Surgeon

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Surgeons performing operations

In modern medicine, a surgeon is a medical doctor who performs surgery. Although there are different traditions in different times and places, a modern surgeon is also a licensed physician or received the same medical training as physicians before specializing in surgery.

Contents

In some countries and jurisdictions, the title of 'surgeon' is restricted to maintain the integrity of the craft group in the medical profession. A specialist medically trained surgeon is to be distinguished from surgeons in podiatry, dentistry, and veterinary medicine. It is estimated that surgeons perform over 300 million surgical procedures globally each year. [1] [2]

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] In August 2021, the Royal Australasian College of Surgeons announced that it was advocating for this practice to be phased out and began encouraging the use of the gender neutral title 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]

Around the world, the array of 'surgical' pathology that a surgeon manages does not always require surgical methods. For example, surgeons treat diverticulitis conservatively using antibiotics and bowel rest. In some cases of small bowel obstruction, particularly where a patient has had previous abdominal surgery, the surgeon treats the patient with fluid resuscitation, nasogastric decompression of the stomach, which gives rise to resolution of the intestinal obstruction in cases where adhesions are the aetiology of the obstruction. The same is true for other craft groups in surgery.

Pioneer surgeons

Russian surgeon Nikolay Pirogov - a pioneer of field surgery N.I.Pirogov 1870 photo by P.S.Zhukov.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

<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. They 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">Neurosurgery</span> 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.

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

Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning, cosmetic surgery aims to improve the appearance of it. A comprehensive definition of plastic surgery has never been established, because it has no distinct anatomical object and thus overlaps with practically all other surgical specialties. An essential feature of plastic surgery is that it involves the treatment of conditions that require or may require tissue relocation skills.

<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 physically reach into a subject's body in order to investigate or treat pathological conditions such as a disease or injury, to alter bodily functions, to improve appearance, or to remove/replace unwanted tissues or foreign bodies. The subject receiving the surgery is typically a person, but can also be a non-human animal.

<span class="mw-page-title-main">Ophthalmology</span> Field of medicine treating eye disorders

Ophthalmology is a clinical and surgical specialty within medicine that deals with the diagnosis and treatment of eye disorders. A former term is oculism.

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 Albucasis or Abulcasis, was a physician, surgeon and chemist from al-Andalus. He is considered one of the greatest surgeons of the Middle Ages.

<span class="mw-page-title-main">Orthopedic surgery</span> Branch of surgery concerned with the musculoskeletal and bones system

Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.

Oral and maxillofacial surgery is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth, and jaws, as well as facial cosmetic surgery/facial plastic surgery including cleft lip and cleft palate surgery.

<span class="mw-page-title-main">Microsurgery</span>

Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves which have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Microsurgical techniques are utilized by several specialties today, such as general surgery, ophthalmology, orthopedic surgery, gynecological surgery, otolaryngology, neurosurgery, oral and maxillofacial surgery, plastic surgery, podiatric surgery and pediatric surgery.

<span class="mw-page-title-main">Lithotomy</span> Surgical method for removal of calculi stones

Lithotomy from Greek for "lithos" (stone) and "tomos" (cut), is a surgical method for removal of calculi, stones formed inside certain organs, such as the urinary tract, bladder, and gallbladder (gallstones), that cannot exit naturally through the urinary system or biliary tract. The procedure is usually performed by means of a surgical incision. Lithotomy differs from lithotripsy, where the stones are crushed either by a minimally invasive probe inserted through the exit canal, or by an acoustic pulse, which is a non-invasive procedure. Because of these less invasive procedures, the use of lithotomy has decreased significantly in the modern era.

Daoud Anastas Hanania is a Jordanian heart surgeon. Hanania is a former Lieutenant General in the Jordanian Armed Forces and former Senator in the Jordanian Parliament.

<i>Sushruta Samhita</i> Ancient Sanskrit medical compendium

The Sushruta Samhita is an ancient Sanskrit text on medicine and surgery, and one of the most important such treatises on this subject to survive from the ancient world. The Compendium of Suśruta is one of the foundational texts of Ayurveda, alongside the Charaka-Saṃhitā, the Bhela-Saṃhitā, and the medical portions of the Bower Manuscript. It is one of the two foundational Hindu texts on the medical profession that have survived from ancient India.

<span class="mw-page-title-main">Sushruta</span> Ancient Indian physician and surgeon

Sushruta, or Suśruta is the listed author of the Sushruta Samhita, a treatise considered to be one of the most important surviving ancient treatises on medicine and is considered a foundational text of Ayurveda. The treatise addresses all aspects of general medicine, but the impressive chapters on surgery have led to the false impression that this is its main topic. The translator G. D. Singhal dubbed Suśruta "the father of plastic surgery" on account of these detailed accounts of surgery.

<span class="mw-page-title-main">History of surgery</span>

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."

Adrian Kantrowitz was an American cardiac surgeon whose team performed the world's second heart transplant attempt at Maimonides Medical Center in Brooklyn, New York on December 6, 1967. The infant lived for only six hours. At a press conference afterwards, Kantrowitz emphasized that he considered the operation to have been a failure.

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. He developed the pulmonary autograft, known as the Ross procedure, for treatment of aortic valve disease.

<span class="mw-page-title-main">Andrew Logan (surgeon)</span> 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

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