This document provides an overview of surgical nursing for adult surgery. It defines surgery and describes different types of surgeries based on timing, purpose, procedure, invasiveness, equipment used, body part, and transplant status. Surgical terminology is explained, including procedures, techniques, and roles in the perioperative process. The duties of surgical nurses are outlined for pre-operative, intra-operative, and post-operative care. Surgical nurses can specialize and have roles as scrub nurses, who set up tools and assist during surgery, or circulating nurses, who oversee safety and supply needs during procedures.

1. Introduction of surgical
nursing for adult
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2. surgery
• Surgery (from the Greek cheirourgikē
(composed of "hand", and "work meaning
"hand work")
• Is medical specialty that uses operative manual
and instrumental techniques on a patient to
investigate or treat a pathological condition
such as disease or injury, or to help improve
bodily function or appearance.
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3. Types of Surgery
Based on timing:
• Optional/Elective surgery:
The condition is not life threatening. The client may
choose whether or not to have the surgery.
Examples include plastic surgery
• Required/ Nonelective:
The surgery is necessary at some time. The client
has some choice as to when the procedure will be
done. Examples are hernia repair and hip joint
replacement.
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4. Types of Surgery
• Urgent/Nonelective:
The surgery must be performed within a short time,
to prevent further damage to the client.
Examples are removal of a malignancy and removal
of an inflamed appendix.
• Emergency:
The surgery must be performed immediately to
save the client’s life.
Examples are severe internal hemorrhage, ruptured
appendix, and angioplasty after a heart attack.
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5. Types of surgery
• Based on purpose:
• Exploratory surgery is performed to aid or
confirm a diagnosis.
• Therapeutic surgery treats a previously
diagnosed condition.
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6. Types of surgery
• By type of procedure:
• Amputation involves cutting off a body part,
usually a limb or digit
• Replantation involves reattaching a severed
body part.
• Reconstructive surgery involves
reconstruction of an injured part.
• Cosmetic surgery is done to improve the
appearance of an otherwise normal structure
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7. Types of surgery
By degree of invasiveness:
• Minimally invasive surgery involves smaller
outer incision(s) to insert instruments within a
body cavity or structure, as in laparoscopic
surgery or angioplasty.
 open surgical procedure or laparotomy
requires a large incision to access the area of
interest.
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8. Types of surgery
By equipment used:
• Laser surgery involves use of a laser for
cutting tissue.
• Microsurgery involves the use of an
operating microscope for the surgeon to
see small structures.
• Robotic surgery makes use of a surgical
robot
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9. Types of surgery
• By body part:
• When surgery is performed on one organ
system or structure, it may be classed by the
organ, organ system or tissue involved.
• Examples include cardiac surgery,
gastrointestinal surgery and orthopedic
surgery.
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10. Types of surgery
• Transplant surgery is the replacement of an
organ or body part by insertion of another
from different human (or animal) into the
patient.
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11. Surgical Terminology
• Excision surgery names often start with a name for the
organ to be excised (cut out) and end in –ectomy
(surgical excision of the organ) example
appendectomy –tonsilectomy.
• Procedures involving cutting into an organ or tissue
end in -otomy.
• A surgical procedure cutting through the abdominal
wall to gain access to the abdominal cavity is a
laparotomy. Craniotomy (surgical opening made in the
skull to allow access to the brain).
•
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12. Surgical Terminology
 Minimally invasive procedures involving small
incisions through which an endoscope is
inserted end in -oscopy. For example, such
surgery in the abdominal cavity is called
laparoscopy.
 Procedures for formation of a permanent or
semi-permanent opening called a stoma in the
body end in -ostomy. Example colostomy -
tracostomy
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13. • Reconstruction, plastic or cosmetic surgery of
a body part starts with a name for the body
part to be reconstructed and ends in -oplasty.
Rhino is used as a prefix for "nose", therefore
a rhinoplasty is reconstructive or cosmetic
surgery for the nose.
Surgical Terminology
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14. Surgical Terminology
• Repair of damaged or congenital abnormal
structure ends in -rraphy. Herniorraphy is the
reparation of a hernia, while perineorraphy is
the reparation of perineum
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15. • Excision – cutting out an organ, tumor,or other
tissue.
• Resection – partial removal of an organ or other
bodily structure.
• Reconnection of organs, tissues, etc., :Internal
suturing.
• Reduction – the movement or realignment of a
body part to its normal position.
• Debridement - removal of dead, damaged, or
diseased tissue
Surgical Terminology
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16. • ligation – tying off blood vessels, ducts, or
"tubes".
• Grafts – pieces of tissue cut from the same (or
different) body .
• Transplant surgery, the donor organ is inserted
into the recipient's body and reconnected to the
recipient in all necessary ways (blood vessels,
ducts, etc.).
Surgical Terminology
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17. • Informed consent: the patient’s autonomous
decision about whether to undergo a surgical
procedure
• perioperative phase: period of time from
when the decision for surgical intervention is
made to when the patient is transferred to the
operating room table.
