surgery (surj'e-re) [Fr. cirurgerie, ult fr Gr. cheirurgia, handwork, surgery]
1. The branch of medicine dealing with manual and operative procedures to correct deformities and defects, repair injuries, and diagnose and cure certain diseases.
2. A surgeon's operating room.
Treatment or work performed by a surgeon. Synonym: operation
Surgery in which a part is removed or destroyed.
aesthetic surgeryCosmetic surgery.
Surgery performed between the time the patient is admitted in the morning and the time the patient is discharged the same day. Synonym: day surgery
Surgery performed on the fetus before delivery. It is performed only at certain medical centers. See: amnioscopy; embryoscopy
antimicrobial prophylaxis in surgery See: antimicrobial prophylaxis in surgery
Surgery performed under sterile conditions.
Surgery of the ear.
Surgical management of morbid obesity. Commonly employed operative procedures are classified either as restrictive (because they decrease the size of the stomach) or malabsorptive (because they limit absorption of nutrients from the gastrointestinal tract), or both restrictive and malabsorptive. They include gastric banding; vertical banded gastroplasty; Roux-en-Y gastric bypass; biliopancreatic diversion or duodenal switch, and long-limb Roux-en-Y gastric bypass. Synonym: weight-loss surgery
This surgery is typically used only for those with a body mass index greater than 40 kg/m2 or 35 kg/m2 in the presence of other weight-related health problems, such as hypertension or diabetes mellitus. Complications include puncture of blood vessels or internal organs, infection, incisional hernia, wound dehiscence, or leakage from surgical sites into the peritoneum. In preparation for surgery the patient should be assessed for other major surgical risks, including heart attack, heart failure, deep vein thrombosis, atelectasis/pneumonia, or respiratory failure after the proposed operation. The patient should be made aware that an intravenous catheter, urinary catheter, and sequential compression stockings will be used to help manage postoperative complications. Incentive spirometry is used to prevent postoperative atelectasis.
Pain and nausea are managed with patient-controlled epidural or intravenous analgesia and antiemetic drugs. Equipment required for obese patients undergoing bariatric surgery includes specially sized litters, operating tables, beds, wheelchairs, blood-pressure cuffs, and gowns. The patient should begin ambulation soon after surgery to help prevent complications of immobility. Adequate staff should be available to assist with transfers and mobilization to prevent patient or staff injuries. Depending on the type of surgery employed, the patient may require vitamin and mineral supplementation after surgery (with B vitamins, calcium, iron, and fat-soluble vitamins). Psychological, nutritional, and physical therapeutic support is critical to optimal outcomes. Instruction at discharge must emphasize diet, hydration, wound care, medications, and prescribed or prohibited activities. Most treated patients have significant, sustainable postoperative weight loss, with improvement in comorbid conditions such as diabetes mellitus, hypertension, and hyperlipidemia. After massive weight loss some patients may require reconstructive surgery to remove excess abdominal wall fat (panniculectomy).
The risk for postoperative death associated with bariatric surgery is greatest in patients with heart failure, renal failure, peripheral vascular disease, who are male or over 50 years old, or who undergo open (versus laparoscopic) surgery.
breast conservation surgery
Removal of a malignant growth from the breast and dissection of axillary lymph nodes without mastectomy. Lumpectomy is an alternative to mastectomy for patients with early stage breast cancer. Its outcomes are equivalent to those of mastectomy when used as part of a treatment plan that includes postoperative radiation therapy to the affected breast.
Surgery on the heart and/or the proximal great vessels.
cold knife surgery
Surgery with a simple metal blade or scalpel; conventional surgery.
Surgery on the anus, rectum, or large intestine.
Reoperation to remove any residual ovarian cancer after the first two stages of treatment. The first stage is initial debulking of the tumor; the second, chemotherapy.
Surgery in which as much as possible of a part or structure is retained. It is often an equally effective alternative to radical surgery.
Surgery performed to revise or change the texture, configuration, or relationship of contiguous structures of a feature of the body. Synonym: aesthetic surgery
See: plastic surgery
day surgeryAmbulatory surgery.
Surgery that is not necessary for one's health but is performed for another reason, e.g., for cosmetic reasons. Synonym: optional surgery
Surgery performed for diagnosis, e.g. an exploratory laparotomy. Exploratory surgeries may become surgeries in which definitive treatment is rendered when a previously undiagnosed lesion is identified and rectified.
