Conventional cardiothoracic surgery involves opening the skin and muscles of the chest and cutting through the sternum to open the rib cage. Source: Wikimedia Commons.
Surgery is a medical treatment in which a physician uses tools to diagnose a condition, manually repair an injury, correct a malformation, or remove a growth or diseased body part in a patient. Surgery has a long history going back to prehistoric times, although medical and technological innovations made over the past few centuries have enabled surgeons to develop more and more complex surgical procedures capable of treating a growing range of medical conditions, ranging from the very simple to the incredibly complex. Basic types of surgery include:
- Minor surgery, which carries a short recovery time and usually allows patients to carry on with their normal activities right away.
- Major surgery, which generally includes operations on the interior of the head, neck, abdomen, or chest. These surgeries are risky and require a long recovery time. Patients are usually hospitalized and closely monitored for complications following a major surgery.
- Elective surgery, which is not considered necessary for the continued life, health or proper functioning of the patient.
- Semi-elective surgery, which is required for the continued health and proper functioning of the patient, but does not need to be done right away.
- Emergency surgery, which should be done immediately to save the patient’s life or prevent permanent damage.
There are many different types of surgical procedures intended to correct injuries, disorders and malformations of the various organs and body systems. Some common surgical procedures include:
- Cardiothoracic surgery, also known as “heart surgery.” Cardiothoracic procedures are intended to correct problems with the heart. Coronary artery bypass, in which a section of vein is transplanted into the heart to redirect blood flow around an arterial clog, is a type of heart surgery. Bypass surgery is typically performed to treat the symptoms of coronary artery disease and prevent heart attacks. Symptoms can include pain in the chest, arms, neck, jaw, or back. They can mimic indigestion.
- Vascular surgery encompasses procedures intended to correct problems with the blood vessels. Angioplasty is a type of surgical procedure in which the surgeon uses a narrow catheter and a small balloon to widen arteries narrowed by arterial plaque and improve blood flow to the heart. A stent may be placed in the artery to keep it open. Without surgery to correct the effects of coronary artery disease, the patient could suffer future heart attacks, damage to the heart and death.
- Imaging procedures, which allow surgeons to see inside of the body to diagnose problems, are considered surgery even when they do not involve making incisions in the body. Angiography is a surgical procedure that uses imaging technology to allow surgeons to identify disorders of the blood vessels. Magnetic resonance imaging (MRI) is a type of scan in which a computer interprets magnetic and radio waves to create an image of the inside of the body. A computed tomography or CT scan uses x-rays to make cross-sectional pictures of the inside of the body. Both procedures require the patient to lie down on a table, which then moves into a scanning device shaped like a tunnel. A positron emission tomography or PET scan is performed after the injection of a radioactive substance known as a tracer. It enables surgeons to monitor the functioning of organs and structures.
- Transplant surgery is a type of surgery in which an organ or other body part, such as a cornea, is taken from one patient and surgically grafted into another patient’s body. In living donor organ transplant, the patient donating the organ remains alive. Kidney transplants are often living donor transplants, because a person needs only one functioning kidney to survive. Liver transplants can also be living donor transplants, because it’s possible to transplant just a part of the organ; it will regenerate to full size in both patients. In cadaveric transplants, the organ is taken from a patient who died of other causes. The alternative to transplant surgeries is often continued deterioration of health leading to death.
- Colorectal surgery procedures are performed on the colon, rectum, and anus, to treat cancers, fistulas, infections, cysts, inflammatory disorders, and more. Laparoscopy, in which several small incisions are made to allow the surgeons to insert cameras and surgical devices into the body, is a popular option for colorectal surgeries, since it carries a much faster recovery time and is less painful. Specific colorectal surgery procedures include colon resection, in which a portion of the large intestine is removed to treat cancer, polyps or inflammatory disorders, rectal resection, in which the rectum is removed. Some colorectal conditions can be alternatively treated with diet and medication. Depending on the nature of the disease being treated, patients could experience extreme discomfort, digestive problems, impaired functioning and even death without surgery.
- Excision is the surgical removal of tissue, whether a tumor, an organ or some other type of tissue. Excision is often used to treat cancer; for instance, it’s a common treatment for melanoma, a skin cancer characterized by the appearance of irregular growths on the skin. If cancerous tumors or growths are not removed promptly, they can spread to other parts of the body and cause death.
- When surgery is performed, physical structures must often be reconstructed, either to repair injury or reconstruct the remaining tissue after an excision or resection (partial removal of an organ). Anastomosis is a type of reconnecting surgery used to reattach the severed ends of hollow structures, like blood vessels or the intestines, to one another. The procedure involves stapling or suturing the two severed ends of the structure back together.
