What is surgery

Surgery is medical treatment provided through an opening in the body. Traditionally, this meant making a large incision to perform the procedure, but advances in technology allow for making a few small (less than 1 centimeter) incisions and using tiny tools and cameras. 

The purpose of surgery varies, but it may be recommended for making or confirming a diagnosis, removing damaged tissue or an obstruction, repairing or repositioning tissues or organs, implanting devices, redirecting blood vessels, or transplanting tissues or organs. Some people opt for surgery for cosmetic reasons. 

Learning that you need surgery can be a confusing and intimidating prospect, and you may have many questions. It can be helpful to understand basic surgical terminology.

Common Surgical Terms

There are many terms that your doctor may use to describe surgery.

Some relate to what prompts the surgery:

  • Elective surgery: This is a surgery that you either plan to have for treatment (e.g., a lumpectomy), improvement of quality of life (e.g., a knee replacement), or for cosmetic purposes (e.g., a rhinoplasty).
  • Emergency surgery: This is a surgery that is done in order to treat an urgent medical need (e.g., appendectomy).

Others pertain to where the procedure will be performed:

  • Inpatient surgery: This is a procedure performed in the hospital with the expectation that the patient will stay overnight for at least one day.
  • Outpatient or same-day surgery: The procedure is performed in a hospital or surgery center with the expectation that the patient will go home after waking completely from anesthesia. This is also sometimes called ambulatory surgery.

Of course, there are myriad more. If you hear a term you are unfamiliar with or confused by, ask your doctor to clarify it for you.

Types and Phases of Surgery

The way in which a procedure is performed can minimize related risks and impact recovery time. Depending on what you are having done, your doctor may perform:

  • Open or traditional surgery: The traditional approach of using a single, full-length incision to perform a procedure.
  • Minimally invasive (laparoscopic) surgery: In contrast to the one long incision used in open surgery, this newer surgical technique involves several small incisions. This type of surgery usually requires a shorter recovery period than the same procedure using a large incision.
  • Robotic surgery: A robot is used to perform surgery, with a surgeon guiding the robot’s steady “hands.” This technique is used most frequently when tiny, undesired movements can change the outcome of the procedure.

Surgery is often broken down into phases that help group the tasks that need to be completed at a given time. There are three primary phases, which are described in greater detail below, are:

  • Preoperative, or pre-op, is the phase that starts with scheduling surgery and lasts until the procedure.
  • The operative phase is the procedure itself, from entering the operating room until leaving.
  • The postoperative, or post-op,phase begins when the surgery is completed and the recovery begins.

The term perioperative refers to the entire surgery experience and includes all three phases.

Deciding on Surgery

Surgery is not a decision to take lightly. With the exception of emergency surgery, most people have time to research the procedure and potential surgeons before committing. All surgeries come with risks, so it is important to talk this through with a physician before making a decision.

The first step is finding a surgeon. Ask around for recommendations. Your doctor will likely give you some suggestions, but it is also helpful to ask for recommendations from friends and loved ones. Once you have a list of names, check to confirm they are in your insurance plan, then research the doctor's reputation and credentials.

Tips for Choosing a Great Surgeon

Narrow the list down to two or three potential surgeons and make an appointment for a consultation and a second opinion. Talking to two surgeons can help solidify your decision to have the surgery, but it can also help you explore alternative options. Medicare, Medicaid, and most insurance plans will pay for a second opinion.

Make a list of questions you have and bring them to your appointment. Your doctor should be able to answer questions you have about your condition, offer possible treatments, and detail any recommended procedures.

Understanding the Risks of Having Surgery

Declining Surgery

If, in the end, you decide that surgery is not right for you, saying "no" is absolutely appropriate. There are times when a procedure may have benefits, but a patient is unwilling to undergo surgery for their own reasons. Making this choice is your right.

While it may lead to disagreements with family and friends, the decision belongs to you. If you go this route, just be sure that you are fully informed about (and willing to accept) any risks your decision may pose to your health.

For others, taking a less invasive approach may be preferred. Many patients view surgery as a last resort, rather than their first choice in treatments. For these patients, physical therapy, medication, lifestyle changes, and other types of interventions may be preferable.

How to Decide If You Need Surgery

Preop: Before Surgery

The preop period includes the time between scheduling the procedure (if elective) and being wheeled into the operating room. This time is your best opportunity to plan and prepare to have the best possible outcome from your surgery.

The office will provide information about where the surgery will be done and what to expect afterward. The exact time of your scheduled surgery and when you need to check-in is typically determined a day or two before the procedure.

Medical Clearance and Consult

When you schedule your surgery, your doctor's office will inform you of the next steps. These typically include a planning appointment or phone call with the anesthesia provider, who will go over your health history and discuss the type of anesthesia you'll receive and the risks involved.

Your doctor will give you a preop check-up to ensure you are healthy for surgery. This is typically done within a month before the surgery and gives the physician time to treat any other conditions you may have. Your doctor may refer you to another specialist such as a cardiologist if you have a history of heart disease, an endocrinologist if you have diabetes, or a hematologist if you have a history of blood clots.

Common tests your doctor may order include blood work, chest X-ray, electrocardiogram (ECG), a colonoscopy or upper endoscopy, heart stress test, lung function tests, and imaging, such as MRI, CT scan, or ultrasound. Make sure these test results and reports are also sent to your surgeon. 

Physical Preparation

Aside from choosing the right surgeon, preparing physically may be the most important thing a surgery patient can do to impact how successful the surgery is and how quickly the recovery phase ends.

This means optimizing one’s health in every possible way. From quitting smoking to doing routine exercise and improving control of diabetes, going into surgery as healthy as possible can mean shorter hospital stays, better long-term success, and a faster return to routine activity.

Your doctor's office will provide instructions for the days leading up to the surgery.

Emotional Preparation

For some, the thought of surgery can be daunting and overwhelming. You may need help overcoming this so you feel comfortable going into your procedure. Talk to your healthcare team about any concerns you have.

More than one million Americans have a successful surgical procedure each week, according to the National Quality Forum. While planning to have surgery can be stressful, it is usually a step toward better health and wellness.

Be sure to follow all of your doctor's preop instructions. This may include stopping prescription medications, avoiding certain over the counter drugs prior to surgery, not eating or drinking in the hours before surgery, and bathing according to directions.