The concept of "surgical operation" is a Greek expression adapted to the Russian language, which literally means "I do it with my hand." Many years have passed since the time of ancient Greece, and today a surgical operation means various effects on living tissues, during which the function of the whole organism is corrected. During the operation, tissues are separated, moved and reconnected.
Background
The first mention of surgical interventions date back to the VI century BC. e. Since the beginning of the ages, people have stopped bleeding, tended to wounds, and cut off shattered or gangrene-affected limbs. Medical historians know that long before our era, the then healers knew how to perform a craniotomy, immobilize broken bones, and even … remove the gallbladder.
In all textbooks on the history of medicine there is an ancient statement that in the arsenal of a doctor there is a knife, an herb and a word. From ancient times to the present day, the knife - now its analogues, of course - is in the first place. Surgery is the most radical treatment that allows a person toget rid of the disease forever. Hippocrates, Galen and Celsus developed surgery more than others.
The best Russian surgeon was Nikolai Ivanovich Pirogov, whose tomb is reverently kept in Vinnitsa. The relatives of those whom he treated and saved from death still take care of his former estate free of charge. Once upon a time, a great surgeon helped his neighbors without payment - and they still remember him. Pirogov removed the gallbladder in 40 seconds, his hands can be seen in the tomb - with long and thin fingers.
Pain relief or anesthesia
Any operation is first of all a pain. Living tissue reacts to pain with spasm and worsening of blood circulation, therefore, removing pain is the first task in surgical intervention. We have received historical information about what our ancestors used for pain relief: decoctions of plants containing narcotic substances, alcohol, marijuana, cold and compression of blood vessels.
A breakthrough in surgery occurred in the middle of the 19th century, when nitrous oxide, diethyl ether, and then chloroform were discovered. Since then, general anesthesia has been used. A little later, surgeons turned their attention to cocaine in the sense that this substance anesthetizes tissues locally. The use of cocaine can be considered the beginning of local - conduction and infiltration - anesthesia.
The discovery of muscle relaxants or substances capable of immobilizing muscles dates back to the middle of the last century. Since that time, anesthesiology has become a separate medical science and speci alty, inextricably linked withsurgery.
Modern surgery is a complex of techniques from various branches of medicine. We can say that this is a synthesis of the accumulated knowledge of medicine.
Surgery: types of operations
There are classifications of operations according to the nature of the intervention, urgency and phasing.
The nature of the operation can be radical, symptomatic or palliative.
Radical surgery is the complete elimination of the pathological process. A classic example is the removal of an inflamed appendix in acute appendicitis.
Symptomatic is the elimination of the most painful signs of the disease. For example, with cancer of the rectum, independent defecation is impossible, and the surgeon displays a he althy part of the rectum on the anterior abdominal wall. Depending on the general condition of the patient, the tumor is removed at the same time or later. This type is adjoined by palliative, which also eliminates various complications.
Urgent and elective surgery
Sometimes a patient needs urgent surgery. Types of emergency operations are performed as quickly as possible, they are required to save lives. These are tracheotomy or conicotomy to restore airway patency, puncture of the pleural cavity in case of life-threatening hemothorax, and others.
Urgent surgery can be delayed up to 48 hours. An example is renal colic, stones in the ureter. If, against the background of conservative treatment, the patient fails to “give birth” to the stone, then it is necessary to remove it surgically.way.
An elective operation is performed when there are no other ways to improve the state of he alth, and there is no direct threat to life either. For example, such a surgical operation is the removal of an enlarged vein in chronic venous insufficiency. It is also planned to remove cysts and benign tumors.
Surgery: types of operations, stages of surgery
In addition to the above, by type, the operation can be one- or multi-stage. Reconstruction of organs after burns or injuries, transplantation of a skin flap to eliminate a tissue defect can take place in several stages.
Any operation is performed in 3 stages: surgical access, prompt admission and exit. Access is the opening of a painful focus, dissection of tissues for an approach. The reception is the actual removal or movement of tissues, and the exit is the stitching of all tissues in layers.
The operation on each organ has its own characteristics. For example, surgery on the brain most often requires trepanation of the skull, because access to the substance of the brain requires first opening the bone plate.
At the stage of operative exit, vessels, nerves, parts of hollow organs, muscles, fascia and skin are connected. All together it makes up a postoperative wound that requires careful care until it heals.
How to reduce injury to the body?
