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Surgery Lap Center Blog
Surgery News and Surgery Informations. Sources about Surgery around the Net.

Keyhole surgery / Laparoscopic surgery Robotics and Technolog

Thursday, September 14, 2006
The process of minimally invasive surgery has been augmented by specialized tools for decades. However, in recent years, electronic tools have been developed to aid surgeons. Some of the features include:

Visual magnification - use of a large viewing screen improves visibility

Stabilization - Electromechanical damping of vibrations, due to machinery or shakey human hands

Reduced number of incisions

Robotic surgery has been touted as a solution to underdeveloped nations, whereby a single central hospital can operate several remote machines at distant locations. The potential for robotic surgery has had strong military interest as well, with the intention of providing mobile medical care while keeping trained doctors safe from the battle.
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Keyhole surgery / Laparoscopic surgery Risks

Some patients have sustained electrical burns unseen by surgeons who are working with electrodes that leak current into surrounding tissue. The resulting injuries can result in perforated organs and lead to peritonitis.
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Keyhole surgery / Laparoscopic surgery

Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. Medically, laparoscopic surgery refers only to operations within the abdomen or pelvic cavity. Laparoscopic surgery belongs to the field of endoscopy.


A laparoscope consists of a Hopkins rod lens system, that is usually connected to a videocamera- single chip or three chip, a fibre optic cable system connected to a 'cold' light source, halogen or xenon, to illuminate the operative field, inserted through a 5 mm or 10 mm canula to view the operative field. Additional 5- 10 mm thin instruments can be introduced by the surgeon through side ports. Rather than a 20 cm cut as in traditional cholecystectomy, two to five cuts of 5-15 mm will be sufficient to perform a laparoscopic removal of a gallbladder.

The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space.

This approach, pioneered by Dr. Camran Nezhat, is intended to minimise operative blood loss and post-operative pain, and speeds up recovery times. However, in some cases the pain caused by the carbon dioxide leaving the body is severe and painkillers have little or no effect. The restricted vision, difficult handling of the instruments (hand-eye coordination), lack of tactile perception and the limited working area can increase the possibility of damage to surrounding organs and vessels, either accidentally or through the difficulty of procedures.

The first transatlantic surgery (Lindbergh Operation) ever performed was a laparoscopic gallbladder removal.
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Cardiothoracic Surgery History

Animal experimentation by various pioneers, including Vladimir Demikhov and Dominique Metras, in 1940s and 1950s demonstrated that the procedure is feasible technically. Hardy performed the first human lung transplantation in 1963. Following a left lung transplantation, the patient survived for 18 days. From 1963-1978, multiple attempts at lung transplantation failed because of rejection and problems with anastomotic bronchial healing.

The first successful human-to-human heart transplantation was performed in South Africa by Dr. Barnard on December 3, 1967. Since 1905 the procedure was investigated by transplanting a puppy's heart into the neck of a dog. This intervention is generally reserved for patients with end-stage congestive heart failure (CHF) with a prognosis of less than a year to live without the transplant and who are not candidates for conventional medical therapy or have not been helped by conventional medical therapy.
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Cardiothoracic Surgery

In medicine, the field of cardiothoracic surgery is involved in the surgical treatment of diseases that affect organs inside the thorax (the chest). In general it will mean conditions of the heart (cardiovascular disease) and lungs (lung disease). Cardiothoracic surgery is a recognised surgical specialty.

Thoracic surgery generally refers to surgery of the chest other than the heart. A general surgeon may have an interest in thoracic surgery.

A cardiothoracic surgeon will perform Coronary Artery Bypass Graft (CABG), Heart valve, lung volume reduction, heart and/or lung transplantation, as well as arrhythmia surgery and thoracic aorta repairs.
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Addiction to cosmetic surgery

Some people appear to become addicted to cosmetic surgery, possibly because of body dysmorphic disorder.

Sufficient amounts of repeated cosmetic surgery can lead to irreversible damage to the normal body structure.

However, due to the high cost of repeated cosmetic surgery, this disorder is generally one limited to the wealthy.

However, others have been known to take out loans for repeat procedures.
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Plastic surgery Related disciplines

Plastic surgery is a broad field, and may be subdivided further. Plastic surgery training and approval by the American Board of Plastic Surgery includes mastery of the following as well:

Craniofacial surgery mostly revolves around the treatment of pediatric congenital anomalies, such as cleft lip and palate, craniosynostosis, and other disturbances in facial growth and development. Because these children have multiple issues, they are often taken care of in an interdisciplinary approach which include oral surgeons, otolaryngologists, speech therapists, occupational therapists, geneticists.

Hand surgery is a field that has some overlap with general surgeons and orthopedic surgeons (see Hand surgeon).