Surgery in which a flap of tissue or periosteum is raised. An amputation flap is a tissue flap produced to cover the amputation stump.
gamma knife surgery
Radiosurgery that can destroy an intracranial target by directing gamma radiation at the lesion while trying to spare adjacent healthy tissue. The gamma knife consists of 201 cylindrical gamma ray (cobalt 60) beams designed to intersect at the target lesion, resulting in about 200 times the dose of any single beam aimed at the periphery. The area to be treated is carefully identified with neuroimaging before the gamma knife is used and the proper dose of gamma energy calculated. The procedure takes about 2 to 3 hr, with the patient under mild sedation, given intravenously, and local anesthesia. The gamma knife can be used to treat primary and metastatic brain tumors, trigeminal neuralgia, arteriovenous malformations, and other lesions. Complications include seizures, confusion, paralysis, nausea and vomiting, other radiation reactions, and radiation necrosis of normal brain tissue, but the incidence of side effects is no greater than with other brain irradiation or neurosurgical techniques.
The patient's vital signs and neurological signs must be checked frequently during and after the procedure.
Any operation associated with a 5% or greater likelihood of adverse cardiovascular events. Examples include operations on peripheral arteries, the aorta, or the heart; surgeries that last more than 2 hours; and emergency surgeries, esp. when they are needed by patients with multiple illnesses or age over 75.
IE surgeryinfarct exclusion surgery
The use of real-time computed tomography, magnetic resonance imagery, or ultrasound to place surgical instruments in precise anatomical locations, e.g., during biopsies or tissue resections. Images taken before the operation are compared with those obtained during surgery to improve the localization of tumors or vascular structures, the placement of prosthetic parts, or the identification of moving structures.
infarct exclusion surgery Abbreviation: IE surgery
The surgical repair of damage to the heart muscle due to a heart attack, e.g., repair or patching of post-myocardial infarction ventricular septal defects.
intestinal bypass surgery
The production of controlled intestinal malabsorption by surgically short-circuiting the small intestine. This surgery is used to treat massive obesity. It is done by anastomosing the proximal jejunum to the distal ileum by bypassing the small intestine between the anastomotic sites. The lengths of jejunum and ileum involved vary by surgeon. Because of long-term metabolic complications (including hepatic injury), this procedure has largely been abandoned in favor of gastric bypass procedures.
A form of endoscopic surgery in which a fiberoptic laparoscope is inserted into the body to inspect, resect, or otherwise surgically treat a wide and expanding variety of conditions. Small incisions (ports) are created to insert required instrumentation. In assisted laparoscopic procedures, a smaller-than-standard ancillary incision may be necessary for removal of large specimens or to perform various surgical maneuvers. Laparoscopic surgery may also be used to complement other procedures, e.g., vaginal hysterectomy. Under certain circumstances, e.g., hemorrhage or dense adhesions, laparoscopic procedure cannot be performed. Operating time is longer and equipment is more expensive in laparoscopic surgery than in laparotomy, but the convalescence of patients who have undergone laparoscopic procedures is shorter; and pain, nausea, vomiting, and obstipation are diminished. Common operations performed with a laparoscope include cholecystectomy, appendectomy, colonic surgery, hernia repairs (including hiatal hernias), and many gynecological surgeries. See: laparoscopic laser cholecystectomy
laryngeal framework surgeryThyroplasty.
limb salvage surgery
Any operative treatment of an injury to bone or a bony tumor in which the basic integrity of the arm or leg is preserved.
Any operation associated with less than a 1% chance of adverse cardiovascular events. Examples include endoscopies, breast biopsies, skin biopsies, and procedures on the eye, e.g. cataract surgeries.
lung volume reduction surgery
Surgical removal of emphysematous lung tissue, esp. of inelastic air spaces in the upper lobes of the lungs, to enhance the ability of the rest of the lung to expand and contract. This surgery improves respiratory function for many patients with advanced chronic obstructive lung disease although the long-term benefits of its use are uncertain.
Surgery risking a potential hazard and disruption of physiological function, e.g., entering a body cavity, excision of large tumors, amputation of a large body part, insertion of a prosthesis, open heart procedures. All surgeries are potentially dangerous and may involve a risk to life.
Use of manipulation in surgery or bone-setting.
The branch of dental practice and/or plastic surgery that deals with the diagnosis and the surgical and adjunctive treatment of diseases, injuries, and defects of the mouth and dental structures. Synonym: oral surgery
Surgery to repair joint cartilage in which small holes are drilled into the bones surrounding the joint to stimulate the growth of replacement cartilage. Recovery and rehabilitation from the surgery are protracted.
A simple operation not involving a major body cavity or structure and usually causing little disruption of the patient's physiological status. As with all surgery, there is risk of injury or death.
