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 ancient Greece, and today a surgical operation is a different effect on living tissue, during which the function of the whole organism is adjusted. During the operation, the tissues are disconnected, moved and connected again.
Background
The first mention of surgical interventions dates back to the VI century BC. e. Since the beginning of the century, people have stopped bleeding, looked after wounds and cut off fragmented or gangrene-affected limbs. Historians of medicine know that long before our era, then healers were able to perform trepanation of the skull, immobilize broken bones and even ... remove the gall bladder.
All textbooks on the history of medicine have an ancient statement that there is a knife, grass and a word in the doctor’s arsenal. From ancient times to the present day, the knife - now its analogues, of course - is in the first place. Surgery is the most radical method of treatment, allowing a person to get 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 treasured in Vinnitsa. His former estate is still taken care of by relatives of those whom he healed and saved from death. Once the great surgeon helped his neighbors without payment - and they still remember him. Pirogov removed the gall bladder in 40 seconds, his hands can be seen in the tomb - with long and thin fingers.
Anesthesia or anesthesia
Any operation is primarily a pain. Living tissue reacts to pain with spasm and poor blood circulation, so removing pain is the first task during surgery. We have heard historical information about what our ancestors used to anesthetize: decoctions of plants containing narcotic substances, alcohol, marijuana, cold and vascular pressure.
A breakthrough in surgery occurred in the middle of the 19th century, when nitrous oxide, diethyl ether, and then chloroform were discovered. Since that time, general anesthesia began to be used . A little later, surgeons drew attention to cocaine in the sense that this substance anesthetizes tissues locally. The use of cocaine can be considered the beginning of local anesthetic and conduction and infiltration.
The discovery of muscle relaxants or substances capable of immobilizing muscles belongs to the middle of the last century. Since that time, anesthesiology has become a separate medical science and specialty, inextricably linked with surgery.
Modern surgery is a complex of techniques from various branches of medicine. We can say that this is a synthesis of knowledge accumulated by medicine.
Surgery: types of operations
Classifications of operations are distinguished by the nature of the intervention, urgency and staging.
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 colorectal cancer self-defecation is not possible, and the surgeon displays the healthy part of the rectum on the anterior abdominal wall. Depending on the general condition of the patient, the tumor is removed simultaneously or later. This species is adjoined by palliative, also eliminating a variety of complications.
Urgent and planned operation
Sometimes a patient needs an urgent surgery. Types of emergency operations are performed as quickly as possible, they are required to save lives. This is a tracheotomy or conicotomy to restore airway patency, puncture of the pleural cavity with life-threatening hemothorax and others.
Emergency surgery can be delayed for a maximum of 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 operatively.
A planned operation is performed when there are no other ways to improve the state of health, 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. Also planned is the removal of cysts and benign tumors.
Surgical operation: types of operations, stages of a surgical operation
In addition to the above, by type of operation, the operation can be single-stage or multi-stage. In several stages, reconstruction of organs after burns or injuries, transplantation of a skin flap to eliminate tissue defect can take place.
Any operation is performed in 3 stages: performing surgical access, prompt admission and exit. Access is the opening of a painful focus, dissection of tissues for the approach. Reception is actually the removal or movement of tissues, and the output is the stitching of all tissues in layers.
The operation on each organ has its own characteristics. Thus, brain surgery most often requires trepanation of the skull, because to access the substance of the brain, you must first open the bone plate.
At the operative exit stage, blood vessels, nerves, parts of the hollow organs, muscles, fascia and skin are connected. All together constitutes a postoperative wound that requires careful care before healing.
How to reduce the trauma of the body?
This question worries surgeons of all time. There are operations that are comparable in trauma to the disease itself. The fact is that not every organism is able to quickly and well cope with injuries sustained during surgery. In places of incisions, hernias, suppurations, dense, non-absorbable scars that violate the functions of the organ are formed. In addition, sutures may diverge or bleeding from injured vessels may open.
All these complications force surgeons to reduce the size of the incision to a possible minimum.
So 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 organs and tissues located under the skin through a video camera placed on the endoscope. Manipulators or small tools are placed there: forceps, loops and clamps, with which help remove diseased tissue sites or entire organs.
Endoscopic operations began to be massively used from 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, with which blood circulation is maintained throughout the body. After the operation, the blood returns to its natural course.
A very complex process is such a surgical operation. Types of operations, its stages are determined by the specific state of the body. This approach avoids blood loss and the need to use donated blood. Such an intervention was made possible at the junction of surgery with transfusiology - the science of donated blood transfusion.
Foreign blood is not only salvation, but also foreign antibodies, viruses and other foreign components. Even the most thorough preparation of donated blood does not always avoid negative consequences.
Vascular surgery
This section of modern surgery has helped save many lives. Its principle is simple - restoration of blood circulation in problem vessels. With atherosclerosis, heart attacks or injuries, obstacles arise in the path of blood flow. This is fraught with oxygen starvation and, as a result, death of cells and tissues consisting of them.
There are two ways to restore blood flow: by installing a stent or shunt.
A stent is a metal frame that extends the walls of a vessel and prevents its spasm. A stent is installed when the walls of the vessels are well preserved. A stent is often installed in relatively young patients.
If the walls of the vessels are affected by an atherosclerotic process or chronic inflammation, then it is already impossible to push them apart. In this case, create a workaround or shunt for blood. To do this, take part of the femoral vein and bleed through it, bypassing an unusable area.
Shunting for beauty
This is the most famous surgical operation, photos of people who have undergone it appear 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 portion of the stomach bordering the esophagus, containing no more than 50 ml of food. The small intestine joins it. The duodenum and the intestine following it continue to be involved in the digestion of food, as this section joins below.
After such an operation, the patient can eat little and lose up to 80% of the previous weight. A special diet enriched with protein and vitamins is required. For some, such an operation really changes their lives, but there are patients who manage to stretch the artificially formed ventricle to almost the same size.
Surgical miracles
Modern technology makes it possible to perform real miracles. In the news every now and then flicker messages about unusual interventions that ended in success. So, most recently, Spanish surgeons from Malaga performed a patient’s brain surgery, during which the patient played the saxophone.
French specialists have been performing face tissue transplants since 2005. Following them, the maxillofacial surgeons of all countries began to transplant the skin and muscles on the face from other parts of the body, restoring the appearance lost after injuries and accidents.
Perform surgery even ... in the womb. Cases are described when the fetus was removed from the uterine cavity, the tumor was removed, and the fetus returned. Born on term full-term healthy baby is the surgeon's best reward.
Science or art?
It is difficult to unequivocally answer this question. Surgery is an alloy of the surgeon's knowledge, experience and personal qualities. One is afraid to take risks, the other does 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 Carrell for work on the vascular suture and organ transplantation. Since then, over 100 years of surgical advances have not won the interest of the Nobel Committee. However, every 5 years in surgery, technologies appear that dramatically improve its results. Thus, rapidly developing laser surgery allows you to remove intervertebral hernias through tiny incisions, "vaporize" the prostate adenoma, and "solder" the thyroid cysts. The absolute sterility of the lasers and their ability to weld blood vessels give the surgeon the opportunity to treat many diseases.
Today, a real surgeon is called not by the number of awards and bonuses, but by the number of saved lives and healthy patients.