Surgery

Colorectal surgery

2011-01-21T22:20:00.000-08:00

Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but the term is outdated in the more traditional areas of medicine. The word proctology is derived from the Greek words Proktos, meaning anus or hindparts, and Logos meaning science or study.

Physicians specializing in this field of medicine are called colorectal surgeons or proctologists. Colorectal surgeons often work closely with urologists. To become colorectal surgeons, these surgical doctors have to complete a general surgery residency, as well as a colorectal surgery fellowship, upon which they are eligible to be certified in their field of expertise by the American Board of Colon and Rectal Surgery or the American Osteopathic Board of Proctology. In other countries, certification to practice proctology is given to surgeons at the end of a 2-3 year subspecialty residency by the country's board of surgery.

Scope of the specialty

2011-01-21T22:19:00.001-08:00

Colorectal surgical disorders include:

varicosities or swelling, and inflammation of veins in the rectum and anus (Hemorrhoids)
unnatural cracks or tears in the anus (Anal fissures)
abnormal connections or passageways between the rectum or other anorectal area to the skin surface (Fistulas)
severe constipation conditions
fecal incontinence
protrusion of the walls of the rectum through the anus (Rectal prolapse)
birth defects such as the imperforate anus
treatment of severe colic disorders, such as Crohn's disease
cancer of the colon and rectum (Colorectal cancer)
anal cancer (rare)
any injuries to the anus
removal of objects deliberately inserted into anus

Surgical treatment and diagnostic procedures

2011-01-21T22:18:00.001-08:00

Surgical forms of treatment for these conditions include: colectomy, ileo/colostomy, polypectomy, strictureplasty, hemorrhoidectomy (in severe cases of hemorrhoids), anoplasty, and more depending on the condition the patient suffers from. Diagnostic procedures, such as a colonoscopy, are very important in colorectal surgery, as they can tell the physician what type of diagnosis should be given and what procedure should be done to correct the condition. Other diagnostic procedures used by colorectal surgeons include: proctoscopy, defecating proctography, sigmoidoscopy. In recent times, the laparoscopic method of surgery has seen a surge of popularity, due to its lower risks, decreased recovery time, and smaller, more precise incisions achieved by using laparoscopic instruments.

Anesthesia

2010-12-25T00:14:00.003-08:00

Anesthesia, or anaesthesia (see spelling differences; from Greekαν-, an-, "without"; andαἴσθησις, aisthēsis, "sensation"), traditionally meant the condition of having sensation (including the feeling of pain) blocked or temporarily taken away. It is a pharmacologically induced and reversible state of amnesia, analgesia, loss of responsiveness, loss of skeletal muscle reflexes or decreased stress response, or all simultaneously. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience. An alternative definition is a "reversible lack of awareness," including a total lack of awareness (e.g. a general anesthetic) or a lack of awareness of a part of the body such as a spinal anesthetic. The word anesthesia was coined by Oliver Wendell Holmes, Sr. in 1846.

2010-12-25T00:14:00.001-08:00

Types of anesthesia include local anesthesia, regional anesthesia, general anesthesia, and dissociative anesthesia. Local anesthesia inhibits sensory perception within a specific location on the body, such as a tooth or the urinary bladder. Regional anesthesia renders a larger area of the body insensate by blocking transmission of nerve impulses between a part of the body and the spinal cord. Two frequently used types of regional anesthesia are spinal anesthesia and epidural anesthesia. General anesthesia refers to inhibition of sensory, motor and sympathetic nerve transmission at the level of the brain, resulting in unconsciousness and lack of sensation. Dissociative anesthesia uses agents that inhibit transmission of nerve impulses between higher centers of the brain (such as the cerebral cortex) and the lower centers, such as those found within the limbic system.

Foot and ankle surgery

2010-11-27T03:23:00.003-08:00

Foot and ankle surgery is a sub-specialty of orthopedics and podiatry that deals with the treatment, diagnosis and prevention of disorders of the foot and ankle. The typical training of an orthopedic foot and ankle surgeon consist of four years of college, four years of medical school, one year surgical internship, 5–6 years of orthopedic training and a 1 year fellowship in foot and ankle surgery. Training for a podiatric foot and ankle surgeon consists of four years of college, four years of podiatric medical school and 2-4 years of a surgical residency. One can also make the distinction between a podiatric and orthopedic foot and ankle surgeon: an orthopedic surgeon has an allopathic medical degree and training that encompasses both orthopedic residency and a 6-month to one year of fellowship training specific in techniques of foot and ankle surgery, while the training of a podiatrist consist of a 4 year podiatric medical degree and mandatory two to four year residency training specific to foot and ankle medicine and surgery, with a possibility of an additional 1 year fellowship.

