Surgery is what? Types and stages of surgical operations
The term "surgical operation" is a Greek expression adapted to the Russian language, which literally means "do it by hand".Since ancient Greece many years have passed, and today a surgical operation is a different effect on living tissues, during which the function of the whole organism is corrected. During the operation, the tissues are separated, moved and reconnected.
The first mention of surgical interventions date back to the 6th century BC.e. Since the beginning of the century, people have stopped bleeding, nursed wounds, and cut off limbs fractured or affected by gangrene. The historians of medicine know that long before our era the healers knew how to perform trepanation of the skull, immobilize the broken bones and even. .. remove the gallbladder.
In all the textbooks on the history of medicine there is an ancient statement that in the arsenal of the doctor there is a knife, grass and word. From ancient times to our days, the knife - now its analogs, of course - is in the first place. Operation is the most radical way of treatment, allowing a person to get rid of the disease forever. Developed surgery more than others Hippocrates, Galen and Celsus.
The best Russian surgeon was Nikolai Ivanovich Pirogov, whose burial vault is treasured in Vinnitsa. For his former estate, relatives of those he treated and saved from death are still courting free of charge. Once a great surgeon helped his neighbors without payment - and they remember him so far. Pirogov removed the gallbladder in 40 seconds, his brushes can be seen in the tomb - with long and thin fingers.
Analgesia or anesthesia
Any operation is primarily a pain. On pain, living tissue reacts with spasm and deterioration of blood circulation, so removing pain is the first task in surgical intervention. We have received historical information about what our ancestors used for anesthesia: decoctions of plants containing narcotic substances, alcohol, marijuana, cold and blood vessels.
A breakthrough in surgery occurred in the middle of the XIX century, when nitrous oxide, diethyl ether, and then chloroform was discovered. From this time, general anesthesia began to be used. A little later, surgeons paid attention to cocaine in the sense that this substance anesthetizes the tissues locally. The use of cocaine can be considered the beginning of local - conductor and infiltration - anesthesia.
By the middle of the last century is the discovery of muscle relaxants or substances that can immobilize muscles. Since that time, anesthesiology has emerged as a separate medical science and specialty, inextricably linked with surgery.
Modern operation is a complex of techniques from various branches of medicine. We can say that this is a synthesis of knowledge accumulated by medicine.
Surgical operations: types of operations
The classification of operations is distinguished by the nature of the intervention, urgency and phase.
By nature, the operation can be radical, symptomatic or palliative.
Radical surgery is the complete elimination of the pathological process. A classic example is the removal of an inflamed vermiform appendage with acute appendicitis.
Symptomatic is the elimination of the most painful signs of the disease. For example, with rectal cancer, self-defecation is impossible, and the surgeon displays a healthy part of the rectum on the anterior abdominal wall. Depending on the general condition of the patient, the tumor is removed simultaneously or later. This species is joined by palliative, also eliminating various complications.
Immediate and scheduled operation of
Sometimes, a patient needs urgent surgery. Types of emergency operations are carried out as quickly as possible, they are required to save lives. This is a tracheotomy or conicotomy for restoring airway patency, pleural cavity puncture with life threatening hemothorax and others.
Immediate operation can be deferred for a maximum of 48 hours. Example - renal colic, stones in the ureter. If the patient can not "give birth" to the stone against the background of conservative treatment, then it is necessary to remove it in an operative way.
A scheduled operation is performed when there are no other ways to improve health, but there is no direct threat to life either. For example, such a surgical operation is the removal of an enlarged vein in chronic venous insufficiency. Also planned is the removal of cysts and benign tumors.
Surgical operation: types of operations, stages of surgical operation
In addition to the above, the operation can be single-or multi-stage by types. In several stages, the reconstruction of organs after burns or injuries, the transplantation of the skin flap for the repair of tissue defect can take place.
Any operation is performed in 3 stages: performing surgical access, online reception and exit. Access - is the opening of a painful focus, dissection of tissues for the approach. Reception is the actual removal or movement of tissues, and the output is the stitching of all tissues layer by layer.
The operation on each organ has its own characteristics. So, a surgical operation on the brain most often requires trepanation of the skull, because to access the substance of the brain it is required to first open the bone plate.
At the stage of operative output, vessels, nerves, parts of hollow organs, muscles, fascia and skin are connected. All together constitutes a postoperative wound requiring careful care until healing.
How to reduce the trauma of the body?