Plastic surgeons receive full training in hand surgery, with some trainees deciding even to do an additional full-year hand fellowship afterwards (this fellowship can also be pursued by general surgeons and orthopedic surgeons). In particular, plastic surgeons receive training in microvascular surgery, which is needed to replant an amputated hand or digit. Many hand operations (such as reconstruction of injuries, replantations, rheumatoid surgery and surgery of congenital defects) are performed by plastic surgeons.

Maxillofacial surgery is surgery of the "maxilla" (which means jaw) and face, and is an important aspect of plastic surgery. This field grew from contributions by both the plastic surgeons and oral surgeons. Examples of repairs here would be traumatic fractures of the jaw and face (such as from fights or vehicle accidents), tumors of the jaw and face.
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Cosmetic surgery

Cosmetic surgery is a very popular avenue for personal enhancement, as demonstrated by the 11.9 million cosmetic procedures performed in the U.S. alone in 2004. As for any operation, cosmetic procedures involve risk, and should therefore not be undertaken lightly. Within the US, critics of plastic surgery note that it is legal for any doctor, regardless of speciality, to perform "cosmetic surgery", but not "plastic surgery". It is thus important to distinguish the terms "plastic surgery" and "cosmetic surgery": Plastic Surgery is recognized by the American Board of Medical Specialties (the only official entity overseeing physician certification in the United States) as the subspecialty dedicated to the surgical repair of defects of form or function -- this includes cosmetic (or aesthetic) surgery, as well as reconstructive surgery. The term "cosmetic surgery" however, simply refers to surgery that is designed to improve cosmetics, or appearance. (One could argue that reconstructive surgery always has some cosmetic aspect to it, because form and function are often both important in plastic surgery repairs.) Thus there is no real art of "cosmetic surgery": it is a catch-all commercial phrase that laypeople understand easily and non-plastic surgeons eagerly use because they are not allowed to use the term "plastic surgery".

The most prevalent aesthetic/cosmetic procedures are listed below. Most of these types of surgery are more commonly known by their "common names." These are also listed when pertinent.

Abdominoplasty (or "tummy tuck"): reshaping and firming of the abdomen

Abdominal etching (or "ab etching": Specialized and trademarked liposuction surgery for male and female patients that affords six-pack abs or a flat, athletic, or countoured stomach.

Blepharoplasty (or "eyelid surgery"): Reshaping of the eyelids or the application of permanent eyeliner, including Asian blepharoplasty

Augmentation Mammaplasty (or "breast enlargement" or "boob job"): Augmentation of the breasts. This can involve either saline or silicone gel prosthetics.

Buttock Augmentation (or "butt augmentation" or "butt implants"): Enhancement of the buttocks. This procedure can be performed by using silicone implants or fat grafting and transfer from other areas of the body.

Chemical peel: Removal of acne scars and sagging skin—not technically surgery and can be performed by a cosmetologist. Chemical peels commonly involve Phenol, TCA, or Glycolic acid as the active agent. Phenol peels, while the most effective, require cardiac monitoring and require longer recovery periods, thus diminishing their current popularity.

Mastopexy (or "breast lift"): Raising of sagging breasts

Labiaplasty: Surgical reduction and reshaping of the labia

Rhinoplasty (or "nose job"): Reshaping of the nose

Otoplasty (or ear surgery): Reshaping of the ear

Rhytidectomy (or "face lift"): Removal of wrinkles and signs of aging from the face

Suction-Assisted Lipectomy (or liposuction): Removal of fat from the body

Chin augmentation: Augmentation of the chin with an implant (e.g. silicone) or by sliding genioplasty of the jawbone.

Cheek augmentation

Collagen, fat, and other tissue filler injections (eg hyaluronic acid)

Mesotherapy : An alternative to liposuction where fluids are injected to break down and dissolve the fat (still a speculative treatment).
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Reconstructive surgery

Common reconstructive surgeries are: breast reconstruction for women who have had a mastectomy, cleft lip and palate surgery, contracture surgery for burn survivors, and closing skin and mucosa defects after removal of tumors in the head and neck region. Sex reassignment surgery for transsexual people is another example of reconstructive surgery.

Plastic surgeons have developed the use of microsurgery to transfer tissue for coverage of a defect when no local tissue is available. Tissue "flaps" comprised of skin, muscle, bone, fat or a combination, may be removed from the body, moved to another site on the body and reconnected to a blood supply by suturing arteries and veins as small as 1-2 mm in diameter.

There is a definite gray area between reconstructive and cosmetic surgery. Many of the techniques of cosmetic surgery are utilized in reconstructive surgery to improve cosmesis.
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Plastic surgery History

The history of cosmetic surgery reaches back to the ancient world. Physicians in ancient India including the great Indian surgeon Susrutha were utilizing skin grafts for reconstructive work as early as the 8th century BC. His work Sushruta Samhita describes rhinoplasty and otoplasty. This knowledge of plastic surgery existed in India up to the late 18th century as can be seen from the reports published in Gentleman's Magazine (October 1794).