Clinical scope

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Foot and ankle surgeons are trained to treat all disorders of the foot and ankle, both surgical and non-surgical. One is also trained to understand the rather complex connections between disorders and deformalities of the foot and ankle and the knee and hip and in return, the spine. Therefore, the surgeon will typically see cases that vary from trauma (such as malleolar fractures, tibial pilon fractures, calcaneus fractures, navicular and midfoot injuries and metatarsal and phalangeal fractures.) Arthritis care (primarily surgical) of the ankle joint and the joints of the hindfoot (tarsals), midfoot (metatarsals) and forefoot (phalanges)also plays a rather significant role. Congentital and acquired deformalities include adult acquired flatfoot, non-neuromuscular foot deformity, diabetic foot disorders, hallux valgus and several common pediatric foot and ankle conditions ( such as clubfoot, flat feet, tarsal coalitions...etc.) Patients may also be referred to a foot and ankle surgeon for proper diagnosis and treatment of heel pain (such as a consequence from plantar heel facitis), nerve disorders (such as tarsal tunnel syndrome) and tumors of the foot and ankle. Amputation and ankle arthroscopy (the use of a laproscope in foot and ankle surgical procedures) have emerged as prominent tools in foot and ankle care. A patient may also be referred to a foot and ankle surgeon for the surgical care of nail problems and phalangeal deformalities (such as bunions and buniettes.)

Non-surgical treatments

2010-11-27T03:22:00.002-08:00

The vast majority of foot and ankle conditions do not require surgical intervention. For example, several phalangeal conditions may be traced to the type of foot box used in a shoe, and a change of a shoe or shoe box may be sufficient to treat the condition. For flammatory processes such as rhuematoid arthritis, non-steroidal anti-inflammatories (NSAIDs) and Disease Modifying antirheumatic drugs (DMARDS) may be used to manage or slow down the process. Orthotics, or an externally applied devie used to modify the structural or functional characteristics of the neuromusculoskeletal system specifically for the foot and ankle may be used as inserts into shoes to displace regions of the foot for more balanced, comfortable or theraputic placements of the foot. Physical therapy may also be used to alleviate symptoms, strengthening muscles such as the gastrocnemius (which in return will pull on the achillies heel which will then pull on the plantar fascia thus changing the structure and shape of the foot).

Surgical treatments

2010-11-27T03:22:00.000-08:00

Surgery is considered to be a last option when more conservative fails to alleviate symptoms (such as the above techniques outlined in the section above.) Such as bunionectomies may be used to surgically remove bunions and other foot and ankle deformalities, arthrodesis (or fusion of joint spaces) for inflammatory processes, and surgical reconstruction (i.e. invasive measures of manipulating neuromusculoskeletal structures) to treat other deformalities. One should note that orthotics, physical therapy, NSAIDs, DMARDs and a change of shoe will act in compliments to surgical intervention, and in most cases will be required for optimal recovery.

Open heart surgery

2010-11-06T23:19:00.001-07:00

This is a surgery in which the patient's heart is opened and surgery is performed on the internal structures of the heart.

It was soon discovered by Dr. Wilfred G. Bigelow of the University of Toronto that the repair of intracardiac pathologies was better done with a bloodless and motionless environment, which means that the heart should be stopped and drained of blood. The first successful intracardiac correction of a congenital heart defect using hypothermia was performed by Dr. C. Walton Lillehei and Dr. F. John Lewis at the University of Minnesota on September 2, 1952. The following year, Soviet surgeon Aleksandr Aleksandrovich Vishnevskiy conducted the first cardiac surgery under local anesthesia.

