The surgeon’s office will review your medical history and may ask questions about medicines, diet, or activity. A healthcare professional called a patient coordinator can also help with this.
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Surgery is a medical treatment that involves cutting, removing, or manipulating tissue and organs in the body. It can also affect the insertion of devices, the redirection of blood vessels, and the transplantation of tissues or organs. Surgery is performed under local, regional, spinal, or general anesthesia. The twin advances of anesthesia and antisepsis (preventing wound infection) have allowed surgeons to perform operations on all parts of the body and have dramatically reduced mortality from surgery.
Surgery can help make or confirm a diagnosis, relieve pain, reduce a symptom, improve function or prolong life, and treat some diseases and injuries. It can also be used for cosmetic reasons. Most surgeries are done to fix a health problem. Some are emergencies, like a ruptured appendix or sudden heart attack. Others are elective, which means you choose to have them for a non-life-threatening condition, such as mole or wart removal or kidney stones.
Some surgeries are very complex and require a long hospital or surgical facility stay. Others are done on an outpatient basis and can be completed in a day or two.
Before deciding to have surgery, it is important to carefully review your options with your doctor. This includes taking into account your medical history and the results of any tests you have had, such as blood work, X-rays, MRI or CT scan, colonoscopy, endoscopy or cardiac stress test. It is also a good idea to discuss your decision with family and friends. Depending on your situation, you may need to talk to a lawyer or someone else who can assist in making decisions about surgery.
What is the purpose of surgery?
Surgery aims to treat disease, restore health and improve quality of life. Advances in surgical science and technique have transformed the profession from a dangerous “art” into a discipline capable of treating a wide range of diseases.
While no surgery is without risk, the benefits of surgery greatly outweigh its complications. For example, surgery allows us to manage conditions such as heart disease, diabetes and cancer that would otherwise result in disability or even death.
Informed consent is a key aspect of safe surgical practice. It requires surgeons to explain the purpose of an operation in a way that is easily understood by patients. This is especially important for populations such as the incarcerated, mentally incompetent, and persons under coercion who may not be able to make informed decisions about their healthcare.
Patients also must understand that no surgery is a guarantee of cure. Surgery can cause side effects that limit the benefits of treatment, such as amputation and loss of movement in the affected limb. These side effects are known as sequelae.
Complications can range from mild to severe. A minor complication might be an infection that can be treated with antibiotics and does not affect the ultimate outcome of surgery, while a major complication might be a nerve or blood vessel injury that causes disability, loss of function or even death. As surgeon and public health researcher Atul Gawande writes, “No surgery is perfect. Complications are the inevitable consequence of an imperfect science.”
There are three phases to any surgical procedure: preoperative, operative and postoperative. The preoperative, or pre-op, phase begins with scheduling the procedure and ends when a patient enters the operating room. The operative, or surgery, phase is the actual procedure itself and the postoperative, or post-op, phase is when a patient leaves the operating room after recovering from anesthesia.
What are the risks of surgery?
Every medical procedure has risks, but surgery can be among the most dangerous. Infection, bleeding, and blood clots are common complications that occur after surgery. Some people have reactions to the anesthesia or other drugs used during the operation. In rare cases, doctors can injure an organ, such as the lungs, heart, or kidneys. Some people have nerve damage that can cause pain, numbness, or loss of movement in the arms, legs, or face. Others experience blood clots in the legs or lungs that can be life-threatening.
Preventing surgical complications requires careful patient selection, diligence during surgery, and rigorous infection control practices. It also means avoiding procedures that are not necessary. Surgical outcomes are improving thanks to better technology, high-volume centers, and progress in surgical education. However, surgical risk assessment remains a challenge because of the difficulty of accurately predicting immediate and long-term outcomes.
Patient-related factors, such as comorbidity, age, and the underlying disease process, increase the likelihood of postoperative morbidity and mortality. Surgeon-related factors include surgical complexity, experience, and the operative procedure chosen.
Other factors that affect risk include a person’s general health, such as smoking, blood pressure, and body size. Bleeding disorders, such as hemophilia, also increase the chance of bleeding before, during and after surgery. And some medications can cause problems, such as a reaction to anesthesia or the drug malignant hyperthermia, which causes the body’s temperature to rise too quickly and is life-threatening. It is important for you to talk openly with your healthcare provider about all the possible complications that can happen during and after your surgery. They will help you weigh the benefits against the risks so that you can decide if surgery is right for you.
How can I prepare for surgery?
Preparing for surgery can help you feel more comfortable as the day approaches. Learn as much as you can about your procedure and meet with members of your surgical team. This will include your surgeon and the expert who manages your pain during surgery, the anesthesiologist. Ask questions and express your concerns.
Your surgeon can give you specific instructions about what to do before and on the day of your surgery. For example, you may be asked to avoid eating anything after a certain time the night before or the day of your surgery. You may also be told to remove your jewelry and not wear lotion or perfume. You may be given a special wash (usually chlorhexidine) to kill bacteria on the skin before your surgery. This helps prevent surgical site infections.
Depending on the type of surgery you have, you might need to take antibiotics before your operation. If this is the case, be sure to follow your doctor’s instructions exactly.
You should also make arrangements for getting to and from the hospital as well as for staying home after your surgery. Make sure family and friends know your schedule, and arrange for someone to stay with you if necessary. If you have children, arrange for a friend or relative to care for them while you’re away.
If you don’t speak fluent English or have difficulty communicating, your surgeon can arrange for a free interpreter for you. This is important to ensure that you receive the best possible care.
How can I find a surgeon?
It’s important to choose a surgeon with a strong track record of successfully performing the procedure you need. You can ask colleagues, friends and family for recommendations, and many surgeons have websites with information about their practice and their surgical experience. Look for testimonials and pictures of patients before and after surgery. You should also consider the hospital or clinic where your surgery will be performed. It’s important to choose a surgeon that is affiliated with a respected center of excellence, and has a good reputation for patient safety and quality care.
When you meet with surgeons for an initial consultation, make sure you’re comfortable with them and that they take the time to answer your questions. Ask about their training, what kind of equipment they use and how much experience they have performing the type of procedure you need. Also, find out if they offer minimally invasive surgery (MIS), which can lead to faster recovery and less pain and scarring.
You should also make sure that your surgeon is board certified. This means they have completed a rigorous training program and passed an exam. You can also check out whether a surgeon has any financial ties to medical device or pharmaceutical companies, suggests Brownlee. This can help you avoid doctors who might push unnecessary or unsafe procedures in order to make money.
In addition, you should know that some hospitals and surgeons have higher complication rates than others. This may be due to factors such as the type of operation or patients who are most at risk for complications. If a surgeon has a high number of complications, it’s worth seeking out another option.
