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A rapidly evolving format, first performed in 2004, for various types of surgical excisions and repair—e.g., appendectomies, cholecystectomies—in which the procedure is performed endoscopically via a natural orifice such as the mouth or vagina (the rectum is theoretically possible as an orifice)
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Hand-written or typed information, which documents a particular task. See OR notes, Progress notes.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


(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.
3. Treatment or work performed by a surgeon. Synonym: operation

ablative surgery

Surgery in which a part is removed or destroyed.

aesthetic surgery

Cosmetic surgery.

ambulatory 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

antenatal 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

aseptic surgery

Surgery performed under sterile conditions.

aural surgery

Surgery of the ear.

bariatric surgery

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

Patient care

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.

cardiac surgery

Surgery on the heart and/or the proximal great vessels.

cold knife surgery

Surgery with a simple metal blade or scalpel; conventional surgery.

colorectal surgery

Surgery on the anus, rectum, or large intestine.

completion surgery

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.

conservative surgery

Surgery in which as much as possible of a part or structure is retained. It is often an equally effective alternative to radical surgery.

cosmetic 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 surgery

Ambulatory surgery.

elective surgery

Surgery that is not necessary for one's health but is performed for another reason, e.g., for cosmetic reasons.
Synonym: optional surgery

exploratory 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.

flap surgery

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.

Patient care

The patient's vital signs and neurological signs must be checked frequently during and after the procedure.

high-risk surgery

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 surgery

infarct exclusion surgery

image-guided 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.

laparoscopic surgery

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 surgery


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.

low-risk surgery

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.

major surgery

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.

manipulative surgery

Use of manipulation in surgery or bone-setting.

maxillofacial surgery

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

microfracture 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.

minor surgery

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.

mucogingival surgery

Plastic surgery for correcting diseases of the gingiva and adjacent oral mucosa.

natural orifice surgery

Natural 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

oncoplastic 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.

open-heart surgery

Surgery involving direct visualization and surgical procedure of the exposed heart.

optional surgery

Elective surgery.

oral surgery

Maxillofacial surgery.

orthopedic surgery

Surgery to prevent and correct musculoskeletal deformities and/or injuries.

palliative surgery

Surgery to relieve symptoms or improve quality of life, usually in patients with incurable illness.

plastic surgery

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.

prenatal surgery

Intrauterine surgical procedures on the fetus. These techniques have been used to repair heart defects and anatomical defects of other organs.
See: prenatal diagnosis

radical surgery

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.

radioguided 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.

reconstructive surgery

Surgery to repair a loss or defect or to restore function.

refractive surgery

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.

remote surgery


ritualistic surgery

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.

scalpel-free surgery

Surgery that relies on acoustic, laser, or radioactive energy to divide, destroy or cauterize tissue.

second-look surgery

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.

split-brain surgery

Surgery that disconnects one hemisphere of the brain from the other by cutting the corpus callosum. It is used to treat drug-resistant seizures.

subcutaneous surgery

Surgery performed through a small opening in the skin.

subtotal surgery

Surgery in which only a portion of the organ is removed, e.g., subtotal removal of the thyroid gland.

thoracic surgery

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.

Patient care

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.

transsexual surgery

Surgical therapy for alteration of the anatomical sex of an individual whose psychological gender is not consistent with the anatomical sexual characteristics.

transsphenoidal surgery

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 surgery

Bariatric 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
See also: surgery
Medical Dictionary, © 2009 Farlex and Partners

Patient discussion about notes

Q. I need to know what needs to be noted in a bipolar, which if unnoticed, will have serious consequences? One of my distant relative who is a bipolar is now an alcoholic…’s dangerous to handle him for the kind of problems he creates to his friends and family………..maybe he is not responsible for all these…..but I need to know what needs to be noted in a bipolar, which if unnoticed, will have serious consequences?

A. Merkel- they tend to stop medication without consulting the doc. this can be a dangerous act, could lead to a major depression. you should notice it ASAP cause stopping can even cause suicidal thoughts.

Q. I was shocked to note that vaccination in the children could cause autism too. Is that true? Very recently I have delivered a cute male baby and I could see a change in me after my delivery in the sense that I always think about him. My sister’s son who is 5 years old is diagnosed with Autism and I just can’t see the sufferings of my sister with him. She experiences difficulty in almost all dealings with him right from brushing, giving bah and making him to study….etc. Now I fear that my son should not get in to autism although I know that this is too early to think about disorder in my son. But as my sister’s son got in to this disorder, this has affected me a lot. Hope you can understand my feelings towards my baby. When I browsed through the net, I was shocked to note that vaccination in the children could cause autism too. Is that true? Can I get some idea…..

A. Hey! I appreciate your care for the new born. But to be honest, fearing at this stage will only trouble you and your baby in the sense that your emotions could catch your baby especially when you breast feed. I want you to be cheerful so as to bring up a healthy child. The signs of autism in the new born are something which should not be thought about at this stage. All you may have to think is to bring up him nicely without any disease. As regards vaccinations that could create autism in children, there is no proof that a vaccine causes Autism. It is only a belief and all the children are vaccinated and not all get autism. It is not a fair idea to suspect vaccination as vaccinations are administered in a new born child after carrying out the necessary tests.

Q. I was shocked to note that genes play a vital role in building muscles Is this possible? I am , 20 years old. I am always dreaming to build muscle like my favorite hero who maintains 8 abs. Anybody can dream but to live that dream is a difficult task. Out of curiosity, I had discussed my desire to build muscles with my friends. But I was shocked to note that genes play a vital role in building muscles. My family doesn’t have a history of muscles and this fact has put me in to a difficult situation. Is this possible…If so, how can I live my dream? If the family doesn’t have a history of muscle growth, then what happens to the generation which follows them? I need a positive feedback to my query……

A. there's a genetic potential for fitness, like there is a genetic connection and potential for inelegance. but no matter how smart are your parents- if you won't study you won't live that potential, and some one who doesn't have that genetic ability and will study- will be better. the same thing with physical fitness.

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