2010-11-06T23:17:00.001-07:00

Surgeons realized the limitations of hypothermia - complex intracardiac repairs take more time and the patient needs blood flow to the body (and particularly the brain); the patient needs the function of the heart and lungs provided by an artificial method, hence the term cardiopulmonary bypass. Dr. John Heysham Gibbon at Jefferson Medical School in Philadelphia reported in 1953 the first successful use of extracorporeal circulation by means of an oxygenator, but he abandoned the method, disappointed by subsequent failures. In 1954 Dr. Lillehei realized a successful series of operations with the controlled cross-circulation technique in which the patient's mother or father was used as a 'heart-lung machine'. Dr. John W. Kirklin at the Mayo Clinic in Rochester, Minnesota started using a Gibbon type pump-oxygenator in a series of successful operations, and was soon followed by surgeons in various parts of the world.

2010-11-06T23:16:00.000-07:00

Dr. Nazih Zuhdi worked for four years under Drs. Clarence Dennis, Karl Karlson, and Charles Fries, who built an early pump-oxygenator. Zuhdi and Fries worked on several designs and re-designs of Dennis' earlier model from 1952–1956 at the Brooklyn Center. Zuhdi then went to work with Dr. C. Walton Lillehei at the University of Minnesota. Lillehei had designed his own version of a cross-circulation machine, which came to become known as the DeWall-Lillehei heart-lung machine. Zuhdi worked on perfusion and blood flow trying to solve the problem of air bubbles while bypassing the heart so the heart could be stopped for the operation. Zuhdi moved to Oklahoma City, OK, in 1957, and began working at the Oklahoma University College. Zuhdi, the heart surgeon, teamed up with Dr. Allen Greer, a lung surgeon and Dr. John Carey, forming a three man open heart surgery team. With the advent of Dr. Zuhdi's heart-lung machine which was modified in size, being much smaller than the DeWall-Lillehei heart-lung machine, and with other modifications, reduced the need for blood down to a minimal amount, and the cost of the equipment down to $500.00 and also reduced the prep time from two hours to 20 minutes. Dr. Zuhdi performed the first Total Intentional Hemodilution open heart surgery on Terry Gene Nix, age 7, on February 25, 1960, at Mercy Hospital, Oklahoma City, OK. The operation was a success; however, Nix died three years later in 1963. In March, 1961, Zuhdi, Carey, and Greer, performed open heart surgery on a child, age 3½, using the Total Intentional Hemodilution machine, with success. That patient is still alive.

In 1985 Dr. Zuhdi performed Oklahoma's first successful heart transplant on Nancy Rogers at Baptist Hospital. The transplant was successful, but Rogers, a cancer sufferer, died from an infection 54 days after surgery.

Etymology

2010-10-18T09:37:00.000-07:00

Coined in English 1819, the word dermatology originated in the form of the words dermologie (in French, 1764) and, a little later, dermatologia (in Latin, 1777). The term derives from the Greek "δέρματος" (dermatos), genitive of "δέρμα" (derma), "skin" (from "δέρω" - dero, "to flay") + "-logy, "the study of", a suffix derived from "λόγος" (logos), amongst others meaning "speech, oration, discourse, quote, study, calculation, reason", in turn from "λέγω" - lego, "to say", "to speak".

History

2010-10-18T09:36:00.000-07:00

Readily visible alterations of the skin surface have been recognized since the dawn of history, with some being treated, and some not. In 1801 the first great school of dermatology became a reality at the famous Hôpital Saint-Louis in Paris, while the first textbooks (Willan's, 1798–1808) and atlases (Alibert's, 1806–1814) appeared in print during the same period of time. In 1952, Dermatology was greatly advanced by Dr. Norman Orentreich's pioneering work in hair transplantation.

Training

2010-10-18T09:28:00.000-07:00

After earning a medical degree (M.D. or D.O.), the length of training for a general dermatologist in the United States is a total of four years. This training consists of an initial medical or surgical intern year followed by a three-year dermatology residency. Following this training, one- or two- year post-residency fellowships are available in immunodermatology, phototherapy, laser medicine, Mohs micrographic surgery, cosmetic surgery or dermatopathology. Within the past several years, dermatology residencies in the United States have been the most competitive in terms of admission

American College of Surgeons

2010-05-24T02:48:00.002-07:00

Members of the American College of Surgeons are referred to as "Fellows." The letters FACS (Fellow, American College of Surgeons) after a surgeon's name mean that the surgeon's education and training, professional qualifications, surgical competence, and ethical conduct have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College.

2010-05-24T02:48:00.001-07:00

The American College of Surgeons also has membership categories for Associate Fellows (provides an opportunity for surgeons who are beginning surgical practice and who meet specific requirements to assume an active role in the College at an early stage in their careers), surgical residents, medical students, and allied health care professionals who are not surgeons, but who interact with surgical patients.

