Surgery

Surgical Procedures

An Overview of Surgical Procedures

When you are in need of surgical procedure—and a great surgeon to perform it—it's important to understand the type of surgeon that you will need.  Knowing the type of surgeon you require is essential to selecting the right person for the job. Being a physician isn't enough to qualify an individual to perform your surgery—they need to be the right type of surgeon. And all surgeons are not the same.

Who Should Perform Your Surgery?

In most cases, there is a very specific type of surgeon who should perform your procedure. For example, if you have broken your leg, you need an orthopedic surgeon who specializes in bone issues.

While it is usually clear what type of surgeon is needed, there are areas where the specialties of surgeons overlap. A good example of this is spinal surgery, which can be performed by both neurosurgeons and orthopedic surgeons.

The neurosurgeon might be more appropriate for surgery on the spine itself, while the orthopedic surgeon could be more appropriate for issues with the bones of the spine.

In general, you want the surgeon who has the best outcomes for performing the procedure that you need. That doctor may be a DO or an MD, young or old, male or female. They may have a warm bedside manner or they may be less friendly. But what is of the highest importance is their ability to perform your procedure with excellence.

Who Should Not Perform Your Surgery

In the United States, a surgeon has a minimum of five years of surgical residency training.

And some specialty and subspecialty surgeons have many more years of training before practicing independently. It isn't enough to be a doctor, the person performing your procedure needs to be trained as a surgeon as well as trained in the right specialty.

The right kind of surgeon will be:

  • Board Certified in the specialty your surgery requires.
  • Performing the procedure you require on a regular or frequent basis.
  • Have a history of excellent outcomes performing the procedure you need.
  • Free of excessive malpractice suits by former patients.
  • In good standing with the Board of Medicine.
  • Performing surgery at a hospital or surgery center that provides excellent care.

Training of Surgeons

Surgeons follow a predictable career path in the United States. Most start their careers by going to medical school which is then followed by a residency in surgery that lasts for five years. Some paths, such as Obstetrics/Gynecology, are slightly different. Residency trains surgeons for the practice of general surgery.

After their residency, a surgeon can practice independently as a general surgeon.  

Surgeons—physicians who practice surgery—can train in one of a dozens areas of specialization and may go on to further pursue a subspecialty after their initial training. For example, a surgeon may complete a general surgery residency and then decide to complete additional education in cardio-thoracic (heart/lung) surgery. Then, they could even go on to pursue another subspecialty, such as pediatric heart transplant surgery.  

Moreover, surgeons can also specialize within their chosen specialty. Cardiac surgeons may focus on performing heart bypass surgeryheart valve repairs, or another heart surgery or they may practice many types of heart surgery. For example, a surgeon who practices as a general surgeon may prefer to perform appendectomies whenever possible. Therefore, by performing many appendectomies, the surgeon has elected to specialize in appendix surgery but still has the ability and training to perform many other surgeries.

Anesthesiology

While anesthesiologists are not surgeons, this specialty typically works hand in hand with surgeons, making it possible for surgery to be performed without the patient feeling the procedure. Anesthesia physicians, who often work side by side with nurses trained in anesthesia (CRNA), provide sedation during surgical procedures or supervise others who do. They also provide pain prevention, such as an epidural prior to childbirth. Some anesthesiologists even practice outside of the operating room, providing pain management to patients who require relief from chronic pain and related symptoms.  

Bariatric Surgery

Bariatric surgeons are those who specialize in the treatment of obesity with surgery. Typically, bariatric surgeons have pursued additional education after a general surgery residency to specialize in this area. Interestingly, there are many types of weight loss procedures

Cardiac and Cardiothoracic Surgery

Cardiac surgery is the specialty of treating heart issues with surgical procedures.

Pediatric cardiac surgeons may perform surgery on newborns and infants to correct issues that were present at birth. Adult issues are more likely to involve repairing and replacing heart valves (that have become diseased with age) and treating coronary artery disease. This specialty is often combined with the treatment of the lungs, referred to as cardiothoracic surgery—the specialty of treating issues within the chest.

Colon and Rectal Surgery

This is the surgical specialty of treating issues of the small and large intestine, the rectum and anus with surgery.

General Surgery

General surgery is the specialty of treating common abdominal issues, such as hernias and appendicitis, with surgery. Most surgeons go through a general surgery residency program and may choose to practice general surgery or train further in a specialty area.

