​Surgery are techniques involving manual and instruments.

• Investigation
• Treatment of diseases (or injuries)
• To improve bodily function
• For appearance
• Remove unwanted areas (e.g. perforated ear drum)

Nothing by mouth (NBM, aka Nil by mouth, Nil per os, NPO) is instruction to withhold oral food and fluids, with the exception of very small drink of water to take with their usual medication. Otherwise, if the Pt accidentally ingests food or water, the surgery would usually be cancelled, or postponed for at least 8 hours. It is used to:

• Prevent aspiration pneumonia (due to general anesthetic, or weak swallowing musculature)
• GI bleeding, GI blockage
• Acute pancreatitis
• Alcohol overdose that results in vomiting, or severe external bleeding

Scrubbing in is the preparation done before surgery. Remember at ALL times to keep hands higher than elbows at all times. The 1st scrub continues for 5 minutes, followed by 3 minutes subsequently:

• First 2 minutes, only required for the 1st scrub (1st minute):
  • Dispose of nail cleaner
  • Clean fingernails under running water
  • Brush fingers, hands, and forearms, to 2.5cm ABOVE the elbows, paying particular attention to finger surfaces, webbing of the fingers, palms, sides, back/front of hands
  • Brush nails
  • Remove dirt from under finger nails
  • Apply cleanser to fingernails
  • Discard fingernail cleanser into sharps, and nail brush into the bin
  • Open brush packet and rest near tap
• Minutes 3-5, or as soon as nails are done:
  • Apply cleanser to foam hands, and with rotating movements cleansing the forearms in ONE direction only
  • Wash and rinse hands and forearms thoroughly
  • And, repeat once

Source: QLD Health

• By urgency/timing, including:
  • Elective surgery, done to correct a non-life threatening condition, carried out at the Pt's request, subject to the surgeon's/facility's availability
  • Emergency surgery, which must be done promptly to save life, limb, or functional capacity
  • Semi-elective surgery, which must be done to avoid permanent disability/death, but can be postponed for a short time
• By purpose, including:
  • Exploratory surgery, performed to aid/confirm a Dx
  • Therapeutic surgery, to Tx a previously Dx condition
• By type of procedure, including:
  • Amputation, involves cutting off a body part, usually a limb or digit
  • Resection, is removal of all or part of an internal organ, or part of the body
  • Replantation, involves reattaching a severed body part
  • Excision (-ectomy), which involves cutting out an organ, tissue, or other body part from the Pt
  • Reconstructive surgery (-oplasty), involves reconstruction of an injured, mutilated, or deformed part of the body
  • Cosmetic surgery (-oplasty), done to improve thea pearance of an otherwise normal structure
  • Transplant, which is the replacement of an organ or body part by insertion of another from a different human (or even animal) into the Pt
• By body part, including:
  • Cardiac surgery, performed on the heart
  • GI surgery, performed on the GI tract
  • Orthopedic surgery, performed on bones/muscles
• By degree of invasiveness, including:
  • Minimally-invasive surgery (-oscopy), involving small incisions to insert miniaturized instruments within a body cavity or structure
  • Open surgery (-otomy), involving a large surgical incision to access the area of interest
• By equipment used, including:
  • Laser surgery, involving use of a laser for cutting tissue instead of a scalpel
  • Microsurgery, involving use of an operating microscope to see small structures
  • Robotic surgery, using a surgical robot

• Minimally invasive procedures
• Forming a stoma (i.e. permanent or semi-permanent opening, -ostomy)
• Repair of damaged or congenital abnormal structures (-rraphy)

• Suction, used to vacuum debris and fluid

Perioperative mortality, which is defined as death within 2 weeks of a surgical procedure.

• Intraoperative complications, include:
  • Complications during surgery, e.g. bleeding or perforation of organs may have lethal sequelae
  • Mistakes (fracture, perforation, sexual dysfunction, artery/nerve injury, incision hernia)
  • Allergies
• Postoperative complications, including:
  • Chronic pain
  • Recurrence
  • Thrombosis/hemorrhage/DVT/shock
  • Systemic Sx (fatigue)
  • Muscle atrophy
  • Anesthetic side effects (sore throat, sleepiness, confusion/delirium, spinal cord injury)
  • Infection
  • Postoperative fever
  • Disordered wound healing

• Postoperative fever
• Delirium
• Postoperative oliguria