association of surgeons created in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.-Membership:...

  • American College of Osteopathic Surgeons
  • American Academy of Orthopedic Surgeons
    American Academy of Orthopedic Surgeons
    The American Academy of Orthopaedic Surgeons is an orthopaedic organization.-Characteristics:Founded at Northwestern University in 1933, the AAOS has grown to include over 36,000 members. The group provides education and practice management services for orthopaedic surgeons and allied health...

  • American College of Foot and Ankle Surgeons
    American College of Foot and Ankle Surgeons
    The American College of Foot and Ankle Surgeons is a professional medical society of foot and ankle surgeons in the USA.-Background:...

  • Royal Australasian College of Surgeons
    Royal Australasian College of Surgeons
    The Royal Australasian College of Surgeons is the body responsible for training and examining surgeons in Australia and New Zealand. The head office of the College is in Melbourne, Australia....

  • Royal Australasian College of Dental Surgeons
    Royal Australasian College of Dental Surgeons
    The Royal Australasian College of Dental Surgeons or RACDS is a professional college established in 1965 that administers Fellowship Exams for both general and specialist dental practitioners in the Australasian region...

  • Royal College of Physicians and Surgeons of Canada
    Royal College of Physicians and Surgeons of Canada
    The Royal College of Physicians and Surgeons of Canada ' , French: Collège royal des médecins et chirurgiens du Canada, is a national, private, nonprofit organization established in 1929 by a special Act of Parliament to oversee the medical education of specialists in Canada...

  • Royal College of Surgeons in Ireland
    Royal College of Surgeons in Ireland
    The Royal College of Surgeons in Ireland , is a Dublin-based medical institution, situated on St. Stephen's Green. The college is one of the five Recognised Colleges of the National University of Ireland...

  • Royal College of Surgeons of Edinburgh
    Royal College of Surgeons of Edinburgh
    The Royal College of Surgeons of Edinburgh is an organisation dedicated to the pursuit of excellence and advancement in surgical practice, through its interest in education, training and examinations, its liaison with external medical bodies and representation of the modern surgical workforce...

  • Royal College of Physicians and Surgeons of Glasgow
    Royal College of Physicians and Surgeons of Glasgow
    The Royal College of Physicians and Surgeons of Glasgow, is an institute of physicians and surgeons in Glasgow, Scotland.Founded by Peter Lowe after receiving a royal charter by James VI in 1599, as the Glasgow Faculty, this institution originally existed as a regulatory authority to ensure that...

  • Royal College of Surgeons of England
    Royal College of Surgeons of England
    The Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...


Qualifications in the UK and Ireland

  • Fellowship of the Royal College of Surgeons
    Fellowship of the Royal College of Surgeons
    Fellowship of the Royal College of Surgeons is a professional qualification to practise as a surgeon in the United Kingdom and Republic of Ireland...

  • Membership of the Royal College of Surgeons
    Membership of the Royal College of Surgeons
    MRCS is a professional qualification for surgeons in the UK and IrelandIt means Member of the Royal College of Surgeons. In the United Kingdom, doctors who gain this qualification traditionally no longer use the title 'Dr' but start to use the title 'Mr', 'Mrs', 'Miss' or 'Ms'.There are 4 surgical...


External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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