- A colostomy, in which the colon is redirected to the outside of the abdomen, is a type of anastomosis. The purpose of a colostomy is to allow stool to travel into a sack on the outside of the body, either because the natural elimination structures are no longer viable, or because they need to recover from the effects of illness or surgery to repair them. Keeping the rest of the colon, the rectum, and the anus clear of stool during recovery prevents infection. A colostomy can be permanent or temporary.
- A ligation is a procedure in which a tubular structure, such as a blood vessel or fallopian tube, is tied off or cut to block passage through it. When the fallopian tubes are cut or tied off as a birth control measure, it’s called a tubal ligation or tubectomy. It’s done to prevent pregnancy in women who no longer wish to have children, and it can also reduce the risk of ovarian cancer. The procedure can be performed on an outpatient basis with laparoscopy. The abdomen is inflated with gas and the fallopian tubes are clamped shut through a small incision. Alternatives to tubal ligation include hormonal birth control, hysterectomy, and hysteroscopic sterilization, in which small objects are inserted into the fallopian tubes to encourage the growth of scar tissue and the blockage of the channel.
- A venous ligation is a type of ligation procedure performed to treat varicose veins. It’s a cosmetic procedure, but can also improve the uncomfortable symptoms of varicose veins, such as feelings of heaviness and swelling in the legs after standing for long periods. This involves making multiple incisions in the leg along the damaged vein, and tying it off around the damaged parts. If the vein is very damaged, it will be removed, or stripped.
- Endocrine surgery refers to the group of surgeries used to treat disorders of the endocrine system, which regulates the body’s hormone levels. Hormone-producing organs in the body include the thyroid, pituitary, adrenal gland, and gonads (ovaries or testicles). Common types of endocrine surgeries include thyroidectomy, or surgical removal of the thyroid, as well as adrenalectomy and parathyroidectomy. Any surgical procedure with the suffix -ectomy indicates a procedure in which an organ is entirely removed. Thyroidectomy is done to treat cancer, hyperthyroidism, or enlargement of the thyroid (goiter). Some problems, like cancer, may not have any symptoms. Other disorders can cause profound metabolic disorder and a large goiter can cause trouble swallowing or breathing. An adrenalectomy is done to treat adrenal cancer or tumors, as well as conditions like Cushing’s disease that cause dangerous metabolic changes. Parathyroidectomy is done as a means of treating hyperparathyroidism, which can cause elevated blood calcium levels, kidney stones, weakness and abdominal pain, among other symptoms.
- Breast surgeries are performed on the female breast. There are several kinds, performed for different reasons. A mastectomy is done to treat breast cancer by removing cancerous tissues. The surgeon may remove part of the breast, the entire breast, or the breast and tissue surrounding the breast. Without a mastectomy, many patients would die. A less radical alternative for some patients is a lumpectomy, in which a breast lump is removed. Some of these lumps turn out not to be cancerous, and no treatment is needed. If the lump is cancerous, sometimes radiation therapy can be used instead of mastectomy.
- Cosmetic breast surgeries include augmentation mammoplasty, or breast augmentation, in which a sac-like implant filled with saline solution is inserted into the breast to increase its size. Breast reduction surgery, or reduction mammoplasty, is done to reduce the size of the breasts in order to relieve pain in the back or give the patient a more proportioned appearance.
- Dental surgeries are common minor procedures intended to protect oral health and preserve functioning teeth. A root canal is a dental surgery used to save an infected or very decayed tooth. The tooth root is hollowed out and a cap installed on the tooth. Alternatives include extracting the tooth and fitting the patient with a bridge, which is a more complicated procedure. Without the procedure, the infection could spread beyond the tooth.
- An appendectomy is a common surgical procedure used to remove the appendix, a small, tube-like pouch located on the colon. Scientists believe that the appendix is an evolutionary leftover; it can be removed without ill effects. The surgery is done to treat appendicitis, an inflammation of the appendix that can be fatal.
- Arthrodesis is a type of surgery used to fuse two bones together. Spinal arthrodesis, also known as spinal fusion, is a common type of arthrodesis. It’s done to stabilize the spine after an injury, another surgical procedure, or after treatment for a spinal disease. In the procedure, bone grafts are used to rebuild or repair missing or damaged vertebrae. Metal implants are inserted to hold everything in place until new, stable bones grow. Arthrodesis can also be used to fuse arthritic bones in the feet and hands to relieve pain symptoms.
What you need to know about having surgery, from the Agency for Healthcare Research and Quality.
What it’s like to have to surgery, a resource for kids from KidsHealth.org.
Information on vitamins and minerals to take before surgery, to speed healing, from The Huffington Post.
Heart surgery resources for patients, from Cleveland Clinic.
Medline Plus, a medical resource from the U.S. National Library of Medicine and the National Institutes of Health.