Elective surgery

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Elective surgery or elective procedure is surgery that is scheduled in advance because it does not involve a medical emergency. Semi-elective surgery is a surgery that must be done to preserve the patient's life, but does not need to be performed immediately. Most surgeries are elective, scheduled at a time to suit the surgeon, hospital, and patient.

Contents

By contrast, an urgent surgery is one that can wait until the patient is medically stable, but should generally be done within 2 days, and an emergency surgery is one that must be performed without delay; the patient has no choice other than immediate surgery if permanent disability or death is to be avoided. Many surgeries can be performed as either elective or emergency surgeries, depending on the patient's needs.

Description

An elective surgery or elective procedure (from the Latin : eligere, meaning to choose [1] ) is surgery that is scheduled in advance because it does not involve a medical emergency. Semi-elective surgery is a surgery that must be done to preserve the patient's life, but does not need to be performed immediately.

Types

Elective

Most surgical medical treatments are elective, that is, scheduled at a time to suit the surgeon, hospital, and patient. These include inguinal hernia surgery, cataract surgery, mastectomy for breast cancer, and the donation of a kidney by a living donor.[ citation needed ]

Elective surgeries include all optional surgeries performed for non-medical reasons. This includes cosmetic surgery, such as facelifts, breast implants, liposuction, and breast reduction, which aim to subjectively improve a patient's physical appearance. Another optional surgery is LASIK—currently the top elective surgery in the United States [2] —where a patient weighs the risks against increased quality of life expectations. [3]

Semi-elective

When a condition is worsening but has not yet reached the point of a true emergency, surgeons speak of semi-elective surgery: the problem must be dealt with, but a brief delay is not expected to affect the outcome. Semi-elective procedures are typically scheduled within a time frame deemed appropriate for the patient's condition and disease. Removal of a malignancy, for example, is usually scheduled as semi-elective surgery, to be performed within a set number of days or weeks.

Urgency

In a patient with multiple medical conditions, problems classified as needing semi-elective surgeries may be postponed until emergent conditions have been addressed and the patient is medically stable. For example, whenever possible, pregnant women typically postpone all elective and semi-elective procedures until after giving birth.

In some situations, an urgently needed surgery will be postponed briefly to permit even more urgent conditions to be addressed. In other situations, emergency surgery may be performed at the same time as life-saving resuscitation efforts.

Many surgeries can be performed as either elective or emergency surgeries, depending on the patient's needs. A sudden worsening of gallbladder disease may require immediate removal of the gallbladder by emergency surgery, but this surgery is more commonly scheduled in advance. An appendectomy is considered emergency surgery, but depending upon how early the diagnosis was made, the patient may have more time before the appendix risks rupturing or the infection spreads. Also, in certain emergency conditions, even ones like a heart attack or stroke, surgery may or may not need to be utilized.

Best practices

Preoperative carbohydrates may decrease amount of time spent in hospital recovering. [4]

Non-elective surgery

Non-elective surgeries may be classified as urgent or emergency. An urgent surgery is one that can wait until the patient is medically stable, but should generally be done within 2 days. An emergency surgery is one that must be performed without delay; the patient has no choice other than immediate surgery if permanent disability or death is to be avoided. [5] Urgent surgery is typically performed with 48 hours of diagnosis and emergency surgery is performed as soon as a surgeon is available.

Related Research Articles

<span class="mw-page-title-main">General surgery</span> Medical specialty

General surgery is a surgical specialty that focuses on alimentary canal and abdominal contents including the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, appendix and bile ducts, and often the thyroid gland. General surgeons also deal with diseases involving the skin, breast, soft tissue, trauma, peripheral artery disease and hernias and perform endoscopic as such as gastroscopy, colonoscopy and laparoscopic procedures.

<span class="mw-page-title-main">Surgery</span> Medical procedures that involve incisive or invasive instruments into body cavities

Surgery is a medical specialty that uses manual and/or instrumental techniques to diagnose or treat pathological conditions, to alter bodily functions, to reconstruct or improve aesthetics and appearance, or to remove unwanted tissues or foreign bodies. The subject receiving the surgery is typically a person, but can also be a non-human animal.

An antiplatelet drug (antiaggregant), also known as a platelet agglutination inhibitor or platelet aggregation inhibitor, is a member of a class of pharmaceuticals that decrease platelet aggregation and inhibit thrombus formation. They are effective in the arterial circulation where classical Vitamin K antagonist anticoagulants have minimal effect.

A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy.

<span class="mw-page-title-main">LASIK</span> Corrective ophthalmological surgery

LASIK or Lasik, commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and an actual cure for astigmatism, since it is in the cornea. LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye's cornea in order to improve visual acuity.

<span class="mw-page-title-main">Photorefractive keratectomy</span> Refractive eye surgery procrdure

Photorefractive keratectomy (PRK) and laser-assisted sub-epithelial keratectomy (LASEK) are laser eye surgery procedures intended to correct a person's vision, reducing dependency on glasses or contact lenses. LASEK and PRK permanently change the shape of the anterior central cornea using an excimer laser to ablate a small amount of tissue from the corneal stroma at the front of the eye, just under the corneal epithelium. The outer layer of the cornea is removed prior to the ablation.

<span class="mw-page-title-main">Cholecystectomy</span> Surgical removal of the gallbladder

Cholecystectomy is the surgical removal of the gallbladder. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed in hospitals in the United States. Cholecystectomy can be performed either laparoscopically, or via an open surgical technique.

<span class="mw-page-title-main">Refractive surgery</span> Surgery to treat common vision disorders

Refractive surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.

