Advances in technology have changed surgery from a risky procedure, often used only as a last resort, to a safe and effective treatment with many applications. New surgical techniques and improved anaesthetic drugs have reduced risks, increased success rates, and shortened recovery times. Many new types of surgery are far less invasive than techniques used previously, and a stay in hospital is now often unnecessary. These improvements have done much to reduce most people’s anxiety about having an operation.
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Surgery now has such a wide range of applications that it has become the first choice treatment for many disorders, often bringing about immediate relief or even a complete cure.
Surgical procedures can be used to remove, repair, or replace damaged tissue anywhere in the body. A surgeon can take out a diseased body part, such as an inflamed appendix, or remove a tumour. Broken bones and torn tendons can be repaired following an accident. Diseased body organs, such as the kidneys, heart, and liver, can now be replaced with healthy donor organs, and artificial body parts, such as heart valves, can be implanted. Artificial joint replacement is now a routine operation.
Surgery can also be used to improve the efficiency of body functions. For example, blood flow to the heart muscle can be substantially improved by an operation to bypass blocked blood vessels using grafted lengths of veins taken from another part of the body.
In recent years, advances in surgical techniques have changed the way in which operations are performed. The most dramatic change has been the development of endoscopic surgery, in which a tube-like viewing instrument called an endoscope is used. The endoscope is inserted through a small incision made in the body or through a natural body opening. It is now possible to use an endoscope to perform many operations that would previously have needed open surgery, such as coronary artery bypass and stenting, and gallbladder removal. Recovery time from endoscopic surgery is much shorter than after open surgery, in which larger incisions are made in the skin. Endoscopes can also be used to take samples of diseased tissue, which are sent for laboratory examination.
Surgeons now use microscopes and tiny instruments to carry out detailed work on minute structures, such as blood vessels and nerves. Lasers are used for delicate operations on the eye, to remove skin blemishes, and to destroy tumours without damaging surrounding tissue. High-intensity, focused ultrasound and surgical techniques using high or low temperatures are increasingly being used to destroy tumours, and robotic surgery is starting to be used for certain operations, such as hernia repair and prostate cancer surgery.
Today, a wide range of body organs can be transplanted, largely due to the development of immunosuppressant drugs, which help the body to accept new organs by reducing the likelihood of rejection after transplant surgery.
There have also been improvements in care and monitoring before, during, and after surgical operations, as well as new anaesthetic drugs that have fewer side effects. Many operations can now be performed under local or regional anaesthesia. As a result of these developments, many people who might once have been considered too ill for surgery can be operated on successfully.
Choices in surgery
Advances in surgery mean that any operation now involves decisions that the patient and doctor need to make together. Many minor procedures can now be done in the doctor’s surgery rather than in hospital, and operations such as cataract removal, which used to require general anaesthesia, are now offered under local anaesthesia. Where the operation takes place and the type of anaesthesia used largely depend on age, general state of health, personal preference, and whether care can be provided at home following surgery.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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