Surgeon

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Cardiac surgery operating room.jpg
Surgeons at Work.jpg
Surgeons performing operations

In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as physicians before specializing in surgery. There are also surgeons in podiatry, dentistry, and veterinary medicine. It is estimated that surgeons perform over 300 million surgical procedures globally each year. [1] [2]

Contents

History

Al-Zahrawi, the Islamic Golden Age physician widely considered one of the '"Fathers of Modern Surgery" Albucasis.gif
Al-Zahrawi, the Islamic Golden Age physician widely considered one of the '"Fathers of Modern Surgery"

The first person to document a surgery was the 6th century BC Indian physician-surgeon, Sushruta. He specialized in cosmetic plastic surgery and even documented an open rhinoplasty procedure. [3] His magnum opus Suśruta-saṃhitā is one of the most important surviving ancient treatises on medicine and is considered a foundational text of both Ayurveda and surgery. The treatise addresses all aspects of general medicine, but the translator G. D. Singhal dubbed Sushruta "the father of surgical intervention" on account of the extraordinarily accurate and detailed accounts of surgery to be found in the work. [4]

After the eventual decline of the Sushruta School of Medicine in India, surgery was largely ignored until the Islamic Golden Age surgeon Al-Zahrawi (936-1013) re-established surgery as an effective medical practice. He is considered the greatest medieval surgeon to have appeared from the Islamic World, and has also been described as the father of surgery. [5] His greatest contribution to medicine is the Kitab al-Tasrif , a thirty-volume encyclopedia of medical practices. [6] He was the first physician to describe an ectopic pregnancy, and the first physician to identify the hereditary nature of haemophilia. [7]

His pioneering contributions to the field of surgical procedures and instruments had an enormous impact on surgery but it was not until the 18th century that surgery emerged as a distinct medical discipline in England. [7]

In Europe, surgery was mostly associated with barber-surgeons who also used their hair-cutting tools to undertake surgical procedures, often at the battlefield and also for their employers. [8] With advances in medicine and physiology, the professions of barbers and surgeons diverged; by the 19th century barber-surgeons had virtually disappeared, and surgeons were almost invariably qualified doctors who had specialized in surgery. Surgeon continued, however, to be used as the title for military medical officers until the end of the 19th century, and the title of Surgeon General continues to exist for both senior military medical officers and senior government public health officers.

Titles in the Commonwealth

In 1950, the Royal College of Surgeons of England (RCS) in London began to offer surgeons a formal status via RCS membership. The title Mister became a badge of honour, and today, in many Commonwealth countries, a qualified doctor who, after at least four years' training, obtains a surgical qualification (formerly Fellow of the Royal College of Surgeons, but now also Member of the Royal College of Surgeons or a number of other diplomas) is given the honour of being allowed to revert to calling themselves Mr, Miss, Mrs or Ms in the course of their professional practice, but this time the meaning is different. It is sometimes assumed that the change of title implies consultant status (and some mistakenly think non-surgical consultants are Mr too), but the length of postgraduate medical training outside North America is such that a qualified surgeon may be years away from obtaining such a post: many doctors previously obtained these qualifications in the senior house officer grade, and remained in that grade when they began sub-specialty training. The distinction of Mr (etc.) is also used by surgeons in the Republic of Ireland, some states of Australia, Barbados, New Zealand, South Africa, Zimbabwe, and some other Commonwealth countries. [9] However, as of August 2021, the Royal Australasian College of Surgeons has announced that this practice is being phased out and now encourages the use of Dr or appropriate academic titles such as Professor. [10]

Military titles

In many English-speaking countries the military title of surgeon is applied to any medical practitioner, due to the historical evolution of the term. The US Army Medical Corps retains various surgeon United States military occupation codes in the ranks of officer pay grades, for military personnel dedicated to performing surgery on wounded soldiers.

Specialties

The Gross Clinic, 1875, Philadelphia Museum of Art and the Pennsylvania Academy of Fine Arts Thomas Eakins, American - Portrait of Dr. Samuel D. Gross (The Gross Clinic) - Google Art Project.jpg
The Gross Clinic, 1875, Philadelphia Museum of Art and the Pennsylvania Academy of Fine Arts

Some physicians who are general practitioners or specialists in family medicine or emergency medicine may perform limited ranges of minor, common, or emergency surgery. Anesthesia often accompanies surgery, and anesthesiologists and nurse anesthetists may oversee this aspect of surgery. Surgeon's assistant, surgical nurses, surgical technologists are trained professionals who support surgeons.