The perioperative period is the period of a patient's surgical procedure. It commonly includes ward admission, anesthesia, surgery, and recovery. Perioperative may refer to the three phases of surgery: preoperative, intraoperative, and postoperative, though it is a term most often used for the first and third of these only - a term which is often specifically utilized to imply 'around' the time of the surgery. The primary concern of perioperative care is to provide better conditions for patients before an operation and after an operation.

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<span class="mw-page-title-main">Veterinary surgery</span> Surgery performed on non-human animals

Veterinary surgery is surgery performed on non-human animals by veterinarians, whereby the procedures fall into three broad categories: orthopaedics, soft tissue surgery, and neurosurgery. Advanced surgical procedures such as joint replacement, fracture repair, stabilization of cranial cruciate ligament deficiency, oncologic (cancer) surgery, herniated disc treatment, complicated gastrointestinal or urogenital procedures, kidney transplant, skin grafts, complicated wound management, and minimally invasive procedures are performed by veterinary surgeons. Most general practice veterinarians perform routine surgeries such as neuters and minor mass excisions; some also perform additional procedures.

The ASA physical status classification system is a system for assessing the fitness of patients before surgery. In 1963 the American Society of Anesthesiologists (ASA) adopted the five-category physical status classification system; a sixth category was later added. These are:

  1. Healthy person.
  2. Mild systemic disease.
  3. Severe systemic disease.
  4. Severe systemic disease that is a constant threat to life.
  5. A moribund person who is not expected to survive without the operation.
  6. A declared brain-dead person whose organs are being removed for donor purposes.

A surgical nurse, also referred to as a theatre nurse or scrub nurse, specializes in perioperative care, providing care to patients before, during and after surgery. To become a theatre nurse, Registered Nurses or Enrolled Nurses must complete extra training. Theatre nurses can focus on different speciality areas, depending on which they are interested in.

<span class="mw-page-title-main">Operating room management</span>

Operating room management is the science of how to run an operating room suite. Operational operating room management focuses on maximizing operational efficiency at the facility, i.e. to maximize the number of surgical cases that can be done on a given day while minimizing the required resources and related costs. For example, what is the number of required anaesthetists or the scrub nurses that are needed next week to accommodate the expected workload or how can we minimize the cost of drugs used in the Operating Room? Strategic operating room management deals with long-term decision-making. For example, is it profitable to add two additional rooms to the existing facility? Typically, operating room management in profit-oriented health-care systems emphasizes strategic thinking whereas in countries with publicly funded health care, the focus is on operational decisions.

<span class="mw-page-title-main">Breast-conserving surgery</span> Surgical operation

Breast-conserving surgery refers to an operation that aims to remove breast cancer while avoiding a mastectomy. Different forms of this operation include: lumpectomy (tylectomy), wide local excision, segmental resection, and quadrantectomy. Breast-conserving surgery has been increasingly accepted as an alternative to mastectomy in specific patients, as it provides tumor removal while maintaining an acceptable cosmetic outcome. This page reviews the history of this operation, important considerations in decision making and patient selection, and the emerging field of oncoplastic breast conservation surgery.

A DIEP flap is type of breast reconstruction where blood vessels, fat, and skin from the lower belly are relocated to the chest to rebuild breasts after mastectomy. DIEP stands for the deep inferior epigastric perforator artery, which runs through the abdomen. This is a type of autologous reconstruction, meaning one's own tissue is used.

Cholecystostomy or (cholecystotomy) is a medical procedure used to drain the gallbladder through either a percutaneous or endoscopic approach. The procedure involves creating a stoma in the gallbladder, which can facilitate placement of a tube or stent for drainage, first performed by American surgeon, Dr. John Stough Bobbs, in 1867. It is sometimes used in cases of cholecystitis or other gallbladder disease where the person is ill, and there is a need to delay or defer cholecystectomy. The first endoscopic cholecystostomy was performed by Drs. Todd Baron and Mark Topazian in 2007 using ultrasound guidance to puncture the stomach wall and place a plastic biliary catheter for gallbladder drainage.

Perioperative nursing is a nursing specialty that works with patients who are having operative or other invasive procedures. Perioperative nurses work closely with surgeons, anaesthesiologists, nurse anaesthetists, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, and postoperative care primarily in the operating theatre.

Laser blended vision is a laser eye treatment which is used to treat presbyopia or other age-related eye conditions. It can be used to help people that simply need reading glasses, and also those who have started to need bifocal or varifocal spectacle correction due to ageing changes in the eye. It can be used for people who are also short-sighted (myopia) or long-sighted (hyperopia) and who also may have astigmatism.

Canine gallbladder mucocele (GBM) is an emerging biliary disease in dogs described as the excessive and abnormal accumulation of thick, gelatinous mucus in the lumen, which results in an enlarged gallbladder. GBMs have been diagnosed more frequently in comparison to prior to the 2000s when it was considered rare. The mucus is usually pale yellow to dark green in appearance.

References

  1. Mosby's Medical, Nursing & Allied Health Dictionary (4 ed.). St. Louis, Missouri: Mosby. 1994. p. 530. OCLC   29185395.
  2. "The brain of Lasik: Santa Ana company develops new device, derived from space telescope, to personalize laser eye surgery". Orange County Register. 2015-08-01. Archived from the original on 2018-01-25. Retrieved 2018-01-24.
  3. LASIK Eye Surgery
  4. Smith, MD; McCall, J; Plank, L; Herbison, GP; Soop, M; Nygren, J (Aug 14, 2014). "Preoperative carbohydrate treatment for enhancing recovery after elective surgery". The Cochrane Database of Systematic Reviews. 8 (8): CD009161. doi: 10.1002/14651858.CD009161.pub2 . PMID   25121931.
  5. "Surgery, elective". MedTerms. MedicineNet. Archived from the original on 2014-03-13. Retrieved 2011-07-19.

Bibliography