Surgical Terminology
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18. • Intraoperative phase: period of time that begins
with transfer of the patient to the operating room
table and continues until the patient is admitted
to the post anesthesia care unit.
• postoperative phase: period of time that begins
with the admission of the patient to the
postanesthesia care unit(PACU) and ends after
follow-up evaluation in the clinical setting or
home
Surgical Terminology
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19. • Anesthesia : a state of narcosis, analgesia,
relaxation, and loss of reflexes
• anesthesiologist: physician trained to deliver
anesthesia and to monitor the patient’s
condition during surgery.
• anesthetist: health care professional, such as
a nurse anesthetist, who is trained to deliver
anesthesia and to monitor the patient’s
condition during surgery.
Surgical Terminology
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20. Post anesthesia care unit (PACU):
• area where postoperative patients are monitored
as they recover from anesthesia; formerly
referred to as the recovery room.
• surgical asepsis: absence of microorganisms in
the surgical environment to reduce the risk for
infection
Surgical Terminology
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21. Skin incision
• The skin incision is made on a prepared
(cleansed, draped) operative field with
taking into consideration of vessels and
nerves of the area.
• During the incision, the surgeon and the
assistant stretch the skin.
• The depth of the incision must be the same
throughout the whole length.
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22. The important requirements of the skin incision
• The length of the incision should be appropriate
for safe surgery.
• Vessels and nerves should not be damaged.
• The skin edges should be smooth.
• The incision is made perpendicularly to the skin
with a single definite cut
• The direction of the incision depends on the
location of the organ being operated on.
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23. Main types of skin incisions based on
body region
• Neck: Kocher’s transverse incision at the base of the neck
(thyroid gland).
• Thorax: sternotomy, thoracotomy.
• Abdomen: subcostal (gallbladder or spleen),
median/paramedian laparotomy (this may be upper or
lower relative to the umbilicus),
• transrectal/pararectal/transverse laparotomies
• Pfannenstiel suprapubic incision (bladder, uterus or
ovaries),
• McBurney incision (appendectomy), inguinal incisions
(hernia).
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25. Duties of surgical nurse
• A surgical nurse is a nurse who specializes in
perioperative care, meaning care provided to
surgical patients before, during, and after
surgery.
• There are a number of different kinds of
surgical nurse. According to their specialist
.(orthopedic – open heart surgery .etc
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26. Duties of surgical nurse
In pre-operative care:
• a surgical nurse helps to prepare a patient for
surgery, both physically and emotionally.
• Surgical nurses may explain the procedure to
the patient, and ease fears about the upcoming
surgery and recovery.
• They also check the patient's vitals, administer
medications, and help to sterilize and mark the
surgical site.
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27. Duties of surgical nurse
During surgery
• a surgical nurse assists the surgeon, passing
instruments, keeping an eye on the patient's vital
signs, and performing other tasks associated with
the surgery, such as providing suction at the
surgical site to remove blood and fluids.
• Some surgical nurses work as circulating nurses,
patrolling the operating room to make sure that
everyone stays sterile, and counting instruments,
drapes, and other equipment to ensure that
everything is where it is supposed to be.
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28. Duties of surgical nurse
Post-operative care
• Nurses can work in acute recovery, keeping an eye
on patients who are at serious risk of complications,
and on more standard recovery floors in the
hospital.
• They are usually responsible for changing dressings,
monitoring vital signs, looking for signs of
complications, and administering medications.
• The care of an attentive surgical nurse ensures that
a patient's recovery goes as smoothly as possible.
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29. Types of Surgical Nurses
The perioperative nurses, fall into two categories:
1. Scrub nurse
2. Circulating nurse a
• While each plays a different role, they work
together to make the surgery easier and ensure
the patient’s safety.
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30. Scrub Nurse
• A scrub nurse inspects the operating room prior to
surgery, ensuring that it’s clean, sterile and ready for
the patient.
• He /She also sets up the surgical tools, counting all
sponges, needles and other instruments before and
after the operation.
• He helps the surgical team wash their hands and put
on the sterile gowns, gloves and masks they wear to
protect themselves and the patient.
• During the surgery, he /she hands the surgeon tools
and other instruments .
• After the operation, he/she removes the surgical tools
and helps prepare the patient for transport to the
recovery room.
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31. Circulating Nurse
• The circulating nurse oversees the procedure and ensures it
follows hospital policy and safety guidelines.
• He begins by inspecting surgical equipment to determine
everything is in working order.
• He /She also confirms the patient’s identity and verifies that
he or his family have completed the necessary consent forms.
• He discusses with the surgeon the type of procedure and any
special concerns, such as allergies or other health conditions,
that could impact the patient’s care.
• assists the anesthesiologist as he puts the patient under.
• During the operation, she retrieves any additional supplies or
tools the team needs.
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32. thanks
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