The Romans were able to perform simple techniques such as repairing damaged ears from around the 1st century BC. In mid-15th century Europe, Heinrich von Pfolspeundt described a process "to make a new nose for one who lacks it entirely, and the dogs have devoured it" by removing skin from the back of the arm and suturing it in place. However, because of the dangers associated with surgery in any form, especially that involving the head or face, it was not until the 19th and 20th centuries that such surgeries became commonplace.

The U.S.'s first plastic surgeon was Dr. John Peter Mettauer. He performed the first cleft palate operation in 1827 with instruments that he designed himself. The New Zealander Sir Harold Gillies developed many of the techniques of modern plastic surgery in caring for those who suffered facial injuries in World War I, he is considered to be the father of modern plastic surgery. His work was expanded upon during World War II by one of his former students and cousin, Archibald McIndoe, who pioneered treatments for RAF aircrew suffering from severe burns. McIndoe's radical, experimental treatments, lead to the formation of the Guinea Pig Club.
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Plastic surgery

Plastic surgery is a general term for operative manual and instrumental treatment which is performed for functional or aesthetic reasons. The word "plastic" derives from the Greek plastikos meaning to mold or to shape; its use here is not connected with modern plastics.

The principal areas of plastic surgery include two broad fields.
Reconstructive surgery, including microsurgery, focuses on undoing or masking the destructive effects of trauma, surgery or disease. Reconstructive surgery may include closing defects using skin grafts or with local, regional or distant flaps—that is, by moving tissue from other parts of the body.

Cosmetic (or aesthetic) surgery is most often performed in order to change features the patient finds unflattering. In many cases, however, there are medical reasons (for example, breast reduction when orthopedic problems are present).
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Laparoscopic surgery

Laparoscopic surgery, also called keyhole surgery (when natural body openings are not used), bandaid surgery, or minimally invasive surgery (MIS), is a surgical technique. Medically, laparoscopic surgery refers only to operations within the abdomen or pelvic cavity. Laparoscopic surgery belongs to the field of endoscopy.

A laparoscope consists of a Hopkins rod lens system, that is usually connected to a videocamera- single chip or three chip, a fibre optic cable system connected to a 'cold' light source, halogen or xenon, to illuminate the operative field, inserted through a 5 mm or 10 mm canula to view the operative field. Additional 5- 10 mm thin instruments can be introduced by the surgeon through side ports. Rather than a 20 cm cut as in traditional cholecystectomy, two to five cuts of 5-15 mm will be sufficient to perform a laparoscopic removal of a gallbladder. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space.

This approach, pioneered by Dr. Camran Nezhat, is intended to minimise operative blood loss and post-operative pain, and speeds up recovery times. However, in some cases the pain caused by the carbon dioxide leaving the body is severe and painkillers have little or no effect. The restricted vision, difficult handling of the instruments (hand-eye coordination), lack of tactile perception and the limited working area can increase the possibility of damage to surrounding organs and vessels, either accidentally or through the difficulty of procedures.

The first transatlantic surgery (Lindbergh Operation) ever performed was a laparoscopic gallbladder removal.

Risks

Some patients have sustained electrical burns unseen by surgeons who are working with electrodes that leak current into surrounding tissue. The resulting injuries can result in perforated organs and lead to peritonitis.

Robotics and Technology

The process of minimally invasive surgery has been augmented by specialized tools for decades. However, in recent years, electronic tools have been developed to aid surgeons. Some of the features include:
Visual magnification - use of a large viewing screen improves visibility
Stabilization - Electromechanical damping of vibrations, due to machinery or shakey human hands
Reduced number of incisions
Robotic surgery has been touted as a solution to underdeveloped nations, whereby a single central hospital can operate several remote machines at distant locations. The potential for robotic surgery has had strong military interest as well, with the intention of providing mobile medical care while keeping trained doctors safe from the battle.
3:30 AM :: 0 comments ::

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Reconstructive surgery

Reconstructive surgery is in its broadest sense the use of surgery to reconstruct damaged or malformed tissues or organs.

Although plastic surgery is involved in some aspects of reconstructive surgery there are other branches of surgery whose main aim is reconstruction of a more normal part of the body. This contrasts with the main alternative type of surgery in which something is removed - for example an inflamed appendix.

In orthopedic surgery, reconstructive surgery is the branch associated with hip replacement and other joint replacements, repair of tendons such as rotator cuff repair and osteotomy to straighten angulated bones. The common feature is that the surgery attempts to restore the anatomy or the function to normal.