As of 2008, total membership was over 75,000 including more than 4,000 members from outside the US and Canada, and more than 2,600 Associate Fellows. Fellows of the College are organized into 100 chapters. There are 65 chapters in the United States, 2 in Canada, 3 in Mexico, and 30 in other countries around the world.

The ACS elected its first black Fellow, Dr Louis T. Wright, in 1934.

blogs

2009-12-13T23:07:00.001-08:00

in reference to: Google (view on Google Sidewiki)

Core Needle Biopsy

2009-08-15T22:01:00.001-07:00

A core needle biopsy is a procedure that removes small but solid samples of tissue using a hollow "core" needle. For palpable (“able to be felt”) lesions, the physician fixes the lesion with one hand and performs a freehand needle biopsy with the other. In case of non-palpable lesions stereotactic mammography, or ultrasound, or PEM guidance is used. With stereotactic mammography it is possible to pinpoint the exact location of a mass based on images taken from two different angles of the x-ray machine. With ultrasound, the radiologist or surgeon can watch the needle on the ultrasound monitor to help guide it to the area of concern. With PEM (positron emission mammagraphy), the lesion is targeted in 3D based on a positron emission tomography (PET) image of the breast. The needle used during core needle biopsy is larger than the needle used with FNA. The core biopsy needle also has a special cutting edge allowing removal of a bigger sample of tissue. With Core Needle Biopsy a relatively large sample can be removed through a small single incision in the skin. Typically, the breast area is first locally anesthetized with a small amount of anesthetic fluid. Then, the needle is placed into the breast. As with FNA, the radiologist or surgeon will guide the needle into the area of concern by palpating the lump. If the lesion can’t be felt the core needle biopsy is performed under image-guidance using either stereotactic mammography, ultrasound or even magnetic resonance imaging (MRI). A core needle biopsy procedure takes a few minutes to perform and is almost painless.

Biopsy

2009-08-15T21:58:00.000-07:00

A biopsy is a medical test involving the removal of cells or tissues for examination. It is the removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When only a sample of tissue is removed with preservation of the histological architecture of the tissue’s cells, the procedure is called an incisional biopsy or core biopsy. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy.

Surgical Oncology

2009-08-02T09:36:00.000-07:00

Surgical oncology, as its name suggests, is the specific application of surgical principles to the oncologic setting. These principles have been derived by adapting standard surgical approaches to the unique situations that arise when treating cancer patients.The surgeon is often the first specialist to see the patient with a solid malignancy, and, in the course of therapy, he or she may be called upon to provide diagnostic, therapeutic, palliative, and supportive care. In each of these areas, guiding paradigms that are unique to surgical oncology are employed.In addition, the surgical oncologist must be knowledgeable about all of the available surgical and adjuvant therapies, both standard and experimental, for a particular cancer. This enables the surgeon not only to explain the various treatment options to the patient but also to perform the initial steps in diagnosis and treatment in such a way as to facilitate and avoid interfering with future therapeutic options.

Sternal Precautions

2009-07-09T08:49:00.001-07:00

Patients undergoing coronary artery bypass surgery will have to avoid certain things for eight to 12 weeks to reduce the risk of opening the incision. These are called sternal precautions. First, patients need to avoid using their arms excessively, such as pushing themselves out of a chair or reaching back before sitting down. To avoid this, patients are encouraged to build up momentum by rocking several times in their chair before standing up. Second, patients should avoid lifting anything in excess of 5-10 pounds. A gallon (U.S.) of milk weighs approximately 8.5 pounds, and is a good reference point for weight limitations. Finally, patients should avoid overhead activities with their hands, such as reaching for sweaters from the top shelf of a closet or reaching for plates or cups from the cupboard.

Coronary artery bypass surgery

2009-07-09T08:45:00.000-07:00

Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle). This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass; techniques are available to perform CABG on a beating heart, so-called "off-pump" surgery.

Cardiothoracic Surgery

2009-06-10T09:54:00.000-07:00

Cardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affecting organs inside the chest. Generally treatment of conditions of the heart (heart disease) and lungs (lung disease) Cardiac surgery (involving the heart and great vessels) and thoracic surgery (involving the lungs and any other thoracic organ) are separate surgical specialties, except in the USA, where they are frequently grouped together, so that a surgeon training in the cardiothoracic specialty will receive a broader but less specialized experience in both fields.