This question excites surgeons of all time. There are operations that are comparable in their traumatic nature to the disease itself. The fact is that not every organism is able to quickly and well cope with the injuries received during surgery. In the places of incisions, hernias, suppurations, dense, non-absorbable scars are formed, which disrupt the functions of the organ. In addition, the stitches may diverge or bleeding from the injured vessels may open.
All these complications cause surgeons to reduce the size of the incision to a possible minimum.
So there was a special section of surgery - microinvasive, when a small incision is made on the skin and muscles, into which endoscopic equipment is introduced.
This is a special surgical procedure. Types and stages in it are different. With this intervention, the precise diagnosis of the disease is extremely important.
The surgeon enters through a small incision or a puncture, located under the skin of the organs and tissues he sees through a video camera placed on the endoscope. In the same place are placed manipulators or small tools: forceps, loops and clamps, by which the diseased parts of tissues or whole organs are removed.
Endoscopic operations have been widely used since the second half of the last century.
This is a method of preserving the patient's own blood during a surgical procedure. This method is most often used in cardiac surgery. During operations on the heart, the patient's own blood is collected into an extracorporeal circuit, through which blood circulation throughout the body is maintained. After the operation, the blood returns to the natural course.
A very complicated process is such a surgical operation. Types of operations, its stages are determined by the specific state of the organism. This approach helps to avoid blood loss and the need to use donor blood. Such intervention became possible at the junction of surgery with transfusiology - the science of transfusion of donor blood.
Alien blood is not only salvation, but also foreign antibodies, viruses and other foreign components. Even the most thorough preparation of donor blood does not always avoid negative consequences.
This section of modern surgery has helped to save a lot of lives. Its principle is simple - restoration of blood circulation in problem vessels. Atherosclerosis, heart attacks or trauma on the path of blood flow, obstacles arise. This is fraught with oxygen starvation and, as a result, the death of cells and tissues consisting of them.
There are two ways to restore blood flow: a stent or a shunt.
A stent is a metal frame that pushes the walls of the vessel and prevents its spasm. The stent is established when the walls of the vessels are well preserved. The stent is more often set relatively young patients.
If the walls of the vessels are affected by an atherosclerotic process or chronic inflammation, then it is no longer possible to push them apart. In this case, a bypass or shunt is created for the blood. To do this, take a part of the femoral vein and let blood through it, bypassing the unusable site.
Shunting for beauty
This is the most famous surgical operation, photos of people who passed it, flashed on the pages of newspapers and magazines. It is used to treat obesity and type 2 diabetes. Both these conditions are associated with chronic overeating. During the operation, a small ventricle is formed from the area of the stomach bordering the esophagus, containing not more than 50 ml of food. To him joins the small intestine. The duodenum and the intestine following it continue to participate in the digestion of food, as this site joins below.
The patient after this operation can eat a little and loses up to 80% of the former weight. Requires a special diet, enriched with protein and vitamins. To some, such surgery does change life, but there are patients who manage to stretch the artificially formed ventricle almost to its former size.
Modern technologies make it possible to perform real miracles. In the news, reports of unusual interventions, which ended in success, flashed by and by. So, more recently, Spanish surgeons from Malaga conducted an operation on the brain to the patient, during which the operated one played the saxophone.
French specialists perform facial transplantation since 2005.Following them, the maxillofacial surgeons of all countries began to transplant the skin and muscles to the face from other parts of the body, restoring the lost face after injuries and accidents.
Perform surgery even. .. in the womb. There are cases when the fetus was removed from the uterine cavity, the tumor was removed, and the fruit returned back. A full-term healthy baby born is the best surgeon's reward.
Science or art?
It is difficult to unequivocally answer this question. Surgical operation is a fusion of knowledge, experience and personal qualities of the surgeon. One is afraid to take risks, the other is doing everything possible and impossible from the baggage that he has at the moment.
The last time the Nobel Prize in Surgery was awarded in 1912 to the Frenchman Alexis Carrel for work on the vascular suture and organ transplantation. Since then, more than 100 years of surgical achievements have not been awarded the interest of the Nobel Committee. However, every 5 years in surgery, there are technologies that dramatically improve its results. So, the rapidly developing laser surgery allows you to remove intervertebral hernias, "evaporate" the prostate adenoma, "solder" the thyroid cysts through tiny incisions. Absolute sterility of lasers and their ability to weld vessels give the surgeon the ability to treat a variety of diseases.
A real surgeon today is called not by the number of awards and bonuses, but by the number of lives saved and healthy patients.