Surgical Treatment
Written by Rhiana Devadasan
4) Basics of surgical treatment - organisation and planning. Surgical instruments - types. Surgical sutures & bandages. Operation greens.
Surgery: a medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a pathological condition (such as a disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas).
Types of Surgery:
- Based on Timing
- Elective (non life-threatening)
- Emergency (done promptly to save a life)
- Semi-elective (to avoid permanent disability)
- Based on Purpose
- Exploratory (to aid or confirm a diagnosis)
- Therapeutic (to treat a diagnosed condition)
- Based on the Need for Anesthesia
- Major (involves anaesthesia or respiratory assistance)
- Minor (does not require anesthesia)
- Based on Type of Procedure
- Amputation (castration)
- Resection (removal of all or part of an organ)
- Replantation (reattaching body parts)
- Reconstructive (rebuilding of injured, mutilated or deformed body part)
- Cosmetic (improve appearance)
- Transplant (replacement of organ using another human's or animal's)
- Explant (removal of an organ or body part to use in transplant)
- Based on Body Part
- Cardiac surgery
- etc.
- Based on Degree of Invasiveness
- Minimal (laparoscopic, angioplasty)
- Open surgical procedures (laparotomy)
- Based on Equipment used
- Laser (cutting)
- Microsurgery (use of operating microscope)
- Robotic (Da Vinci, Zeus)
PLANNING OF SURGICAL TREATMENT
Before Planning:
- Surgeon must determine whether the patient is ready for surgery (by confirming the goals for presurgical state has been met & that the patient's health has been optimised to ensure the lowest possible surgical risk)
- Once the surgeon confirms that the patient is ready for surgery, surgical treatment planning begins.
Planning involves:
- Identifying the diagnosis + any other important information from the patient's history
- Identifying the type of operation needed
- Identify whether anesthesia is required (using ASA grading system)
- Perform any required preoperative investigations (effects: delay surgery, change in intensity of management, change of operation, referral to a specialised centre, change in surgical approach, change of anaesthetic management, specific monitoring, change in drugs, new consultation, etc.)
- Evaluate the risks (is this a high risk patient)
- Figure out how to reduce the risks
- Prepare for the operation
- Identify the outcome & figure out what is expected for the postoperative course