In the United States, the Department of Labor description of a surgeon is "a physician who treats diseases, injuries, and deformities by invasive, minimally-invasive, or non-invasive surgical methods, such as using instruments, appliances, or by manual manipulation". [11]

Pioneer surgeons

Kakish Ryskulova - first female surgeon in Kyrgyzstan Kakish Ryskulova.jpg
Kakish Ryskulova - first female surgeon in Kyrgyzstan
Russian surgeon Nikolay Pirogov - a pioneer of field surgery Ilya Repin Portrait of the Surgeon Nikolay Pirogov 1881.jpg
Russian surgeon Nikolay Pirogov - a pioneer of field surgery
Victor Horsley pioneered neurosurgery Victor Horsley.jpg
Victor Horsley pioneered neurosurgery

Organizations and fellowships

Related Research Articles

General surgery 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. They also deal with diseases involving the skin, breast, soft tissue, trauma, peripheral artery disease and hernias and perform endoscopic procedures such as gastroscopy and colonoscopy.

Neurosurgery Medical specialty of disorders which affect any portion of the nervous system

Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.

Surgery Use of incisive instruments on a person to investigate or treat a medical condition

Surgery is a medical or dental specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas.

Al-Zahrawi Arab Andalusian physician, surgeon and chemist (936–1013)

Abū al-Qāsim Khalaf ibn al-'Abbās al-Zahrāwī al-Ansari, popularly known as Al-Zahrawi (الزهراوي), Latinised as Abulcasis, was an Arab Andalusian physician, surgeon and chemist. Considered to be the greatest surgeon of the Middle Ages, he has been referred to as the "father of modern surgery".

Cardiothoracic surgery Medical specialty involved in surgical treatment of organs inside the thorax

Cardiothoracic surgery is the field of medicine involved in surgical treatment of organs inside the thoracic cavity — generally treatment of conditions of the heart, lungs, and other pleural or mediastinal structures.

Magdi Yacoub Egyptian retired professor and surgeon (born 1935)

Sir Magdi Habib Yacoub, is an Egyptian-British retired professor of cardiothoracic surgery at Imperial College London, best known for his early work in repairing heart valves with surgeon Donald Ross, adapting the Ross procedure, where the diseased aortic valve is replaced with the person's own pulmonary valve, devising the arterial switch operation (ASO) in transposition of the great arteries, and establishing the heart transplantation centre at Harefield Hospital in 1980 with a heart transplant for Derrick Morris, who at the time of his death was Europe's longest-surviving heart transplant recipient. Yacoub subsequently performed the UK's first combined heart and lung transplant in 1983.

Walter Randolph "Ranny" Chitwood, Jr. is known for his work as a cardiothoracic surgeon at the Brody School of Medicine at East Carolina University located in Greenville, North Carolina.

Bruce A. Reitz is an American cardiothoracic surgeon, best known for leading the first combined heart-lung transplantation in 1981 with pioneer heart transplant surgeon Norman Shumway. He obtained an undergraduate degree at Stanford University a medical degree at Yale Medical School and completed an internship at Johns Hopkins Hospital (1971) and residencies and fellowships at Stanford University Hospital the National Institutes of Health (1974). He joined the surgical faculty at Stanford University (1978) then became chief of cardiac surgery at Johns Hopkins University (1982–92) and Chairman of the Department of Cardiothoracic Surgery at Stanford (1992–2005). In 1995 he conducted another pioneering operation: the first Heartport procedure, using a device that allows minimally invasive coronary bypass and valve operations. Reitz also played a major role in the resident education program at Stanford, which he reorganized and maintained.

Sushruta Ancient Indian physician

Sushruta, or Suśruta was an ancient Indian physician and world's first surgeon known as “Father of Surgery”, “Father of Plastic Surgery" for inventing and developing surgical procedures. His work on the subject, the Sushruta Samhita is considered one of the oldest texts in the world on plastic surgery and is highly regarded as one of the Great Trilogy of Ayurvedic Medicine, the Brihat-Trayi; the other two being the Charaka Samhita, which preceded it, and the Astanga Hridaya, which followed it.

John W. Kirklin American physician

John Webster Kirklin was an American cardiothoracic surgeon, general surgeon, prolific author and medical educator who is best remembered for refining John Gibbon's heart–lung bypass machine via a pump-oxygenator to make feasible under direct vision, routine open-heart surgery and repairs of some congenital heart defects. The success of these operations was combined with his other advances, including teamwork and developments in establishing the correct diagnosis before surgery and progress in computerized intensive care unit monitoring after open heart surgery.

History of surgery

Surgery is the branch of medicine that deals with the physical manipulation of a bodily structure to diagnose, prevent, or cure an ailment. Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery is, "To eliminate that which is superfluous, restore that which has been dislocated, separate that which has been united, join that which has been divided and repair the defects of nature."

Cardiothoracic anesthesiology is a subspeciality of the medical practice of anesthesiology, devoted to the preoperative, intraoperative, and postoperative care of adult and pediatric patients undergoing cardiothoracic surgery and related invasive procedures.

