SURGERY INTODCUI

1. SURGERY
SOLOMON MUTINTA KAYASA

2. COMMON TERMINOLOGIES USED IN SURGERY
AND SURGICAL NURSING
• Surgeon: A physician or medical officer who is specially
trained and qualified to perform operations and practice
surgery (Brooker, 2008)

3. • Anaesthetist: A technician or nurse who is trained to
administer anaesthetics (Saunders, 2009)
• Anaesthesia: The loss or absence of sensation or feeling.
Commonly used to describe a reversible process which
operations and painful or unpleasant procedures to be
performed without distress to the patient( black’s medical
dictionary, 2004)

4. • Anaesthesiologist: This is the doctor who is trained to
administer anaesthetics (Encarta, 2009)
• Surgical Operation: The procedure which involves the use of
the hands and surgical instruments (Phillips, 2012)
• Peri-Operative: This is the period before, during and after
surgical operations (Encarta, 2009)

5. • Preoperative Phase: This is a period from the time when the
decision is made for surgery.
• Intra Operative Phase: This is the period the patient is
brought to the operating room until admission to the
recovery room.
• Post Operative Phase: This is the period from the admission
to the recovery room after operation to the follow up clinic
for evaluation and rehabilitation at home.

6. • -Otomy: Surgical incision or cut into organs e.g.
gastrostomy is a surgical incision made on the stomach
(Encarta, 2009)
• -Ectomy: Surgical removal of segment of or all of an
organ or part, e.g., Gastrectomy is surgical removal of the
stomach (Saunders, 2009)

7. • Incision – Surgical cutting of soft tissues or muscle with a
knife or scapel (Brooker, 2008)
• Excision: This is the surgical removal of an organ or
tumour from the body (Elsevier, 2009)
• Lapa: Refers to abdomen (Pudner, 2010)
• Rrhaphy: Repair e.g. herniorrhaphy (Hughes & Mardell,
2009)

8. • Plasty: Indicates plastic surgery; which is a branch of surgery
dealing with reconstruction of parts of the body deformed,
for example, after severe burns (Hughes & Mardell, 2009)
• Consent: Permit from patient or relatives or authorized
personnel to allow surgery to proceed (Hughes & Mardell,
2009)

9. • Stoma: Mouth-like opening, particularly an incised
opening which is kept open for drainage or feeding, etc
e.g. colostomy opening (Encarta, 2009)

10. • Anastomosis; Communication between two normally
distinct spaces or organs
• Artificial connection between two tubular organs or parts,
especially between two normally separate parts of the
intestine or two blood vessels to allow for continuity e.g.
gastrojejunostomy is the surgical joining or connection of
stomach and the jejunum (Brooker, 2008)

12. • Amputation: Surgical removal of the limb or other
appendage of the body (Encarta, 2009)
• Baseline: A value representing a normal background level
or an initial level of a measurable quantity and used for
comparison with values representing response to an
environmental stimulus or intervention (Saunders, 2009)

13. • Haemostasis: This is the stoppage of bleeding during
surgery, either by use of suturing material or diathermy
(Phillips, 2000)
• Operating Theatre Ventilation: This is the ideal ventilation
control system from within the operating theatre which
brings in filtered air free from bacteria and dust and
contaminated air (Phillips, 2000)

14. • Scrub Nurse: This is a nurse who participates as a member
of the surgical operation scrub up team and works with
surgeon (Phillips, 20009)
• Runner Nurse/circulating nurse: This is a nurse who
circulates or helps the scrub nurse in handing the required
items intra operatively and also participates in the swab
count policy (Phillips, 2009)

15. • Impairment: loss or abnormality of psychological,
physiologic, or anatomic structure or function at the organ
level (e.g., dysphagia, hemiparesis); an abnormality of
structure, appearance, and organ or system function
resulting from any cause. For example; a person who
see, cannot hear, or cannot move a limb because of some
injury or defect in the organ or limb, has impairment.

16. • Disability: restriction or lack of ability to perform an
activity in a normal manner; the consequences of
impairment in terms of an individual’s functional
performance and activity—disabilities represent
disturbances at the level of the person (e.g., bathing,
dressing, communication, walking, grooming)

17. • Handicap: This results when an individual is placed at an
actual or perceived disadvantage in the performance of
normal life functions because of personal or societal
expectations and attitudes towards the impairment.
• In short, handicap is disadvantage experienced by a person
a result of impairment and disability e.g. prone to accidents.

18. ILLUSTRATIONS

20. • Prosthesis: Artificial substitute for a missing body part
(such as an arm, leg, breast, and eye) used for functional
or cosmetic reasons.
• Swab Count: This is one of the Policies in Operating
theatre which is very critical and involves counting of
swabs, needles and surgical instruments to prevent
accidental leaving of the items inside body cavities
(Phillips, 2012)

21. • A Clean Procedure is one in which there is no contact with
pus.
• A Dirty procedure is one where there is pus and is divided
into.
• Sterile field :This is the aseptic area provided on the place
where a surgical operation will be performed by use of sterile
draping.
• Surgical asepsis; is the exclusion of all microorganisms

22. PRINCIPLES OF GENERAL SURGERY
• When providing nursing care to patients with surgical
conditions, you should base the general principles of surgery
on the following ‘Safe Surgery’ challenge policy statements
adopted by the World Health Organisation (WHO)

23. SAFE SURGERY SAVES LIVES
• The goal of the Safe Surgery Saves Lives Challenge is to
improve the safety of surgical care around the world by
ensuring adherence to proven standards of care in all
countries.

