Surgery: What is the role of the surgeon?
What is general surgery?
General surgery is a surgical specialty that deals with operations on the organs of the abdominal cavity such as the intestine, esophagus, stomach, colon, liver, and gallbladder (including the biliary tract). This is also referred to as "abdominal surgery." General surgery also encompasses the thyroid gland and hernias. This discipline includes routine procedures like vasectomy, and more complex operations such as laparoscopic cholecystectomy.
Certain precautions must be considered when performing these operations. For instance, obese patients, those prone to bleeding, patients over 60, and other specific categories require care tailored to their conditions.
Surgeons specializing in general surgery can sub-specialize in the following areas:
- Trauma surgery;
- Laparoscopic surgery;
- Colorectal surgery;
- Breast surgery;
- Vascular surgery;
- Endocrine surgery;
- Transplant surgery;
- Oncological surgery;
- Cardiac surgery;
- Visceral surgery;
Minimally invasive surgery is currently of significant interest. These recently developed surgical procedures allow for operations with minimal invasiveness. Robotic surgery, using state-of-the-art machines controlled by the surgeon, offering great precision and efficiency, is gaining prominence. The operator is physically distant from the patient and, via a control console, manipulates robotic arms to perform the operation. Minimally invasive surgery is booming in general surgery, and other fields as well. Examples include orthopedic surgery, thoracic surgery, and urological surgery.
When does the surgeon intervene?
The general surgeon specializes in operating on organs within the abdominal cavity, as well as the breast and thyroid gland, to improve or alleviate the prognosis of related pathologies.
Patients typically see a general surgeon on referral from their general practitioner or other specialists.
Appointments are also scheduled with this surgeon for postoperative monitoring.
Given the breadth of a general surgeon's activities and the numerous organs they treat, the pathologies encountered are diverse.
These include:
- Functional diseases of the breast, thyroid gland, and abdominal cavity organs;
- Inflammatory diseases of the breast, thyroid gland, and abdominal cavity organs;
- Neoplasms of the breast, thyroid, and abdominal cavity organs (gastric, esophageal, intestinal, pancreatic, colon, rectal, liver, biliary tract);
- Diverticulitis;
- Hernias (hiatal and inguinal);
- Ulcers;
- Calculi;
- Cysts;
- Polyposis;
- Pain syndromes due to abdominal adhesions;
General surgeons utilize various procedures. Common ones include:
- Endoscopic examinations, providing internal views of organs for anatomical, functional, and pathological assessment (diagnostic endoscopy). These also allow for tissue sampling for histological analysis and minor procedures under local anesthesia, such as fibroid removal (operative endoscopy). Lymph node and breast biopsies are frequently performed by general surgeons, particularly in oncology;
- Radiological examinations (X-ray of the digestive tract, barium swallow, CT scan, MRI);
- Surgical interventions, performed openly (laparotomy) or minimally invasively (laparoscopy or robotic surgery);
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What does the surgeon do?
A surgeon is a doctor specializing in surgery. They operate on patients in the operating room, performing surgical interventions to diagnose or treat various diseases. Surgery is a branch of medicine involving manual or instrumental procedures on the human body to address therapeutic problems.
The general surgeon handles major surgery and outpatient or short-stay operations for minor pathologies (e.g., cysts).
Interventions are typically performed under anesthesia using instruments such as scalpels, forceps, scissors, lasers, micro-cameras, endoscopy, or laparoscopic techniques. Modern surgery prioritizes minimally invasive techniques, including robotic surgery.
In the operating room, the surgeon meticulously follows hygiene protocols to maintain a sterile environment and prevent contamination.
However, a surgeon's work extends far beyond the operating room. It begins well before the operation.
The surgeon conducts a general surgical examination, gathering patient history and ordering tests for accurate diagnosis. Based on these results, they determine whether surgery is the best option or if a non-invasive treatment, such as medication, is appropriate.
The surgeon then informs the patient of the risks, benefits, and potential complications of the surgery, and prepares them for the procedure (preoperative phase).
This process applies to planned operations, not emergency surgeries, which require different protocols.
During surgery, the surgeon must remain highly focused, often for extended periods; operations can last from minutes to hours. They are supported by a surgical team (surgeons, anesthesiologists, nurses, support staff, and other specialist doctors).
Post-operation, the surgeon manages postoperative care, establishing a rehabilitation program, monitoring the patient's recovery, and overseeing therapy to prevent complications.
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