Trauma surgery

2009-03-28T07:43:00.000-07:00

In the United States and Canada, the overall responsibility for trauma care falls under the auspices of general surgery. Some general surgeons obtain advanced training and specialty certification in this field alone. General surgeons must be able to deal initially with almost any surgical emergency. Often they are the first port of call to critically ill or gravely injured patients, and must perform a variety of procedures to stabilise such patients, such as intubation, burr hole, cricothyroidotomy, and emergency laparotomy or thoracotomy to staunch bleeding.
All General Surgeons are trained in emergency surgery. Bleeding, infections, bowel obstructions and organ perforations are the main problems they deal with. Cholecystectomy, the surgical removal of the gallbladder, is one of the most common surgical procedures done worldwide. This is most often done electively, but the gallbladder can become acutely inflamed and require an emergency operation. Ruptures of the appendix and small bowel obstructions are other common emergencies.

Terminology

2009-03-01T00:58:00.000-08:00

Excision surgery names often start with a name for the organ to be excised (cut out) and end in -ectomy.

Procedures involving cutting into an organ or tissue end in -otomy. A surgical procedure cutting through the abdominal wall to gain access to the abdominal cavity is a laparotomy.

Minimally invasive procedures involving small incisions through which an endoscope is inserted end in -oscopy. For example, such surgery in the abdominal cavity is called laparoscopy.

Procedures for formation of a permanent or semi-permanent opening called a stoma in the body end in -ostomy.

Reconstruction, plastic or cosmetic surgery of a body part starts with a name for the body part to be reconstructed and ends in -oplasty. Rhino is used as a prefix for "nose", so rhinoplasty is basically reconstructive or cosmetic surgery for the nose.

Reparation of damaged or congenital abnormal structure ends in -rraphy. Herniorraphy is the reparation of a hernia, while perineorraphy is the reparation of perineum.

Types of surgery

2009-03-01T00:56:00.001-08:00

Surgical procedures are commonly categorized by urgency, type of procedure, body system involved, degree of invasiveness, and special instrumentation. Elective surgery is done to correct a non-life-threatening condition, and is carried out at the patient's request, subject to the surgeon's and the surgical facility's availability. Emergency surgery is surgery which must be done quickly to save life, limb, or functional capacity. Exploratory surgery is performed to aid or confirm a diagnosis. Therapeutic surgery treats a previously diagnosed condition.

Amputation involves cutting off a body part, usually a limb or digit. Replantation involves reattaching a severed body part. Reconstructive surgery involves reconstruction of an injured, mutilated, or deformed part of the body. Cosmetic surgery is done to improve the appearance of an otherwise normal structure. Excision is the cutting out of an organ, tissue, or other body part from the patient. Transplant surgery is the replacement of an organ or body part by insertion of another from different human (or animal) into the patient. Removing an organ or body part from a live human or animal for use in transplant is also a type of surgery. When surgery is performed on one organ system or structure, it may be classed by the organ, organ system or tissue involved. Examples include cardiac surgery (performed on the heart), gastrointestinal surgery (performed within the digestive tract and its accessory organs), and orthopedic surgery (performed on bones and/or muscles).

Minimally invasive surgery involves smaller outer incision(s) to insert miniaturized instruments within a body cavity or structure, as in laparoscopic surgery or angioplasty. By contrast, an open surgical procedure requires a large incision to access the area of interest. Laser surgery involves use of a laser for cutting tissue instead of a scalpel or similar surgical instruments. Microsurgery involves the use of an operating microscope for the surgeon to see small structures. Robotic surgery makes use of a surgical robot, such as the Da Vinci or the Zeus surgical systems, to control the instrumentation under the direction of the surgeon.

Scar less Surgery

2009-02-24T00:36:00.000-08:00

The modern technology has come up with a promise for a painless and scar less surgery. It is termed as natural orifice translumenal endoscopic surgery (NOTES). It is performed by passing an endoscope through a natural orifice. This new approach goes beyond laparoscopic surgery which is done after making several small holes in the skin. NOTES is known as scar less surgery as it makes use of natural openings like the mouth, anus, vagina or bladder and eliminates the need for any external incisions. The main benefits of NOTES are minimal postoperative pain and scarring and quick recovery. There are challenging issues, such as the risk of infection and leakage. Additionally, it is more time consuming and technically difficult. A related technique is being perfected in neurosurgery- endoscopic transnasal brain surgery. Surgical access through the nose has proven to be successful in removing pituitary tumours for years. Now, some surgeons are using this route to reach into the brain and remove tumours at the base of the skull. Here also, the main benefit is the absence of any visible scars.

