One of the most dramatic medical procedures is surgery. Ever since ancient times. people have tried to cure medical problems by cutting into the body. Surgical operations are depicted on the tombs of the Egyptian Pharaohs, dating from 3 000 B. C. These early operations were painful and hazar dous. If an amputation was necessary, for example, alcohol was often used to dull the pain somewhat, but the patient did not have the benefit of an effective anesthetic drug. And after the surgery was performed, there was great risk of infection because the use of antiseptics was unknown.
Today, operations are performed under sterile conditions, and great care is taken during and after eạch operation to avoid infection. A variety of anesthetic drugs are availabte to make the patient pain-free during the operation, and highly trained medical specialists(anesthesiologists) can determine the proper drug and dosage to use. Many operations which used to require lengthy hospital stays are now pertormed under local anesthetic, often on an outpatient basis. Hernia repair (herniorrhaphy ), hemorrhoidectomy, and cataract removal are some of the operations that have been dramatically improved in recent years. Greater precision and smaller incisions greatly decrease the risk and pain of surgery as well as the recuperation period and cost.
In recent years. major advances have been made. Operations are now performed that were not even imagined 30 years ago. Clogged blood vessels can be cleaned out or replaced. Kidneys, livers, and even hearts and lungs can be transplanted from one person to another. Heart valves are routinely replaced, and severed limbs sewn back onto the body. These sophisticated operations require extremely skilled and experienced physicians. Most surgeons concentrate on learning and practicing in one area of surgery. An orthopedic surgeon, for example, repairs or replaces broken or damaged bones, while a neurosurgeon handles surgery involving the nervous system. A plastic surgeon repairs or replaces defects of form and function, most commonly on the skin, head, limbs, breasts, and external genitalia. A thoracic surgeon operates on patients with chest and respiratory ailments. General surgeons operate mostly on the abdominal organs, breasts. and endocrine glands.
Most patients are referred to a surgeon by their regular in ternist or family physician. who has recognized the possible need for surgical involvement. After examining the patient and the medical records from the patient's physician. the surgeon must determine whether surgery is needed and can improve the patient's condition without undue risk. Sometimes, exploratory surgery must be done to determine whether corrective surgery should be undertaken.
Surgery may be classified as emergency, urgent, required, elective or optional. Emergency surgery is done when there is a tite-threatening crisis which demands immediate action (for example, a tracheotomy, which is done to enable a patient to breathe). Urgent surgery requires prompt but not immediate action. Required surgery is that which the patient needs to cure a particular health problem but which can be postponed for weeks or months. Elective surgery can correct a condition but is not necessary to the health of the patient (for example, middle ear surgery to correct a hearing loss). Optional surgery is done primarily for cosmetic rather thạn health reasons. Exploratory surgery is performed for diagnostic purposes.
A patient about to undergo surgery is instructed not to eat or drink anything for several hours prior to the operation in order to make it easier tor the surgeon to operate and to avoid complications from the anesthetic. A patient is often given an enema just before the operation to void the colon of waste material. Sometimes, a urinary catheter is used to drain the bladder. The area to be operated on is shaved and scrubbed with soap. and an an tiseptic is applied to avoid infection.
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