Surgery Today - Surgery classifications

Surgery is classified according to whether it is vital to life, necessary for continued health, or desirable for medical or personal reasons. Although there are many ways in which surgical procedures are classified, the following breakdown is one that is widely accepted among surgeons.

Emergency Surgery

Unpredictable events that result in the need for medical immediate attention are classified as emergency surgeries. An automobile accident, a fire, a violent crime, or even a sudden change in a chronic medical problem, like a perforated ulcer or a strangulated hernia, can create situations in which the life of the patient depends upon the time it takes to get the victim into the hands of a trained surgeon. Emergency surgery cases typically involve the treatment of gunshot and stab wounds, fractures of the skull and other major bones, severe eye injuries, or life-threatening situations, such as obstruction of the windpipe caused by choking on a piece of food.

Emergency surgery may be one of the most common routes for patients entering the operating room. Accident patients present tremendous challenges to surgeons, because emergency room patients frequently have multiple injuries involving several organ systems. Such victims are often unconscious or otherwise unable to communicate coherently about their injuries, and there may be little or no time to obtain medical histories or information about their blood types, allergies to medicines, etc.

When possible, vital information about the patient and the circumstances surrounding the injury or sudden need for surgery is obtained by medical personnel who question anybody who might provide one or more clues. Efforts to maintain life are begun even while blood samples are taken for laboratory analysis and X-ray photographs made of the chest, abdomen, and other body areas that may be involved. When life is in immediate peril, resuscitation, induction of anesthesia, and surgery might proceed simultaneously as soon as a diagnosis is made.

Urgent Surgery

Next in priority for the surgeon are cases in which an operation is vital but can be postponed for a few days. A person injured in an automobile accident but conscious and suffering a minor bone fracture may be classed as an urgent rather than emergency surgery case, and the delay would give surgeons and other medical personnel time to study X-rays carefully, evaluate blood tests and other diagnostic data, and otherwise plan corrective therapy while under less pressure. Kidney stones, an acute, inflamed gall bladder, or cancer of a vital organ are examples of urgent surgery.

Elective Surgery

Elective surgery is usually subdivided into three categories: required, selective, and optional.

Required Surgery

Physical ailments that are serious enough to need corrective surgery but that can be scheduled a matter of weeks or months in advance generally are designated as required surgery cases. Conditions such as a chronically inflamed gall bladder, cataracts, bone deformities, or diseased tonsils and adenoids would be examples of conditions that require surgery.

Selective Surgery

Selective surgery covers a broad range of conditions that are of no real threat to the immediate physical health of the patient but nevertheless should be corrected by surgery in order to improve his comfort and emotional health. Certain congenital defects such as cleft lip and cleft palate would be included in this classification, as well as removal of certain cysts and nonmalignant fatty or fibrous tumors.

Optional Surgery

Of the lowest priority are operations that are primarily of cosmetic benefit, such as removal of warts and other nonmalignant growths on the skin, blemishes of the skin, and certain cases of varicose veins. Optional surgery also includes various kinds of plastic surgery undertaken for cosmetic effect. Among popular types of plastic surgery are operations to reduce or enlarge the shape of female breasts, reshape the nose, correct protruding ears, remove bags under the eyes, decrease facial wrinkles.

Types of Surgery

Surgery is further divided according to the following groups of major operations.

Surgeries with the suffix - ectomy involve the partial or complete removal of an organ, the most common being the appendectomy.

Operations to restore, reconstruct or refigure body parts are denoted by the suffix - plasty ; thus cosmetic surgery to reshape the nose is called rhinoplasty.

Surgeries with the suffix - otomy involve the perforation or incision of organs or tissue, as in radial keratotomy, laser surgery performed on the eye.