Painless Surgery

2009-02-17T08:12:00.000-08:00

There are methods by which a person can be subjected to surgery whilst he/she is awake. It can be achieved by the use of local anaesthetic and this is termed as "freezing". This is very effective in maxillofacial surgery. The main procedures in a maxillofacial surgery are surgical removal of wisdom teeth, dental extractions, surgical treatment for chronic tooth abscess and removal of skin both inside and outside the mouth. All these procedures can be done without pain using the local anaesthetic. Eventhough a freezing of the gum or face provides a painfree state of surgery, it is always recommended that mild painkillers are taken before the numbness wears off.

Herbal derivatives

2009-02-16T06:28:00.000-08:00

The first anesthesia (a herbal remedy) was administered in prehistory. Opium poppy capsules were collected in 4200 BC, and opium poppies were farmed in Sumeria and succeeding empires. The use of opium-like preparations in anaesthesia is recorded in the Ebers Papyrus of 1500 BC. By 1100 BC poppies were scored for opium collection in Cyprus by methods similar to those used in the present day, and simple apparatus for smoking of opium were found in a Minoan temple. Opium was not introduced to India and China until 330 BC and 600–1200 AD respectively, but these nations pioneered the use of cannabis incense and aconitum. In the second century, according to the Book of Later Han, the physician Hua Tuo performed abdominal surgery using an anesthetic substance called mafeisan (麻沸散 "cannabis boil powder") dissolved in wine. Throughout Europe, Asia, and the Americas a variety of Solanum species containing potent tropane alkaloids were used, such as mandrake, henbane, Datura metel, and Datura inoxia. Classic Greek and Roman medical texts by Hippocrates, Theophrastus, Aulus Cornelius Celsus, Pedanius Dioscorides, and Pliny the Elder discussed the use of opium and Solanum species. In 13th century Italy Theodoric Borgognoni used similar mixtures along with opiates to induce unconsciousness, and treatment with the combined alkaloids proved a mainstay of anaesthesia until the nineteenth century. In the Americas coca was also an important anaesthetic used in trephining operations. Incan shamans chewed coca leaves and performed operations on the skull while spitting into the wounds they had inflicted to anaesthetize the site.[citation needed] Alcohol was also used, its vasodilatory properties being unknown. Ancient herbal anaesthetics have variously been called soporifics, anodynes, and narcotics, depending on whether the emphasis is on producing unconsciousness or relieving pain.

Oral and maxillofacial surgery - Organizations

2008-11-13T03:50:00.000-08:00

* Association of Oral and Maxillofacial Surgeons of India
* American Association of Oral and Maxillofacial Surgeons
* American Board of Oral and Maxillofacial Surgery
* American College of Surgeons
* Australian and New Zealand Association of Oral and Maxillofacial Surgeons
* The Royal College of Surgeons of England
* Canadian Association of Oral and Maxillofacial Surgeons
* Faculty of Dental Surgery of The Royal College of Surgeons of England
* Directive 2001/19/EC (Official Journal of the European Communities L 206, 31.07.2001)
* European Association for Cranio-Maxillofacial Surgery
* Internacional Association of Oral and Maxillofacial Surgeons
* British Association of Oral and Maxillofacial Surgeons
* Clinica de Cirujia Maxilofacial - Clinimax
* Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie
* Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften
* Österreichische Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie
* Schweizerische Gesellschaft für Kiefer- und Gesichtschirurgie
* Sociedad Española de Cirugía Oral y Maxilofacial
* Société Française de Stomatologie et Chirurgie Maxillo-Faciale
* Société Royale Belge de Stomatologie et de Chirurgie Maxillo-Faciale
* Société Suisse de Chirurgie Maxillo-Faciale
* Società Italiana di Chirurgia Maxillo-Facciale
* OMS Foundation
* Consejo Mexicano de Cirugía Oral y Maxilofacial
* Towarzystwo Chirurgii Jamy Ustnej i Chirurgii Szczękowo-Twarzowej
* Colégio Brasileiro de Cirurgia e Traumatologia Buco-maxilo-facial

