The field of surgery encompasses a total of eight different subfields, all of which deal with the surgical, i.e. invasive, treatment and follow-up treatment of complaints, injuries or diseases of different body regions and body components. For example, while the visceral surgeon is concerned with the surgical treatment of organs of the abdominal cavity, the thoracic surgeon is responsible for the invasive treatment of the lungs, bronchi and other parts of the chest cavity. Surgical procedures usually take place under general or local anesthesia and thus involve stress on the lungs, heart, and kidneys, which poses an increased surgical risk especially for patients with disease of these organs.
What is surgery?
The field of surgery encompasses a total of eight different subfields, all of which deal with the surgical, or invasive, treatment and follow-up care of ailments, injuries, or diseases of various body regions and body components. Surgery is a medical subfield that develops surgical solutions for injuries and diseases. Surgical interventions already existed in the Stone Age, for example in the form of amputations. Since then, of course, surgery has evolved, anesthesia has been introduced and, most importantly, its hygiene standards have improved to minimize the risk of infection or even sepsis. While patients often died during surgical procedures in the distant past, much of today’s surgery involves minimal risk, as many surgical procedures are part of a hospital’s daily routine. Today, there are a total of eight different specialties of surgery, each of which the physician can specialize in during training. In addition to general surgery, vascular surgery and cardiac surgery, for example, pediatric surgery, orthopedics and trauma surgery are important orientations, but plastic surgery, thoracic surgery and visceral surgery are also surgical subspecialties.
Function, effect, and goals
Each subfield of surgery is responsible for different symptoms and each includes its own surgical methods for treatment. Therefore, a blanket statement about the areas of application in this case is nearly impossible. One of the most important tasks of vascular surgeons, for example, is the creation of vascular bypasses, which restore blood circulation in cases of arterial occlusion. In contrast, the layperson often associates heart transplants with cardiac surgery. In fact, however, the coronary artery bypass forms the heart of cardiac surgery, a blood vessel bridge in the event of an occlusion of the coronary artery at the heart muscle. In pediatric surgery, the focus is again on the surgical treatment of urological diseases, organ tumors or injuries in childhood. Orthopedic surgeons and trauma surgeons treat malformations and diseases of the musculoskeletal system, including skeletal disorders and complaints of the musculature, ligaments or tendons. Bone fractures are one of the most frequent areas of application for orthopedists and trauma surgeons. Plastic surgery, on the other hand, is aesthetic or reconstructive. For functional or cosmetic reasons, plastic surgeons thus intervene to change the shape of organs or parts of tissue. Thoracic surgery, on the other hand, is concerned with malformations and diseases of the lungs, bronchi, pleura or thoracic wall and mediastinum. Especially in the case of tumor diseases of the mentioned areas, the patient is referred to a thoracic surgeon. Despite these and many other differences, all surgical procedures have the invasive approach in common. Endoscopy and related procedures are considered minimally invasive procedures with the least amount of skin and soft tissue injury. They are particularly relevant to visceral surgery, which deals with surgical treatments of the abdominal organs. Regardless of the subspecialty, the patient is placed under anesthesia prior to any surgical procedure. In addition to general anesthesia, local anesthesia may also be considered. Where exactly the doctor opens the patient’s body during the operation, takes something out or inserts something depends on the clinical picture. Various methods are now available even for bone incisions, including the laser procedure, for example. Regardless of which method is used for which purpose, they all have sterile work in common.Therefore, all surgical procedures have in common disinfection of the surgical field, instruments, operating physicians and the patient.
Risks, side effects, and hazards
Ultimately, each individual surgery is related to specific risks and side effects that cannot be generalized. For example, the greatest risk of plastic surgery is usually implant rejection, while for vascular surgery, bleeding and clot formation play an increased role. Despite such differences, however, some risks apply to any surgical procedure. These include, for example, the risk of infection, but this is forced down to a minimum by an experienced and competent physician. Open surgery in particular carries an increased risk of sepsis, i.e. the risk of systemic blood poisoning or inflammatory reaction due to bacteria or fungi. However, given the current state of medicine, this risk also occurs only rarely, especially in Western countries. Some dispositions may prevent a surgical procedure under certain circumstances. In principle, surgical procedures are not indicated for people with existing inflammations, for example. Therefore, the doctor takes blood samples before an invasive procedure. If elevated levels of inflammation are thus suspected of being active, it must heal completely before surgery is performed. Every surgical procedure puts a strain on the heart, lungs and kidneys. The extent of this stress depends in each case on the type and duration of anesthesia. If the heart, lungs or kidneys themselves are affected by disease, the patient faces an increased risk of anesthesia and surgery. The same applies to people who are overweight, regardless of existing diseases.