Various individuals have advanced the surgical art and, as a result, have been called the father of surgery by various sources.

Donald Nixon Ross, FRCS was a South African-born British thoracic surgeon who was a pioneer of cardiac surgery and led the team that carried out the first heart transplantation in the United Kingdom in 1968. More significantly, he developed the pulmonary autograft, known as the Ross procedure, for treatment of aortic valve disease. Ross was born in Kimberley, South Africa, on 4 October 1922. He died in London on 7 July 2014.

Terence English South African-birn British retired surgeon

Sir Terence Alexander Hawthorne English is a South African-born British retired cardiac surgeon. He was Consultant Cardiothoracic Surgeon, Papworth Hospital and Addenbrooke's Hospital, Cambridge, 1973–1995. After starting a career in mining engineering, English switched to medicine and went on to lead the team that performed Britain's first successful heart transplant in August 1979 at Papworth, and soon established it as one of Europe's leading heart–lung transplant programmes.

Margaret Allen is an American cardiothoracic surgeon and an academic at the Benaroya Research Institute. She was the first woman to perform a heart transplant and is a former president of the United Network for Organ Sharing.

Philip Caves (1940–1978) was an Irish cardiothoracic surgeon. In 1972, while at Stanford University, he pioneered the use of the bioptome and transvenous endomyocardial biopsy in the early diagnosis of heart transplant rejection. It was considered the most significant advance in antirejection therapy of the time. Awarded the British American Research Fellowship in 1971, Caves worked with pioneering cardiothoracic surgeon Norman Shumway at Stanford and became staff surgeon leading the transplant programme by 1973. A year later he went to Edinburgh as a senior lecturer in cardiac surgery, where he became particularly interested in pediatric cardiac surgery.

Andrew Logan (surgeon) British cardio-thoracic surgeon

Andrew Logan, FRCS, FRCSEd was a British cardiothoracic surgeon. For most of his career he worked in Edinburgh where he established the specialty of cardio-thoracic surgery. He devised a mitral valve dilator to treat mitral stenosis and this technique, modified by Oswald Tubbs and by Russell Brock, became widely used to treat this condition. He assisted at the first pneumonectomy in the UK and performed the first lung transplant in the UK.

References

  1. Weiser TG, Haynes AB, Molina G, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet. 2015;385(suppl 2):S11.
  2. Liu L.Q., Mehigan S. A Systematic Review of Interventions Used to Enhance Implementation of and Compliance With the World Health Organization Surgical Safety Checklist in Adult Surgery. AORN J.. 2021;114(2):159-170. doi:10.1002/aorn.13469
  3. 1 2 Ira D. Papel, John Frodel, Facial Plastic and Reconstructive Surgery
  4. Singhal, G. D. (1972). Diagnostic considerations in ancient Indian surgery: (based on Nidāna-Sthāna of Suśruta Saṁhitā). Varanasi: Singhal Publications.
  5. Ahmad, Z. (St Thomas' Hospital) (2007), "Al-Zahrawi - The Father of Surgery", ANZ Journal of Surgery, 77 (Suppl. 1): A83, doi:10.1111/j.1445-2197.2007.04130_8.x, S2CID   57308997
  6. al-Zahrāwī, Abū al-Qāsim Khalaf ibn ʻAbbās; Studies, Gustave E. von Grunebaum Center for Near Eastern (1973). Albucasis on surgery and instruments. University of California Press. ISBN   978-0-520-01532-6 . Retrieved 16 May 2011.
  7. 1 2 Cosman, Madeleine Pelner; Jones, Linda Gale (2008). Handbook to Life in the Medieval World. Handbook to Life Series. Vol. 2. Infobase Publishing. pp. 528–530. ISBN   978-0-8160-4887-8.
  8. "Surgeons and Surgical Spaces #The barbers shop". sciencemuseum.org.uk. Retrieved 2020-05-05.
  9. "Patients: The Surgical Team: Qualifications of a surgeon". Royal College of Surgeons of England . Retrieved 13 June 2015.
  10. "RACS phases out gendered titles for surgeons". Royal Australasian College of Surgeons . Retrieved 31 August 2021.
  11. "Occupational Employment Statistic: Occupational Employment and Wages, May 2015: 29-1067 Surgeons". bls.gov. Retrieved 2016-04-26.
  12. http://www.neurosocietyindia.org/site/Past-president/Basant%20Kumar%20Misra,%20President%20NSI%202008.pdf [ bare URL PDF ]
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  14. "When Cornea Transplants Fail. What Next?" Archived 2006-09-09 at the Wayback Machine
  15. US Patent 4,840,175, "METHOD FOR MODIFYING CORNEAL CURVATURE", granted June 20, 1989
  16. A. Martin-Araguz, C. Bustamante-Martinez, Ajo V. Fernandez-Armayor, J. M. Moreno-Martinez (2002)