Overview of modern surgery

2008-02-20T03:19:00.000-08:00

Although it is sometimes difficult to determine when a medical procedure is considered surgery,a medical treatment that involves a cutting of a patient's live tissue (e.g., hair and nails are dead tissue) is usually considered surgery of some sort. A medical procedure involving a drilling of live tissue in a body would often be considered surgery, but mere piercing of a body is not necessarily surgery since piercing is often done for taking samples or draining fluids from or injecting materials into the body, or setting up intravenous drip, and usually does not require suturing to close the pierced opening. Even if a medical procedure or treatment does not include cutting or drilling of live tissue in a body, it may be considered surgery, if it involves common surgical procedure or a setting, such as use of an operating room or table in a hospital, anesthesia, ntiseptic conditions, typical surgical instruments, and suturing or stapling. Surgery is considered an invasive procedure. Examples of surgery without cutting the body may include debridement or closing (suturing or stapling) an open wound or applying skin grafts if done under typical surgical conditions. Many types of more complicated or involved surgery are obviously considered surgery, since they involve common surgical procedure or setting as mentioned above. A medical procedure may be surgery even if not all of the typical surgical conditions or procedures mentioned above are used.

Replantation

2008-02-15T02:00:00.000-08:00

Replantation is the reattachment of a completely detached body part. Fingers and thumbs are the most common but the ear, scalp, nose, arm and penis have all been replanted. Generally replantation involves restoring blood flow through arteries and veins, restoring the bony skeleton and connecting tendons and nerves as equired.

Initially, when the techniques were developed to make replantation possible, success was defined in terms of a survival of the amputated part alone. However, as more experience was gained in this field, surgeons specializing in replantation began to understand that survival of the amputated piece was not enough to ensure success of the replant. In this way, functional demands of the amputated specimen became paramount in guiding which amputated pieces should and should not be replanted. Additional concerns about the patients ability to tolerate the long rehabilitation process that is necessary after replantation both on physical and psychological
levels also became important. So, when fingers are amputated, for instance, a replantation surgeon must seriously consider the contribution of the finger to the overall function of the hand. In this way, every attempt will be made to salvage an amputated thumb, since a great deal of hand function is dependent on the thumb, while an index finger or small finger may not be replanted, depending on the individual needs of the patient and the ability of the patient to tolerate a long surgery and a long course of rehabilitation.

However, if an amputated specimen is not able to be replanted to its original location entirely, this does not mean that the specimen is unreplantable. In fact, replantation surgeons have learned that only a piece or a portion may be necessary to obtain a functional result, or especially in the case of multply amputated fingers, a finger or fingers may be transposed to a more useful location to obtain a more functional result. This concept is called "spare parts" surgery.

Techniques and procedures

2008-02-10T22:00:00.000-08:00

Common techniques used in plastic surgery are:

* incision
* excision
* microsurgery
* chemosurgery
* electrosurgery
* laser surgery
* dermabrasion
* liposuction

In plastic surgery the transfer of skin tissue (skin grafting) is one of the most common procedures. (In traditional surgery a “graft” is a piece of living tissue, organ, etc., that is transplanted.

* Autografts: Skin grafts taken from the recipient. If absent or deficient of natural tissue, alternatives can be:
o Cultured Sheets of epithelial cells in vitro.
o Synthetic compounds (e.g., Integra--a 2 layered dermal substitute consisting superficially of silicone and deeply of bovine tendon collagen with glycosaminoglycans).
* Allografts: Skin grafts taken from a donor of the same species.
* Xenografts: Skin grafts taken from a donor of a different species.

Usually, good results are expected from plastic surgery that emphasizes:

* Careful planning of incisions so that they fall in the line of natural skin folds or lines.
* Appropriate choice of wound closure.
* Use of best available suture materials.
* Early removal of exposed sutures so that the wound is held closed by buried sutures.

Bleeding

2007-10-29T02:36:00.000-07:00

Before modern surgical developments, there was a very real
threat that a patient would bleed to death before treatment, or
during the operation. cauterization (fusing a wound closed with extreme heat)
was successful but limited - it was destructive, painful and in the long term had
very poor outcomes. Ligatures, or material used to tie off severed blood vessels,
are believed to have originated with Ambroise Pare (sometimes spelled "Ambrose"[5])
during the 16th century, but were highly dangerous until infection risk was brought
under control - at the time of its discovery, the concept of infection did not exist.
Finally, early 20th century research into blood groups allowed the first effective blood
transfusions.