24. PRINCIPLES
• Make sure that all equipment to be used in a surgical procedure is
sterilized or high level disinfected.
• Start with clean procedures and end with dirt ones
• Always begin with serious cases then proceed to the non urgent
ones
• Start with children first and end with adults

25. CONTI’D….
• All the procedures must be done 30 minutes to an hour after
cleaning the operating environment.
• Wash hands before and after each and every procedure
• Ensure that you put on protective garments before entering the
operating room.

26. LETS TAKE A BREAK!!!!!

27. TYPES OF SURGERIES
• Surgical procedures are commonly categorized by
urgency, type of procedure, body system involved, the
degree of invasiveness, and special instrumentation.

29. THERE TWO MAIN CLASSES OF SURGERY
•Major surgery
•Minor surgery

30. MAJOR SURGERY
• Major surgeries are usually extensive and warrant an
overnight or extended stay in a hospital.
• These surgeries include extensive work such as entering a
body cavity, removing an organ or altering the body’s
anatomy. E.g Open Cholecystectomy,nephrectomy,
hysterectomy,radical mastectomy, Laparotomy etc.

31. MAJOR CONT’D…
• Patients undergoing major surgeries usually require
anesthesia or respiratory assistance and sometimes even
both.
• Examples of major surgery include cardiac operations, any
bowel cavity operations, reconstructive surgery, deep tissue
procedures, any transplant procedures, as well as any
surgeries in the abdomen, chest or cranium.

32. MINOR SURGERY
• Minor surgeries are generally superficial and do not
require penetration of a body cavity. They do not involve
assisted breathing or anesthesia and are usually
performed by a single doctor.
• Examples of minor surgeries include biopsies, repairs of
cuts or small wounds, and the removal of warts, benign
skin lesions, hemorrhoids or abscesses.

33. EMERGENCY SURGERY
• This is a type of surgery done without delay in the interest of
the patient’s survival. The patient requires immediate
attention as the disorder may be life threatening.
• Examples include severe bleeding (haemorrhage), intestinal
or urinary bladder obstruction, fractured skull, gun short or
stab wounds, extensive burns etc.

34. URGENT SURGERY
• This is the type of surgery done within 24 – 30 hours.
• The patient requires prompt attention because if delayed a bit
longer may cause worsening (complications) in the condition
and thus may require more complicated procedures; e.g.
acute gall bladder infection, kidney or ureteral stones.

35. REQUIRED SURGERY
• This is the type of surgery done within a few weeks or
months.
• The patient needs to have surgery at a coming stage as
there is no immediate threat to life and complications are not
eminent; e.g. prostatic hyperplasia without urinary bladder
obstruction, thyroid disorders, cataracts etc.

36. ELECTIVE SURGERY
• This is a type of surgery which is usually planned and
whereby failure to do it has no immediate catastrophic
end.
• Thus the patient should be operated on anyway; e.g.repair
of scars, simple hernia, vaginal repair etc.

37. OPTIONAL SURGERY
• This is a type of surgery done for personal preference.
The decision entirely rests with the patient; e.g. cosmetic
surgery.

38. DIAGNOSTIC SURGERY
• This is a type of surgery done for diagnostic purposes; e.g.
biopsy, exploratory laparotomy, broncoscopy, endoscopy
etc.

39. ABLATIVE SURGERY
• Surgeries to remove a diseased body part eg ,appendectomy,
amputation.

40. PALLIATIVE SURGERY
• This is a type of surgery that is done to relieve the
symptoms or effects of a surgical problem without
necessarily total removal of the causative factors; e.g. relief
of pain, insertion of a nasogastric tube for failure to
swallow, gastric distension, colostomy, nerve root
resection etc.

41. COSMETIC/RECONSTRUCTIVE SURGERY
• This is a type of surgery done for the purpose of
beautification or alteration in the natural make up of
individuals.
• The indication is recognised by the person concerned; e.g.
mammoplasty, facelift, Scar revision, plastic surgery,
internal fixation of a fracture,breast reconstruction etc.

42. REPARATIVE SURGERY
• This is a type of surgery where repairing is done due to
damage of the normal structure; e.g. repair of multiple
wounds, ruptured uterus or urinary bladder, etc.

43. CONSTRUCTIVE SURGERY
• Surgeries to restore functions in congenital anomalies.
Examples
• Cleft lip Repair
• Closure of Atrial Septal Defect

44. CONCLUSION
• Surgery is the art and science of treating diseases, injuries
or deformities by operation or instrumentation.
• Classification of types of surgery is based on Urgency, risk
and Purpose.

45. REFERENCES
• Doenges, M. E., Moorhouse, M. F. and Murr, A. C. (2010). Nursing Care Plans:
Guidelines for Individualizing Client Care Across the Life Span, 8th edition,
Philadelphia: F. A. Davis Company.
• Lewis, S. L., Dirksen, S. R., et. al. (2014). Clinical Companion-Medical-Surgical-Nursing,
Assessment and Management Of Clinical Problems, 9th Edition, St. Louis; Elsevier
• Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Butcher, L., & Harding,M. M. (2017)
Medical-Surgical Nursing: Assesment and Management of Clinical Problems, 10th
Edition, St. Louis: Elsevier.
• Kumar, V., Abbas, A., & Aster, J. (2007). Robbins and Cotran Pathological Basis of
Disease, 9th Edition, Philadelphia, Saunders.
• Smeltzer, C. S., Brunner, L. S.,(2010) Brunner and Suddarth’s Textbook of Medical-
Surgical Nursing, 12th Ed, Wolters Kluwer Health / Lippincott Williams & Wilkins
Philadelphia:.