An Overview of Modern Surgery——Part 1

An Overview of Modern Surgery

One of the most dramatic medical procedures is surgery. Even since ancient times, people have tried to cure medical problems by cutting into the body. Surgical operations are depictedon the tombs of ancient Egyptian rulers, dating from 3000 B.C. These early operations were painful and hazardous. If an amputationwas necessary, for example, alcohol was often used to dullthe pain somewhat, but the patient did not have the benefit of an effective anestheticdrug. And after the surgery was performed, there was great risk of infection because the use of antisepticswas unknown.

Today, operations are performed understerile conditions, and great care is taken during and after each operation to avoid infection. A variety of anesthetic drugs are available 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 requirelengthy hospital stays are now performed underlocal anesthetic, often on an outpatientbasis. Herniarepair (herniorrhaphy), hemorrhoidectomy; and cataract removal are some of the operations that have been dramatically improved in recent years. Greater precisionand smaller incisionsgreatly decrease the risk and pain of surgery as well as the recuperationperiod and cost.

In recent years, major advances have been made. Operations are now performed that were not even imagined 30 years ago. Cloggedblood 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 severedlimbs sewn back onto the body.

These sophisticated operations required extremely skilled and experienced physicians. Most surgeons concentrate on learning and practicing in one area of surgery. An orthopedicsurgeon, for example, repairs or replaces broken or damaged bones, while a neurosurgeonhandles surgery involving the nervous system. A plasticsurgeon 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 patientsare referred to a surgeon by their regular internistor family physician, who has recognized the possible need for surgical involvement. After examining the patient and the medical records from the patient, physician, the surgeon must determine whether surgery is needed and can improve the patient's condition without unduerisk. Sometimes, exploratory surgery must be done to determine whether corrective surgery should be undertaken.