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Surgery (Surgical Procedure)

A procedure to remove or repair a part of the body or to find out whether disease is present.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Surgery

What surgery involves will depend very much on what kind of situation the patient is in: The exact same procedure might be quick and easy to do in one patient, and difficult and risky in another. Surgery is often one treatment option among several — and sometimes it is the only way. Some operations can save your life, but others may be unneeded. There are also major differences in planning: Some operations can be done using just local anesthesia, whereas others require a general anesthetic.

But all kinds of surgery have one thing in common: Most people would rather avoid them altogether — they may be nervous or even afraid about "going under the knife." So many of them want to know as much as possible about the chances of success and possible risks for upcoming surgery. That includes finding out about things like the best way to cope with anxiety before surgery and relieving pain or nausea afterwards... Read more about Surgery

What works? Research summarized

Evidence reviews

Crohn's Disease: Management in Adults, Children and Young People

This guideline intends to show the place of both new and established treatments in the wider care pathway for Crohn's disease. This will be useful for clinicians and people with Crohn's disease because new drugs have been licensed for Crohn's disease in the last decade. The guideline also deals with those medications which are unlicensed for treatment of the condition, but which have been used in this way (off-label) for many years and their role is recognised in other NICE documents as well as the British National Formulary. They include azathioprine, mercaptopurine and methotrexate. The guideline aims to help improve the care offered to people with Crohn's disease and provide information about the clinical and cost effectiveness of potential care pathways. Management of Crohn's disease in specific populations (for example, in pregnancy) may require special consideration.

Laparoscopic Surgery for Benign Gynaecological Disease [Internet]

Background Today laparoscopy, or minimally invasive surgery, is used for many surgical and gynaecological conditions which earlier required open surgery.

The Management of Hip Fracture in Adults [Internet]

Although hip fracture is predominantly a phenomenon of later life, it may occur at any age in people with osteoporosis or osteopenia, and this guidance is applicable to adults across the age spectrum. Skills in its management have, however been accrued, researched and reported especially by collaborative teams specialising in the care of older people (using the general designation ‘orthogeriatrics’). These skills are applicable in hip fracture irrespective of age, and the guidance includes recommendations that cover the needs of younger patients by drawing on such skills in an organised manner.

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Summaries for consumers

This review assesses the usefulness surgery for anal fissure, a painful ulcer at the anal opening, by comparing the efficacy of various surgical procedures and how likely they are to result in complications.

Does surgery provide a long term cure for anal fissure? Yes, in better than 90% of patients having recommended operative procedures. Such operations include principally partial division of the anal sphincter, or controlled dilation of the narrowed anal opening. The technique for cutting the muscle has been refined in recent years and appears to improve cure and diminish the risk of bowel control problems. The method of achieving controlled anal dilation needs further investigation.

No evidence to show whether removing nail polish and finger rings prevents wound infection after surgery

People having surgery can get a serious wound infection from bacteria (germs) on the hands of operating theatre staff (doctors, nurses, and assistants). Theatre staff scrub their hands intensively before operations to reduce the number of bacteria on them. It may be that nail polish (varnish) and rings (jewellery) hide bacteria and reduce the effectiveness of hand scrubbing. This review could not locate any trials that investigated the effect of theatre staff wearing rings, but did find one small trial that investigated the number of bacteria before and after scrubbing on the hands of theatre staff with varnished and unvarnished nails. This trial did not identify any clear differences between the number of bacteria on varnished and unvarnished nails, but evidence from more trials is required before we can be certain that this is a true result.

TAP blocks (nerve blocks) for analgesia after abdominal surgery

Poorly controlled pain after abdominal surgery is associated with a variety of unwanted post‐operative consequences, including patient suffering, distress, confusion, chest and heart problems, and prolonged hospital stays. Traditionally, pain relief is provided by: medications injected in to a vein using a 'drip' such as morphine or paracetamol; administering local anaesthetic into the skin around the surgical wound; or by providing epidural pain relief where local anaesthetic and other pain relieving medications are injected through a fine plastic tube into the epidural space of the lower back ‐ numbing the nerves that supply the abdomen. Following surgery, Transversus Abdominis Plane (TAP) block is a relatively new way of anaesthetising nerves which numb the abdomen after surgery in order to help improve patient comfort after their surgery. In the past few years, there has been increasing research and interest describing how TAP blocks are being used for pain relief in both adults and children having abdominal surgical procedures. However, there have not been any systematic reviews evaluating the effectiveness of the TAP block in reducing pain after surgery. We have searched for research investigating the effectiveness of rectus sheath (a similar block to TAP) and TAP blocks in providing pain relief after abdominal surgery. We have included eight studies, with a total of 358 participants in this review, that show some limited evidence that TAP blocks improve pain relief after abdominal surgery. More research is indicated, comparing TAP blocks with other standard methods of pain relief such as, morphine medication, epidural analgesia and local anaesthetic injection into and around the surgical wound. There are many studies currently underway or awaiting publication which assess the effectiveness of the TAP block and compare it with other techniques. We intend to include these studies in an updated version of this review in the near future.

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Terms to know

Abdominal Surgery
The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen.
Anti-Reflux Surgery
Surgery to assist in correcting a problem with the muscles at the bottom of the esophagus (the tube from the mouth to the stomach).
Cone Biopsy (Conization)
A procedure in which a cone-shaped piece of abnormal tissue is removed from the cervix.
Elective Surgery
Surgery that may be scheduled or undertaken by choice.
Excision
The act of cutting out; the surgical removal of part or all of a structure or organ.
Incision
A cut made in the body to perform surgery.
Laparoscopic Surgery (Keyhole Surgery)
Surgery done with the aid of a laparoscope. A laparoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Also called laparoscopic-assisted resection.
Mohs Surgery
A surgical procedure used to treat skin cancer. Individual layers of cancer tissue are removed and examined under a microscope one at a time until all cancer tissue has been removed.
Nerve-Sparing Surgery
A type of surgery that attempts to save the nerves near the tissues being removed.
Surgical Sutures
Material used to close a surgical or accidental wound and to secure the edges and join tissues.

More about Surgery

Photo of an adult woman

Also called: Operative procedure, Operation, Surgical

Other terms to know: See all 10
Abdominal Surgery, Anti-Reflux Surgery, Cone Biopsy (Conization)

Related articles:
How To Relieve Anxiety Before Surgery
Pain After Surgery

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