Introduction To Surgery

INTRODUCTION
TO SURGERY
MD. Ramon Ramirez Perez

First Degree Specialist Doctor in General Surgery
Assistant Professor
SURGERY
Surgery may be defined as “the art of treating lesions and malformations of

the human body by manual operations, mediate and immediate.”
INTRODUCTION TO SURGERY
 Surgery (chirurgiae, meaning "hand work“):is an ancient medical specialty that

uses operative manual and instrumental techniques on a patient to investigate or
treat a pathological condition, such as disease or injury, to help improve bodily
function or appearance or to repair unwanted ruptured areas.
 A surgeon is a person who practices surgery and a surgeon's assistant is a person
who practices surgical assistance. A surgical team is made up of surgeon,
surgeon's assistant, anesthesia provider, circulating nurse and surgical technologist
.
 An act of performing surgery may be called a "surgical procedure", "operation", or

simply "surgery".
SURGERY
MINIMALLY INVASIVE
INVASIVE PROCEDURES
SURGERY
TYPES OF SURGERY
 Based on timing
 Based on purpose
 By type of procedure
 By body part
 By degree of invasiveness of surgical procedures

 By equipment used
BASED ON TIMING
• EMERGENCY SURGERY, such as stopping rapid internal bleeding, is performed as

soon as possible; minutes can make a difference. It must be done quickly to save
life, limb, or functional capacity.
• URGENT SURGERY, such as removal of an inflamed appendix of caecum, is best
performed within hours.
• ELECTIVE SURGERY, 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; such as replacement of a hip joint, can be delayed for some
period of time, until everything has been done to optimize a person‘s chances of
doing well during and after the surgical procedure.
BASED ON PURPOSE
EXPLORATORY SURGERY COSMETIC SURGERY

BY TYPE OF PROCEDURE
AMPUTATION REPLANTATION
RECONSTRUCTIVE SURGERY
RESECTION
TRANSPLANT
BY DEGREE OF INVASIVENESS OF SURGICAL
PROCEDURES
MINIMALLY-INVASIVE SURGERY OPEN SURGICAL

OPERATIONS CAN BE ALSO DIVIDED ACCORDING TO
INDICATIONS
 Vital indication: means that patient definitely dies without a surgery.

 Absolute indication: represents an ideal solution.
 Relative indication: one of the treatment options.

By equipment used
• Laser surgery involves use of a laser for cutting
tissue instead of a scalpel or similar surgical
instruments. Microsurgery involves the use of
an operating microscope for the surgeon to
see small structures.
• Robotic surgery makes use of a surgical robot,
such as the Da Vinci or the Zeus surgical
systems, to control the instrumentation under
the direction of the surgeon.
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 is a laparotomy.
 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.
 Procedures for formation of a permanent or semi-permanent opening
called a stoma in the body end in -ostomy.
TERMINOLOGY
 Surgery of a body part starts with a name for the body part to be
reconstructed and ends in -oplasty.Eg.(rhinoplasty), (Hernioplasty)
 Repair of damaged or congenital abnormal structure ends in -rraphy.
 Reoperation (return to the operating room) refers to a return to the

operating theater after an initial surgery is performed to re-address an
aspect of patient care best treated surgically. Reasons for reoperation
include persistent bleeding after surgery, development of or persistence of
infection or, more insidiously, retained foreign objects.
TERMINOLOGY
 Excision: Cutting out an organ, tumor or other tissue.
 Resection: Partial removal of an organ or other bodily structure.