2007-05-11T22:57:00.000-07:00

Techniques used in plastic surgery

Among the techniques which are commonly used in plastic surgery are:

Incision.
Excision.
Chemosurgery.
Electrosurgery.
Laser surgery.
Dermabrasion.
Liposuction.

plastic surgery

2007-04-13T22:55:00.000-07:00

Plastic surgery is a specialty that uses surgical techniques to change the appearance and function of a person's body. Some of these operations are called "cosmetic", and others are called "reconstructive".

The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with the synthetic polymer material known as plastic.

SURGERY

2007-02-22T04:42:00.002-08:00

Surgery (from the Greek χειρουργική meaning "hand work") is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. Surgeons may be physicians, dentists, or veterinarians who specialize in surgery.

A surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentists, or veterinarians

2007-02-22T04:42:00.001-08:00

Ancient India

Indian physician Sushruta (c. 600 BC) taught and practiced surgery on the banks of the Ganges in the area that corresponds to the present day city of Benares in Northern India. Much of what is known about Sushruta is contained in a series of volumes he authored, which are collectively known as the Susrutha Samhita. It is the oldest known surgical text and it describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments, as well as procedures on performing various forms of plastic surgery, such as cosmetic surgery and rhinoplasty.

In the Sushruta school, the first person to expound Āyurvedic knowledge was Dhanvantari who then taught it to Divodasa who, in turn, taught it to Sushruta, Aupadhenava, Aurabhra, Paushakalāvata, Gopurarakshita, and Bhoja.

2007-02-22T04:41:00.004-08:00

Ancient Egypt

Researchers have uncovered an Ancient Egyptian mandible, dated to approximately 2650 BC, with two perforations just below the root of the first molar, indicating the draining of an abscessed tooth. Recent excavations of the construction workers of the Egyptian pyramids also led to the discovery of evidence of brain surgery on a labourer, who continued living for two years afterwards.

2007-02-22T04:41:00.003-08:00

Ancient Greece

While surgeons are now considered to be specialised physicians, the profession of surgeon and that of physician have different historical roots. For example, Greek tradition was against opening the body, and the Hippocratic Oath warns physicians against the practice of surgery. Specifically, cutting persons laboring under the stone (i.e.lithotomy, an operation to relieve kidney stones) was to be left to such persons as practice [it]. Of course, most knowledge of surgery comes from dissecting bodies, a science which was repulsive to many healers.

2007-02-22T04:41:00.001-08:00

Ancient China

Hua Tuo was a famous Chinese physician during the Eastern Han and Three Kingdoms era. He was the first person to perform surgery with the aid of anesthesia, some 1600 years before the practice was adopted by Europeans.

2007-02-22T04:40:00.001-08:00

Medieval Europe

Abucasis was an Andulusian - Arab physician and scientist who praticised in the Zahra suburb of Cordova. He is considered a great medieval surgeon, whose comprehensive medical texts, combining Middle Eastern and Greco-Roman classical teachings, shaped European surgical procedures up until the Renaissance. He is often regarded as the Father Of Surgery. Patients and students from all parts of Europe came to him for treatment and advice. According to Will Durant, Cordova was in this period the favourite resort of Europeans for surgical operations.

Surgery in Holland (ca. 1690)

By the thirteenth century, many European towns were demanding that physicians have several years of study or training before they could practice. Montpellier,Padua and Bologna Universities were particularly interested in the academic side to Surgery, and by the fifteenth century at the latest, Surgery was a separate university subject to Physics. Surgery had a lower status than pure medicine, beginning as a craft tradition until Rogerius Salernitanus composed his Chirurgia, which laid the foundation for the species of the occidental surgical manuals, influencing them up to modern times.

2007-02-22T04:38:00.000-08:00

Europe

Ambroise Pare pioneered the treatment of wounds by gunshots. Among the first modern surgeons were battlefield doctors in the Napoleonic Wars who were primarily concerned with amputation. Naval surgeons were often barber surgeons, who combined surgery with their main jobs as barbers.

In London, an operating theatre or operating room from the day before modern anasthesia or antiseptic surgery still exists, and is open to the public. It is found in the roof space of St Thomas Church, Southwark, London and is called the Old Operating Theatre.