General Surgical
Considerations
Dr. Ramy Ibrahim
Dr. Ahmed Noshy
Dr. Mostafa Abd-El Aziz
Lecturers of General Surgery
Introduction
In addition to
surgeons and other
therapeutic
professionals, In many
nurses have a situations,
pivotal role.nurses are the
first contact for
patients and
This requires
face not only
advanced the illness
professional nursing related
qualification and complications,
expertise in the field.
but also all
other issues the
patients
experience
during their
Introduction
Nurses assist
patients to achieve Furthermore,
the activities of daily medical treatments,
living, which are such as wound care
normally limited or and drug therapy,
impossible after also require high
surgery such as competencies in
personal hygiene or nursing.
mobility.
Types of Surgery and its specialties
General surgery
General surgeons manage a broad
spectrum of surgical conditions that
involve almost any part of the body
including Abdomen and GIT surgeries .
Cardiothoracic surgery
A major surgical specialty with very
high demands , pathologic conditions
within the chest, including the heart
and its valves, cancers of the lung, and
chest wall, and chest vessels.
Types of Surgery and its specialties
Neurosurgery
Neurosurgical teams specialize in surgery
of the nervous system, including the
brain, spine, and peripheral nervous
system, and their supporting structures.
Oral and maxillofacial surgery
Head and neck surgical teams provide
treatment for problems of the ears,
sinuses, mouth, pharynx, jaw, and other
structures of the head and neck.
Orthopedic surgery
where fixation of limb fractures ,
insertion of protheses, and managing
joints diseases .
Types of Surgery and its specialties
Reconstructive and plastic
surgery
Reconstructive surgery is
performed on abnormal structures
of the body due to injury, birth
defects, infection, tumors, or
disease. Cosmetic surgery is
performed to improve a patient's
appearance.
Transplantation
Transplant surgical teams specialize
in specific organ transplant
techniques, such as heart, heart-
lung transplants, liver transplants,
and kidney transplants and
pancreas transplants. These highly
intricate surgeries require very
advanced training and
Types of Surgery and its specialties
Urology
Urinary tract and problems associated
with external genitalia dysfunction and
trauma.
Vascular surgery
Vascular surgery offers diagnosis and
treatment of such arterial and venous
disorders as aneurysms, lower extremity
revascularization, and other problems.
Pediatric surgery
Pediatric surgical teams are specially
trained to treat a broad range of
conditions affecting infants and children.
childhood diseases of the head, neck,
chest, and abdomen, birth defects and
Types of anaesthesia
General anesthesia: renders the patient unconscious during
surgery. The anesthesia is either inhaled or given intravenously. A
breathing tube may be inserted into the trachea to facilitate
breathing. The patient is carefully monitored and wakes up in the
recovery room .
Regional anesthesia: numbs the surgical section of the body.
This is usually accomplished via injection through the spinal canal
(spinal anesthesia) or through a catheter to the lower part of the
back (epidural). Regional anesthetics numb the area of the nerves
that provide feeling to the designated part of the body.
Local anesthesia: medicates only the direct operative site, and
is administered through injection. The patient remains conscious
during the operation.
CATEGORIES OF SURGICAL CARE
When life,
E.g.
limb or organ- Expected
saving location: next * Repair of
Normally it
intervention is available ruptured
occurs within
I) required and operating aortic
minutes of
Immediate resuscitation
decision to
theatre, if aneurysm
is performed required
operate. * Laparotomy
simultaneous “break-in” to
for control of
with existing lists
haemorrhage
intervention.
CATEGORIES OF SURGICAL CARE
Intervention for
acute onset or
clinical deterioration E.g.
Expected location:
of life, limb or organ
day time * Debridement plus
survival. Normally it
II) Urgent occurs within hours
“emergency” list or fixation of fracture
Out-of-hours
of decision to * Laparotomy for
emergency theatre
operate and once perforation
resuscitation is
completed.
CATEGORIES OF SURGICAL CARE
When a patient
Expected E.g.
is stable but
Location:
requires early * Retinal
Normally it Elective list
III) intervention
occurs within with “spare”
detachment
for a condition
Expedite that is not an
days of capacity or Day * Excision of
decision to time tumour with
d immediate
operate. “emergency” potential to
threat to life,
list (except at bleed or
limb or organ
night). obstruct
survival.
CATEGORIES OF SURGICAL CARE
E.g.
Surgical Expected
It occurs all other
procedure Location:
within a conditions
planned or Elective
planned time
IV) booked in theatre list not classified
that suits as immediate,
Elective advance of
patient,
(after being
urgent, or
routine booked and
hospital and expedited;
admission to planned prior
staff. example,
hospital. to Admission).
Cystoscopy
Key principles in Surgical care
Privacy and respect for the patient are mandatory.
Surgery and Anaesthesia will not be performed without the consent of
the patient or, if incapable, his representative.
Surgery is intrinsically linked to Anaesthesia and vice versa. Surgical
activities cannot be performed without the presence of an
anaesthesia service.
Before starting surgery and anaesthesia activities, a number of
requirements should be assured.
Key principles in Surgical care
Emergency Preparedness is essential, in order to respond to any catastrophe, regardless of its extent (e.g. traffic
accident, multiple casualty incident, etc.) to keep ensuring the following:
Maintenance of skills by assuring routine surgery.
Permanent availability of a minimum number of instruments sets, materials / disposables and drugs for
the most prevalent emergency procedures.
Well-functioning sterilization department.
Regular review and updating of the Multiple / Mass Casualty Plan for large influx of patients.
Quality Control; Assurance of quality and efficacy of the surgical and anaesthetic activities should be
respected in every project.
Appropriate record keeping (documentation) in patients’ files, anaesthesia and surgical records.