 Surgical connection between blood vessels or other tubular or hollow
structures such as loops of intestine is called Anastomosis
 Reduction: The movement or realignment of a body part to its normal
position
 Ligation: Tying off blood vessels, ducts, or "tubes".
 Stoma: a permanent or semi-permanent opening in the body

TERMINOLOGY
 Transplantation: means transfer of the harvested tissue or organ from the

donor site to the recipient area.
 Prosthetics: are artificial substitutes, which is used for repair or for
replacement of particular part of the body or tissue.
DESCRIPTION OF SURGICAL PROCEDURE
Location
Preoperative care
Surgery
Post-operative care
OPERATING ROOM EQUIPMENT
 The operating table in the center of the room can be raised, lowered, and tilted in any
direction.
 The operating room lights are over the table to provide bright light, without shadows,
during surgery.
 The anesthesia machine is at the head of the operating table. This machine has tubes
that connect to the patient to assist him or her in breathing during surgery, and built-in
monitors that help control the mixture of gases in the breathing circuit.
 The anesthesia cart is next to the anesthesia machine. It contains the medications,
equipment, and other supplies that the anesthesiologist may need.
 Sterile instruments to be used during surgery are arranged on a stainless steel table.
 An electronic monitor.
 The pulse oximeter machine attaches to the patient's finger with an elastic band aid.
SURGEON AND ASSISTANTS EQUIPMENT
 A protective cap covering their hair
 Masks over their lower face, covering their mouths and noses with minimal gaps
to prevent inhalation of plume or airborne microbes
 Shades or glasses over their eyes, including specialized colored glasses for use with
different lasers. a fiber-optic headlight may be attached for greater visibility
 Vinyl gloves on their hands; latex is used as well, but much less common due to
latex sensitivity which affects some health care workers and patients
 Long gowns, with the bottom of the gown no closer than six inches to the ground.
 Protective covers on their shoes
 If x-rays are expected to be used, lead aprons/neck covers are used to prevent
overexposure to radiation.
Preoperative care
• Medical examination
• ASA physical status classification system.
• Autologousblood donation
• Investigations( Blood, X-ray,USS, Others)
• NPO order, IV Canula, IV Fluid
• Skin Prep., NGT, Urinary catheter, Bowel prep.
• Prophylactic antib.
• Sedant.
Surgery
• Incision- cutting skin

• Excision – cutting out an organ, tumor, or other tissue.
• Resection – partial removal of an organ or other bodily structure.
• Reconnection of organs, tissues
• Reduction – the movement or realignment of a body part to its
normal position.
• Ligation – tying off blood vessels, ducts, or "tubes".
• Grafts
• Creation of a stoma
• Repair of a fistula, hernia, or prolapse
• Others.
Post-operative care
• Post anesthesia care unit

• Medications ( analgesics, antibiotics)
• Monitoring (B.P;R.R;R.P; Wound ;IV Fluid; Urine,
Drenages. ) 15 min, 30 min, 45 min, 1 hour,3
hours, 6 hours, 9 hours, 12 hours,18 hours,24
hours
• AFTER 24 HOURS(Possible changes:Oppen Oral
via;remove NGT,Urinary
Catheter,Drenages,stitches,etc)

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INTRODUCTION

MD. Ramon Ramirez Perez

Surgery may be defined as “the art of treating lesions and malformations of

 Surgery (chirurgiae, meaning "hand work“):is an ancient medical specialty that

 An act of performing surgery may be called a "surgical procedure", "operation", or

 By degree of invasiveness of surgical procedures

• EMERGENCY SURGERY, such as stopping rapid internal bleeding, is performed as

EXPLORATORY SURGERY COSMETIC SURGERY

MINIMALLY-INVASIVE SURGERY OPEN SURGICAL

 Vital indication: means that patient definitely dies without a surgery.

 Relative indication: one of the treatment options.

 Repair of damaged or congenital abnormal structure ends in -rraphy.

 Reoperation (return to the operating room) refers to a return to the

 Excision: Cutting out an organ, tumor or other tissue.

 Resection: Partial removal of an organ or other bodily structure.

 Stoma: a permanent or semi-permanent opening in the body

 Transplantation: means transfer of the harvested tissue or organ from the

 A protective cap covering their hair

 Protective covers on their shoes

• Incision- cutting skin

• Post anesthesia care unit

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