Introduction

to surgery
Prof Oluwadiya Kehinde
Department of Surgery
Ekiti State University Teaching Hospital
www.oluwadiya.com
 What is surgery?
• Surgery is the medical specialty that uses
operative manual and instrumental
techniques on patients to investigate and treat
pathological conditions.
• Derived from Latin word, chirurgiae which
means "hand work"
• Aim is to help improve bodily function or
appearance
 Word Play
• The act of performing
surgery is called surgical
procedure
• It may also be referred
to as an operation
• Thus operation is
synonymous to surgery
• Operating….. is
equivalent to
performing surgery
 Word Play
• The word Surgical….is an adjective that means
pertaining to surgery
• Surgical ward: Wards in which surgical
patients are admitted
• Surgical instruments: Instruments used for
surgery
 Who is a surgeon?
• The surgeon is a
medical practitioner
who performs surgical
operations
• Usually, the person is a
specialist
• There are many types of
surgeons depending on
their sub-specialization
 Surgery Subspecialties
1. General surgery 7. Cardiothoracic surgery
2. Orthopaedic surgery 8. Paediatric surgery
3. Neurosurgery 9. Plastic surgery
4. Ophthalmology 10. Trauma surgery
5. Otolaryngology 11. Oral and maxillofacial
6. Urology surgery
 General surgery
• Colorectal surgery
• Vascular surgery
• Transplant surgery
• Breast surgery
• Surgical oncology
• Endocrine surgery
 Types of surgical procedures
• Broadly divided into two:
i. Elective surgery
ii. Emergency surgery
 Types of surgical procedures
• An elective surgery is done to correct a non-
life-threatening condition.
• Usually done either at the behest of the
patients or their relatives
• But timing is subjected to availability of time,
facilities and patient’s fitness
• Have the best outcomes
 Types of surgical procedures
• Emergency surgeries must be done quickly to
save lives, limbs, or preserve functions.
• They must be done even when conditions are
not optimal
• But even then, certain conditions need to be
fulfilled before they are done.
• Outcomes may not be as satisfactory as
elective surgeries
 Other terminologies
• Exploratory surgery: Done when a surgeon is
not sure of the diagnosis. It is done to aid or
confirm a diagnosis
• Biopsy: The surgical removal of a small portion
of tissue for diagnosis
 Other terminologies
• Biopsy: The surgical removal of part of, or the
whole tissue or organ for diagnosis. They are
of two types:
i. Incision biopsy: When only part of a tissue
or organ is removed. They are done when
the growth is considered malignant
ii. Excision biopsy: When the whole tissue is
removed. It is done when the condition is
considered benign
 Other terminologies
• Cosmetic surgeries are done to improve the
appearance of otherwise normal tissue
• Transplant surgery is the replacement of a
patient's diseased organ or body part with one
from another human (or animal).
 Other terminologies
• Endoscopic surgery is a
form of minimally
invasive surgeries
where small incisions
are made to use
miniaturized
instruments to perform
surgeries
Structure of surgery department

Surgery

General
Subspecialties
surgery

Paediatric
Firm I Firm II Orthopaedics Urology Plastic surgery Neurosurgery
surgery
Departmental Organogram
Consultants
Senior
Registrars

Registrars

House Officers

Students
 Surgical Postings
• Surgery I: Introduction to surgery. Mainly
through general surgery
• Surgery II: Postings through surgical
subspecialties
• Special Posting: Postings in departments allied
to surgeries
• Surgery III: Revision posting
• Department dues for each posting is N300
 Surgical Postings
• Students are distributed into general surgery
firms or special posting groups
• Each firm has different schedules.
• But most schedules consists of:
o Ward Rounds
o Outpatients
o Surgical procedures in the thearters
o Call duties in Accident and emergency wards
o Student presentations and seminars
 Student assessments
• Two ways
i. Continuous assessments
ii. Final Year Examinations
 Student assessments
• Continuous assessments
• Makes 30% of students overall assessment
• Spans S1 to S3
• Include the following:
i. Attendance
ii. End of posting Examinations
iii. Mock Final year examination
 Student assessments
• Attendance
o Very important
o Must make at least 75% of attendance to sit
for exam
o Consists of attendance at all departmental
and units’ activities
o Monitored by means of departmental log
books, which each student must have
 Student assessments
• Surgery Department logbooks
o Each student must have one
o This must be purchase at the beginning of
S1 posting.
o The same one is used for S2 and S3
o It must not be lost!
o Do not give it to others to submit for you.
This is examination fraud.
 Some Rules

• Students must be in the hospital by 7:30 am

• Students must respect the personnel above
them in the organogram
• They must also respect other health
professionals in the hospitals
 Rules
• Above all, empathize with patients. Show
them
– Respect
– Courtesy
Be
•Patient!! with them
 Rules: Dressing
• Modest Dressing
• In Ward Cloths
• Have your name tags
 Do’s of grooming

Acceptable Beards
 Don’ts of grooming
Unacceptable beards
 Hijab
Accetable Unacceptable
Don’ts of dressing
 Rules: Theater
• This is a very special
place
• It has its own mode of
dressing
• Its own codes of
conduct which is
designed to reduce the
possibilities of
infections
 Surgical Postings: Time table

Days Time Departmental Activities

Mondays 8am-9am Morning reviews
Wednesdays 3pm-5pm Departmental seminars
Everyday except Mondays 8am-10am Lectures
Everyday except 3pm-5pm Lectures
Wednesdays

Everyday including 5pm to 8pm Call duties in the Accident and

weekends Emergency Department
 Venues of departmental activities

Activities Venues
Seminars and Morning Reviews Pathology Seminar room
Lectures • Pathology Seminar room
• Theatre Lecture room
• Mortuary Lecture room
• Admin Block seminar room (Rarely)
Operative procedures Theatre
Clinics Consultant Outpatient Building
Ward rounds Wards
Call duties Accident and Emergency Ward
 Essential places
• Wards
 Essential places
• Outpatient Department
 Essential places
• Accident and Emergency
 Essential places
• Library
 Essential places
• Operating Theater
 Making Diagnosis
• Taking History
• Examination of the
patient
• Taking Investigations
 Making Diagnosis
Involves three main processes:
• History Taking
Process of communication by which information
is obtained from patients for the clinical
diagnosis of their illnesses.
• Physical Examination
Process of communication by which signs are
elicited in patients for the clinical diagnosis of
their illnesses
• Investigation
The use of instruments and tests to obtain
information to arrive at patients’ diagnosis
 Making Diagnosis
• The process of taking
history and examining
the patient is called
Clerking
 Some advice
• Learn to love the hospital
• It’s going to be your laboratory and classroom
 Some advice
• Make sure that you clerk and present at least
one patient per week
• Attend all lectures
• Attend all ward rounds
• Attend all clinics
 Penalties
• A student who fails to attend up to 75%of
departmental activities will not be allowed to
sit for examinations
• A student who is improperly dressed will not
be allowed to take part in departmental
activities
• A student who is late to the departmental
activity may be sent out or otherwise
punished
 Surgery is life

• Winning is overrated. The only time it is really

important is in surgery and war.”
Al McGuire
 Welcome to surgery
• Surgery is the red flower that blooms among
the leaves and thorns that are the rest of
medicine.
Tradeu
Thank You