Surgery (< cheirourgia, from the Greek cheir, “hand” + ergon, “work”) is the branch of medicine that deals with the physical manipulation of a bodily structure to diagnose, prevent, or cure an ailment. Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery is, “To eliminate that which is superfluous, restore that which has been dislocated, separate that which has been united, join that which has been divided and repair the defects of nature.”
Since humans first learned to make and handle tools, they have employed their talents to develop surgical techniques, each time more sophisticated than the last; however, until the industrial revolution, surgeons were incapable of overcoming the three principal obstacles which had plagued the medical profession from its infancy: bleeding, pain and infection. Advances in these fields have transformed surgery from a risky “art” into a scientific discipline capable of treating many diseases and conditions.
The first surgical techniques were developed to treat injuries and traumas. A combination of archaeological and anthropological studies offer insight into man’s early techniques for suturing lacerations, amputating unsalvageable limbs, and draining and cauterizing open wounds.
The oldest operation for which evidence exists is trepanation (from Greek τρύπανον and τρυπανισμός), in which a hole is drilled or scraped into the skull for exposing the dura mater to treat health problems related to intracranial pressure and other diseases.
The discipline of surgery was put on a sound, scientific footing during the Age of Enlightenment in Europe (1715–89) and was significantly influenced by these three major factors: the modern pain control through anesthesia, the development of improved methods of antisepsis and asepsis, and the use of X-rays as an important medical diagnostic tool. In the past century, a number of technologies have had a significant impact on surgical practice. These include Electro surgery in the early 20th century, practical Endoscopy beginning in the 1960s, and Laser surgery, Computer-assisted surgery and Laparoscopic Surgery, developed in the 1980s.
General surgery is a medical discipline. Despite the name, is actually a surgical specialty. As the title indicates, it is a wide-ranging area of surgery with many subspecialties. The defining feature of general surgeons is that they have a wide range of knowledge and skills to deal with all kinds of surgical emergencies, with an emphasis on acute abdominal problems. They also carry out a large number of elective operations. The surgical specialty focuses on abdominal contents including esophagus, stomach, small bowel, large bowel, liver, pancreas, appendix, gallbladder, and bile ducts, and the thyroid gland. It also deal with diseases involving the skin, breast, soft tissue, trauma, peripheral vascular surgery and hernias.
General Surgery is a large specialty which requires the acquisition of knowledge in basic sciences required in the development of clinical and operative skills as well as specialized knowledge and skills in managing congenital and acquired diseases and injuries of most organ systems which are treated by operations and other interventions. It provides for operative and non-operative management, i.e. prevention, diagnosis, evaluation, decision making, treatment, intensive care and rehabilitation of patients with pathological processes that affect these organs. So, general surgeons not only perform surgeries but are also responsible for patient care before, during, and after surgery.
General Surgery co-operates with other medical specialties, like anesthesia, intensive care, emergency medicine, radiology, neurology, pediatrics, internal medicine, geriatrics, rehabilitation medicine, obstetrics and gynecology, and also pharmacy in the management of patients.
Modern surgery has developed to such an extent that the body of knowledge and technical skills required have led to surgeons specializing in particular areas, usually an anatomical area of the body or occasionally in a particular technique or type of patient.
Fields of General Surgery:
- Breast Surgery: assessment of a large number of patients with breast symptoms, and surgery on breast lesions or breast cancers.
- Colorectal Surgery for diseases of the colon, rectum and anal canal.
- Endocrine Surgery for diseases of the thyroid, parathyroid and adrenal glands.
- Upper Gastrointestinal Surgery for diseases affecting the liver, gallbladder, esophagus and stomach.
- Anti-reflux Surgery
- Spleen Surgery
- Hernia Surgery
- Surgical Critical Care
- Surgical Oncology
- Trauma and acute care surgery
- Skin and soft tissue surgery
- Obesity Surgery for morbidly obese patients.
- Laparoscopic (or “keyhole”) Surgery is recognized as an integral and crucial skill that is developing across the entirety of general surgical practice and its subspecialties. Operations are being carried out increasingly by minimally invasive techniques that offer patients less pain, better outcomes and shorter postoperative recovery. Virtually every abdominal operation can and has been done by this route.