General surgery

Source: Wikipedia, the free encyclopedia.
This article is about the surgical specialty. For goregrind band, see General Surgery (band).
A surgeon operating.
General surgeon
Occupation
Names
  • Physician
  • Surgeon
Occupation type
Specialty
Activity sectors
Medicine, Surgery
Description
Education required
Fields of
employment
Hospitals, Clinics

General surgery is a

gastroscopy, colonoscopy
and laparoscopic procedures.

Scope

General surgeons may sub-specialise into one or more of the following disciplines:[1]

Trauma surgery

Main article: Trauma surgery

In many parts of the world including

cricothyroidotomy, compartment fasciotomies and emergency laparotomy or thoracotomy to stanch bleeding. They are also called upon to staff surgical intensive care units or trauma intensive care units.[citation needed
]

All general surgeons are trained in emergency surgery. Bleeding, infections, bowel obstructions and organ perforations are the main problems they deal with.

appendix
and small bowel obstructions are other common emergencies.

Laparoscopic surgery

Main article:
Laparoscopic surgery

This is a relatively new specialty dealing with

obese
patients. General surgeons that are trained today are expected to be proficient in laparoscopic procedures.

Colorectal surgery

Main article: Colorectal surgery

General surgeons treat a wide variety of major and minor colon and rectal diseases including inflammatory bowel diseases (such as ulcerative colitis or Crohn's disease), diverticulitis, colon and rectal cancer, gastrointestinal bleeding and hemorrhoids.

Upper Gastrointestinal Surgery

General surgeons can specialise in Upper Gastro-intestinal (or foregut) surgery, which includes the surgical treatment of diseases of the stomach and oesophagus, liver, pancreas and gallbladder.[2] In the UK, Upper GI surgeons can subspecialise further as benign surgeons, dealing with hiatus hernias and gallbladder diseases, bariatric surgeons, providing surgical care for weight management and metabolic diseases, or oesophago-gastric surgeons, dealing with complex problems related to the upper gastrointestinal tract (the foregut), including cancer. Surgical care of complex liver and pancreatic problems (including liver cancer and pancreatic cancer) is undertaken by Hepatobiliary and Pancreatic Surgery sub-specialists.

Breast surgery

Main article: Breast surgery

General surgeons perform a majority of all non-cosmetic breast surgery from lumpectomy to mastectomy, especially pertaining to the evaluation, diagnosis and treatment of breast cancer.

Vascular surgery

Main article: Vascular surgery

General surgeons can perform vascular surgery if they receive special training and certification in vascular surgery. Otherwise, these procedures are typically performed by vascular surgery specialists. However, general surgeons are capable of treating minor vascular disorders.

Endocrine surgery

Main article: Endocrine surgery

General surgeons are trained to remove all or part of the thyroid and

kidney
in the abdomen. In many communities, they are the only surgeon trained to do this. In communities that have a number of subspecialists, other subspecialty surgeons may assume responsibility for these procedures.

Transplant surgery

Main article:
Transplant surgery

Responsible for all aspects of pre-operative, operative, and post-operative care of abdominal organ transplant patients. Transplanted organs include liver, kidney, pancreas, and more rarely small bowel.

Surgical oncology

Main article: Surgical oncology

Surgical oncologist refers to a general surgical oncologist (a specialty of a general surgeon), but thoracic surgical oncologists, gynecologist and so forth can all be considered surgeons who specialize in treating cancer patients. The importance of training surgeons who sub-specialize in cancer surgery lies in evidence, supported by a number of clinical trials, that outcomes in surgical cancer care are positively associated to surgeon volume (i.e., the more cancer cases a surgeon treats, the more proficient he or she becomes, and his or her patients experience improved survival rates as a result). This is another controversial point, but it is generally accepted, even as common sense, that a surgeon who performs a given operation more often, will achieve superior results when compared with a surgeon who rarely performs the same procedure. This is particularly true of complex cancer resections such as pancreaticoduodenectomy for pancreatic cancer, and gastrectomy with extended (D2) lymphadenectomy for gastric cancer. Surgical oncology is generally a 2-year fellowship following completion of a general surgery residency (5–7 years).

Cardiothoracic surgery

Main article: Cardiothoracic surgery

Most cardiothoracic surgeons in the U.S. (D.O. or M.D.) first complete a general surgery residency (typically 5–7 years), followed by a cardiothoracic surgery fellowship (typically 2–3 years). However, new programmes are currently offering cardiothoracic surgery as a residency (6–8 years).

Pediatric surgery

Main article: Pediatric surgery

Pediatric surgery is a subspecialty of general surgery. Pediatric surgeons do surgery on patients under age 18. Pediatric surgery is 5–7 years of residency and a 2-3 year fellowship.

Trends

In the 2000s,

minimally invasive surgery became more prevalent. Considerable enthusiasm has been built around robot-assisted surgery (also known as robotic surgery), despite a lack of data suggesting it has significant benefits that justify its cost.[3]

Training

In Canada, Australia, New Zealand, and the United States general surgery is a five to seven year

residency and follows completion of medical school, either MD, MBBS, MBChB, or DO degrees. In Australia and New Zealand, a residency leads to eligibility for Fellowship of the Royal Australasian College of Surgeons. In Canada, residency leads to eligibility for certification by and Fellowship of the Royal College of Physicians and Surgeons of Canada, while in the United States, completion of a residency in general surgery leads to eligibility for board certification by the American Board of Surgery or the American Osteopathic Board of Surgery
which is also required upon completion of training for a general surgeon to have operating privileges at most hospitals in the United States.

In the

Mrs' rather than doctor. This tradition dates back hundreds of years in the United Kingdom from when only physicians attended medical school and surgeons did not, but were rather associated with barbers in the Barber Surgeon's Guild. The tradition is also present in many Commonwealth countries including New Zealand and some states of Australia. After completion of phase 1 training, trainees may apply for a nationally awarded Higher Surgical Training (HST) programme, which lasts six years and is now divided into two further phases (phases 2 and 3). Trainees are expected to declare a sub-specialty before the end of phase 2, and training during phase 3 focusses on that sub-specialty. Before the end of HST, the examination for Fellowship of the Royal College of Surgeons (FRCS) must be taken in general surgery plus the subspeciality. Upon completion of training, the surgeon will be eligible for entry on the GMC Specialist Register. They may then apply to work both in the NHS and independent sector as a consultant surgeon, although many trainees complete further fellowships.[4] The implementation of the European Working Time Directive limited UK surgical residents to an average 48-hour working week.[5]

See also

References

  1. ^ "Surgery — General Specialty Description". American Medical Association. Retrieved 21 Sep 2020.
  2. ^ sitecore\[email protected]. "Surgical Specialties". Royal College of Surgeons. Retrieved 2024-03-14.
  3. PMID 16400356
    .
  4. ^ sitecore\[email protected]. "Surgery Entry Requirements and Training". Royal College of Surgeons. Retrieved 2024-03-14.
  5. PMID 22925631
    .

External links
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