This question worries surgeons of all times. There are operations that are comparable in their trauma to the disease itself. The fact,that not every organism is able to quickly and well cope with the damage received during surgery. In places of incisions, hernias, suppurations, dense non-absorbable scars are formed that disrupt the functions of the organ. In addition, the sutures may come apart or bleeding from injured vessels may open.
All these complications force surgeons to keep the size of the incision to the minimum possible.
This is how a special section of surgery appeared - microinvasive, when a small incision is made on the skin and muscles, into which endoscopic equipment is inserted.
Endoscopic Surgery
This is a special surgical operation. Types and stages in it are different. With this intervention, accurate diagnosis of the disease is extremely important.
The surgeon enters through a small incision or puncture, he sees the organs and tissues located under the skin through a video camera placed on the endoscope. Manipulators or small instruments are also placed there: forceps, loops and clamps, with the help of which diseased areas of tissues or entire organs are removed.
Endoscopic operations have been widely used since the second half of the last century.
Bloodless Surgery
This is a way to preserve the patient's own blood during surgery. This method is most often used in cardiac surgery. During heart surgery, the patient's own blood is collected in an extracorporeal circuit, which maintains blood circulation throughout the body. After the operation, the bloodback to natural.
Such a surgical operation is a very complicated process. Types of operations, its stages are determined by the specific state of the body. This approach avoids blood loss and the need to use donor blood. Such an intervention became possible at the intersection of surgery with transfusiology - the science of donated blood transfusion.
Alien blood is not only salvation, but also foreign antibodies, viruses and other foreign components. Even the most careful preparation of donated blood does not always allow avoiding negative consequences.
Vascular Surgery
This branch of modern surgery has helped save many lives. Its principle is simple - the restoration of blood circulation in problematic vessels. With atherosclerosis, heart attacks or injuries, there are obstacles in the way of blood flow. This is fraught with oxygen starvation and, as a result, the death of cells and tissues consisting of them.
There are two ways to restore blood flow: by installing a stent or a shunt.
A stent is a metal frame that pushes the walls of the vessel apart and prevents its spasm. The stent is placed when the vessel walls are well preserved. The stent is more often installed in relatively young patients.
If the walls of blood vessels are affected by an atherosclerotic process or chronic inflammation, then it is no longer possible to push them apart. In this case, a bypass or shunt is created for the blood. To do this, they take part of the femoral vein and bleed through it, bypassing the unusable area.
Bypass for beauty
This is the most famous surgical operation, photos of people who underwent it flash on the pages of newspapers and magazines. It is used to treat obesity and type 2 diabetes. Both of these conditions are associated with chronic overeating. During the operation, a small ventricle is formed from the area of the stomach adjacent to the esophagus, which can hold no more than 50 ml of food. It is joined by the small intestine. The duodenum and the intestine following it continue to participate in the digestion of food, as this site joins below.
The patient after such an operation can eat little and loses up to 80% of the previous weight. Requires a special diet enriched with protein and vitamins. For some, such an operation is really life-changing, but there are patients who manage to stretch the artificially formed ventricle almost to its previous size.
Surgical miracles
Modern technologies make it possible to perform real miracles. In the news now and then flashed reports of unusual interventions that ended in success. So, quite recently, Spanish surgeons from Malaga performed a brain operation on a patient, during which the patient played the saxophone.
French specialists have been performing facial tissue transplants since 2005. Following them, maxillofacial surgeons from all over the world began to transplant skin and muscles onto the face from other parts of the body, restoring the appearance lost after injuries and accidents.
Perform surgical interventions even … in the womb. Cases are describedwhen the fetus was removed from the uterine cavity, the tumor was removed and the fetus returned back. A term he althy baby born at term is the surgeon's best reward.
Science or art?
It is difficult to answer this question unambiguously. A surgical operation is a combination of knowledge, experience and personal qualities of a surgeon. One is afraid to take risks, the other is doing everything possible and impossible from the baggage that he currently has.
The last time the Nobel Prize in Surgery was awarded in 1912 to the Frenchman Alexis Carrel for his work on vascular suture and organ transplantation. Since then, for more than 100 years, surgical achievements have not been honored with the interest of the Nobel Committee. However, every 5 years, technologies appear in surgery that radically improve its results. Thus, rapidly developing laser surgery allows removing intervertebral hernias through tiny incisions, "evaporating" prostate adenoma, and "soldering" thyroid cysts. The absolute sterility of lasers and their ability to weld blood vessels give the surgeon the ability to treat many diseases.
A real surgeon today is called not by the number of awards and prizes, but by the number of lives saved and he althy patients.