Gynecology and Obstetrics Surgery

This specialty, commonly known as OB/GYN, provides wellness care, treats issues with the female reproductive system with and without surgery, provides birth control, and offers care during pregnancy and childbirth—which may include a cesarean section.  

Gynecologic Oncology

This is the surgical specialty of treating reproductive cancer in women. There is some overlap between OB/GYN and gynecologic oncology. For example, both specialties are trained to perform a hysterectomy procedure. But a gynecologic oncologist has specialized in performing the surgery as a treatment specifically for cancer rather than for another condition. 

Maxillofacial Surgery

Maxillofacial surgery is the specialty of treating issues of the mouth, jaw, neck, and facial bones with surgery. These issues may be present at birth or can be caused by trauma or disease.

Neurosurgery

This is the specialty of treating the central nervous system, including the brain and spinal cord, with surgery. This type of surgery may include brain surgery, surgery to correct back pain, treatment of cancer in the nervous system, and other neurological conditions.

Oncology

Oncology is the general term for specialties that use surgery to treat cancers throughout the body. Many specialties, however, treat cancer as part of their practice. For example, otolaryngology might treat throat cancer and orthopedic surgeons may play a role in treating bone cancer. While they may not specifically practice in the area of oncology, they are able to do so with their training. 

Ophthalmology

This is the specialty of treating eye conditions with surgery. These conditions may be present from birth, related to an accident or trauma, or develop with age.

Oral Surgery

This specialty treats dental issues with surgery, such as wisdom tooth removal and root canals.

Orthopedic Surgery

Surgery is used in this specialty to treat issues with bones, joints, ligaments, and tendons in both children and adults. 

Otolaryngology (Ear, Nose, and Throat)

This is the specialty of using surgery to treat issues of the ears, nose, and throat (ENT).  

Pediatric Surgery

This specialty of treating health issues of children with surgery is often combined with others specialties, such as pediatric neurosurgery or pediatric orthopedic surgery. Interestingly, some adults are treated by pediatric surgeons at pediatric facilities if their condition was present at birth or in childhood. The following surgeons are best trained to deal with specific pediatric issues:

  • Neonatal Surgeon: Focuses on surgery of newborns and infants.
  • Prenatal Surgeon: A new and often experimental area of surgery where a procedure is performed to correct issues prior to a fetus being born.

Plastic/Cosmetic and Reconstructive Surgery

This involves the specialty of improving appearance for cosmetic reasons or correcting defects or damage for a more appealing appearance or better function. This specialty can be practiced on pediatric patients, performing correction for issues such as a cleft palate, or on adults, providing rhinoplasty (nose job) or breast augmentation.

Podiatry

The specialty of foot surgery may be performed by a physician, such as an orthopedic surgeon, or a podiatrist. The terms podiatric medicine and podiatry generally refer to a podiatrist, who is not a physician but is trained to perform foot and ankle surgeries.

Thoracic Surgery

This is the specialty of treating issues in the chest cavity, excluding the heart (cardiothoracic surgery), with surgery.

Transplant Surgery

Replacing failing or diseased organs with donated organs in surgery is this specialty. There are many types of surgeons and specialties that participate in a variety of transplantation. For example, pediatric and adult transplant surgeons typically work with abdominal organs, including the intestine, pancreas, kidneys, and liver. And cardiothoracic surgeons, both pediatric and adult, typically work with heart and lung transplants. 

Trauma Surgery

This is the specialty of treating injuries from car crashes, gunshot wounds, stabbings, and other types of impact trauma with surgery. Multiple specialties, including trauma trained surgeons, vascular surgeons, general surgeons, and neurosurgeons may participate in trauma care.

Urology

Urology is both a medical and surgical specialty of treating issues in the urinary tract. This can range from treating symptoms of an overactive bladder to performing minimally invasive procedures for kidney stones. Some urologists perform both minor and major surgical procedures, such as removal of the prostate to treat cancer. 

Vascular Surgery

This is the specialty of treating issues of blood vessels with surgery. It is done to cosmetically treat conditions like varicose veins, to surgically treat vessels that aren't carrying enough blood to extremities, and to repair trauma. 

Source:

Taber's Cyclopedic Medical Dictionary. 2005.

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