Other branches of surgery (eg dentistry, oral and maxillofacial surgery, general, gynecological surgery and pediatric surgery) also undertake reconstructive surgery.
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Development of modern surgery

Before the advent of anesthesia, surgery was a traumatically painful procedure and surgeons were encouraged to be as swift as possible to minimize patient suffering. This also meant that operations were largely restricted to amputations and external growth removals. In addition, the need for strict hygiene during procedures was little understood, which often resulted in life threatening post-operative infections in patients.

Beginning in the 1840s, surgery began to change dramatically in character with the discovery of effective and practical anaesthetic chemicals such as ether and chloroform. In addition to relieving patient suffering, anaesthesia allowed more intricate operations in the internal regions of the human body. In addition, the discovery of muscle relaxants such as curare allowed for safer applications.

However, the move to longer operations increased the danger of dangerous complications since the prolonged exposure of surgical wounds to the open air heightened the chance of infections. It was only in the late 19th century with the rise of microbiology with scientists like Louis Pasteur and innovative doctors who applied their findings like Joseph Lister did the idea of strict cleanliness and sterile settings during surgery arise. In the United Kingdom, Australia and New Zealand surgeons are distinguished from physicians by being referred to as "Mister." This tradition has its origins in the 18th century, when surgeons were barber-surgeons and did not have a degree (or indeed any formal qualification), unlike physicians, who were doctors with a university medical degree.

By the beginning of the 19th century, surgeons had obtained high status, and in 1800, the Royal College of Surgeons (RCS) in London began to offer surgeons a formal status via RCS membership. The title Mister became a badge of honour, and today only surgeons who hold the Membership or Fellowship of one of the Royal Surgical Colleges are entitled to call themselves Mister, Miss, Mrs or Ms.

In contrast, North American physicians and surgeons are always addressed as "Doctor."
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Surgery History.

In 2001, archaeologists studying the remains of two men from Mehrgarh, Pakistan, made the discovery that the people of Indus Valley Civilization, even from the early Harappan periods (c. 3300 BC), had knowledge of medicine and dentistry. The physical anthropologist that carried out the examinations, Professor Andrea Cucina from the University of Missouri-Columbia, made the discovery when he was cleaning the teeth from one of the men (see History of medicine). Later research in the same area found evidence of teeth having been drilled, dating back 9,000 years.

Researchers have uncovered an Ancient Egyptian mandible, dated to approximately 2750 BC, with two perforations just below the root of the first molar, indicating the draining of an abscessed tooth. Recent excavations of the construction workers of the Egyptian pyramids also led to the discovery of evidence of brain surgery on a labourer, who continued living for two years afterwards.

Indian physician Sushruta (c. 600 BC) is an important figure in the history of surgery. He lived, taught and practiced his art of surgery on the banks of the Ganges in the area that corresponds to the present day city of Benares in Northern India. Because of his seminal and numerous contributions to the science and art of surgery he is also known by the title "Father of Surgery". Much of what is known about this inventive surgeon is contained in a series of volumes he authored, which are collectively known as the Susrutha Samhita. It is the oldest known surgical text and it describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments, as well as procedures on performing plastic surgery.

Surgeons are now considered to be specialised physicians, the profession of surgeon and that of physician have different historical roots and surgeons have now even subspecialised as have physicians. For example, Greek tradition was against opening the body and the Hippocratic Oath warns physicians against the practice of surgery, specifically that cutting persons laboring under the stone, i.e. lithotomy, an operation to relieve kidney stones, was to be left to such persons as practice [it]. Of course, most knowledge of surgery comes from dissecting bodies, a science which was repulsive to many healers.

By the thirteenth century, many European towns were demanding that physicians have several years of study or training before they could practice. Montpellier, Padua and Bologna Universities were particularly interested in the academic side to Surgery, and by the fifteenth century at the latest, Surgery was a separate university subject to Physic. Surgery had a lower status than pure medicine, beginning as a craft tradition until Rogerius Salernitanus composed his Chirurgia, which laid the foundation for the species of the occidental surgical manuals, influencing them up to modern times.

Among the first modern surgeons were battlefield doctors in the Napoleonic Wars who were primarily concerned with amputation. Naval surgeons were often barber-surgeons, who combined surgery with their main jobs as barbers.

In London, an operating theatre or operating room from the day before modern anaesthesia or antiseptic surgery still exists, and is open to the public. It is found in the roof space of St Thomas Church, Southwark, London and is called the Old Operating Theatre.

Surgery recently came under the domain of unmanned robots
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Surgery Information.

Surgery (from the Greek cheirourgia meaning "hand work") is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment. Surgeons may be physicians, dentists, or veterinarians who specialize in surgery.
A surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentist, or veterinarian.
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