Plastic surgery for correcting diseases of the gingiva and adjacent oral mucosa.
natural orifice surgeryNatural orifice transluminal endoscopic surgery.
natural orifice transluminal endoscopic surgery Abbreviation: NOTES
Surgery performed with incisions made through internal organs after an endoscope has been inserted into those organs through the mouth, the vagina, the bladder, or the anus. The surgery produces no external scars because the skin is not cut. For example, a diseased gallbladder is removed through an endoscope inserted through the urinary bladder wall and into the peritoneum or through an incision made in the muscular wall of the stomach. Synonym: natural orifice surgery
Surgery to remove malignant tumors from the body and then sculpt the operated tissue to an esthetically pleasing outcome.
one-port umbilical surgery Abbreviation: OPUS
A form of minimally invasive laparoscopic surgery in which a single endoscopic instrument is inserted into the peritoneal cavity through the umbilicus to minimize the visibility of scars on the skin.
Surgery involving direct visualization and surgical procedure of the exposed heart.
optional surgeryElective surgery.
oral surgeryMaxillofacial surgery.
Surgery to prevent and correct musculoskeletal deformities and/or injuries.
Surgery to relieve symptoms or improve quality of life, usually in patients with incurable illness.
Surgery to repair or restore defective or missing structures, frequently involving the transfer of tissue from one part to another and sometimes including the use of prosthetic materials.
Intrauterine surgical procedures on the fetus. These techniques have been used to repair heart defects and anatomical defects of other organs. See: prenatal diagnosis
Surgery to remove a large amount of damaged or neoplastic tissue and/or adjoining areas of lymphatic drainage to obtain a complete cure. This is in contrast to conservative surgery.
1. The use of radionuclides, such as isotopes of technetium, to locate lymph nodes or other tissues to excise during an operation.
2. The use of computed tomography, magnetic resonance imaging, or plain radiography to plan and/or carry out an invasive procedure.
radioimmunoguided surgery Abbreviation: RIGS
The use of tumor-specific, radioactively labeled monoclonal antibodies to detect and stage cancers and distinguish malignant tissue from surrounding normal tissue. This improves the management of surgical tumors.
Surgery to repair a loss or defect or to restore function.
An operation to improve the ability of the eye to focus and thus to eliminate the patient's need for eyeglasses. Examples include keratoplasty and keratomilleusis.
Surgery having no scientific justification, performed in primitive societies without the purpose of treating or preventing disease. Included are alterations of the skin, ears, lips, teeth, genitalia, and head. In some cases, even in advanced societies, surgical procedures without rational justification are considered ritualistic.
Surgery that relies on acoustic, laser, or radioactive energy to divide, destroy or cauterize tissue.
Surgery some months after the original operation for cancer to detect possible recurrences. Second-look procedures are also performed on a more immediate basis, e.g., within hours of the initial surgery, when vascular injuries created by the initial operation or condition are suspected. Occasionally an endoscopic second look may be performed instead of an open surgical procedure.
Surgery that disconnects one hemisphere of the brain from the other by cutting the corpus callosum. It is used to treat drug-resistant seizures.
Surgery performed through a small opening in the skin.
Surgery in which only a portion of the organ is removed, e.g., subtotal removal of the thyroid gland.
Surgery involving the rib cage and structures contained within the chest. It is used to biopsy or remove masses in the hilum, lung, or mediastinum, to drain abscesses, treat empyema, repair cardiac valves or vessels, or implant devices such as cardioverter/defibrillators in the chest.
Preoperative: Preparation involves the usual preoperative teaching, with special emphasis on breathing and coughing, incentive spirometry, incisional splinting, pain evaluation, invasive and noninvasive relief measures that will be available, and basic information about the chest drainage tube and system that will be required in most such surgeries. The health care professional should encourage the patient to voice fears and concerns, allay misapprehensions, and correct misconceptions. Postoperative care: All general patient care concerns apply. Vital signs and breath sounds should be monitored. Water-seal chest drainage should be maintained as prescribed and the volume and characteristics of drainage monitored. The health care professional should maintain sterile wound dressings; provide analgesia and comfort to ensure patient cooperation with respiratory toilet, exercises, and rest and activity; provide emotional support and encouragement; and provide instructions to be followed by the patient and family after discharge and follow-up care. As necessary, the respiratory therapist provides mechanical ventilation in the immediate postoperative period and evaluates the patient for weaning from the ventilator.
Surgical therapy for alteration of the anatomical sex of an individual whose psychological gender is not consistent with the anatomical sexual characteristics.
Surgery on the pituitary gland, performed with an incision made through the base of the sphenoid sinus. It is typically performed through the nasal passages or the oral cavity to remove an adenoma of the pituitary gland in patients with acromegaly, prolactinomas, or other pituitary tumors.
video-assisted thoracic surgery Abbreviation: VATS
Surgery for the diagnosis and treatment of many conditions affecting the lung or the pleural space, e.g., biopsies, drainage of empyema, pulmonary resections, Heller procedures.
weight-loss surgeryBariatric surgery.