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Physician surgeon elective surgery
You have to know everything of these entities.
Physician surgeon medical emergency
Physician surgeon elective surgery

Physician surgeon elective surgery
What should physician surgeon elective surgery know?
You have to know everything of these entities.
  1. General surgery elective surgeries

  2. Thoracic surgery elective surgeries

  3. Colon and rectal elective surgeries

  4. Obstetrics elective surgeries

  5. Gynecologic elective surgeries

  6. Neurological elective surgeries

  7. Ophthalmic elective surgeries

  8. Oral and maxillofacial elective surgeries

  9. Orthopaedic elective surgeries

  10. Otolaryngology elective surgeries

  11. Pediatric elective surgeries

  12. Plastic and maxillofacial elective surgeries

  13. Urology elective surgeries

  14. Vascular elective surgeries

How are other regions categorizing surgical categories?
In some regions, even anethesiologist is expected to have physician surgeon medical emergency, physician surgeon elective surgery abilities.
Here are various subcategories of surgery in other regions that needs to be updated.
Anesthesiology The specialty of anesthesia during surgery and pain management.
Bariatric Surgery The specialty of treating obesity with surgery.
Cardiac Surgery The specialty of treating heart problems with surgery.
Cardiothoracic Surgery The specialty of treating heart, lung and other problems in the chest with surgery.
Colon & Rectal Surgery The specialty of treating problems of the small and large intestine, the rectum and anus with surgery.
General Surgery The specialty of treating common abdominal problems such as hernias and appendicitis with surgery.
Gynecologic Surgery The specialty of treating problems with the female reproductive system with surgery.
Maxillofacial Surgery The specialty of treating problems of the mouth, jaw, neck and facial bones with surgery.
Neurosurgery The specialty of treating the central nervous system, including the brain and spinal cord, with surgery.
Obstetrics The specialty of treating women before, during and after childbirth which may include surgery such as a C-section.
Oncology The specialty of treating cancer with surgery.
Ophthalmology The specialty of treating conditions of the eye with surgery.
Oral Surgery The specialty of treating dental problems with surgery, such as wisdom tooth removal and root canals.
Orthopedic Surgery The specialty of treating problems of the bones, joints, ligaments and tendons with surgery.
Otolaryngology (Ear, Nose and Throat, ENT ) The specialty of treating problems of the ears, nose and throat with surgery.
Pediatric Surgery The specialty of treating health problems of children with surgery.
Plastic Surgery: Cosmetic & Reconstructive Surgery The specialty of improving the appearance for cosmetic reasons, or to correct defects for a more appealing appearance.
Podiatry Surgery (Podiatry) The specialty of treating problems of the feet with surgery.
Thoracic Surgery The specialty of treating problems in the chest cavity, except the heart, with surgery.
Transplant Surgery The specialty of replacing failing organs with donated organs with surgery.
Trauma Surgery The specialty of treating injuries from car crashes, gunshot wounds, stabbings and other traumatic injuries with surgery.
Vascular Surgery The specialty of treating problems of the blood vessels with surgery.
Critical, emergency, urgent surgeries have to be performed by physician surgeon medical emergency.
Surgery: Is it really indicated?
A statement mentions that the surgery department lacks equipments and infrastructure.
What type of equipment do you need?
If you audit existing surgeries, you will discover that most of them are not required, and there has been wrong clinical diagnosis.
A diagnosis of appendicitis: on operation, no findings of appendicitis.
A diagnosis of cholecystitis or cholelithiasis: on operation, no findings of cholecystitis or cholelithiasis.
A medical doctor is required to make correct clinical diagnoses. A surgeon is basically a medical doctor.
They ask for number of unwanted investigations but after that they still cannot reach a correct diagnosis and treatment.
Q: Who is a surgeon?
A: A surgeon is a medical doctor with additional training in specific medical procedures. Getting the title of surgeon does not mean he or she is a competent medical doctor. Not all surgeons can perform all medical procedures. Not all medical doctors can perform all medical procedures. Making an eight-inch incision and closing in three layers does not prove you are a surgeon or a medical doctor. Doing a burr hole and closing does not prove you are a surgeon. This is a medical or surgical procedure that can be taught in a few weeks. Doing medical or surgical procedures does not prove you are a competent medical doctor.

The ability to reach to a correct diagnosis and provide treatment is a requirement of all medical doctors while maintaining good character and good behavior.
Surgical Skills
A-Z Surgical Specialties

What are the surgical specialties?
  1. General Surgery

  2. Thoracic Surgery

  3. Colon and Rectal Surgery

  4. Obstetrics

  5. Gynecologic Surgery

  6. Neurological Surgery

  7. Ophthalmic Surgery

  8. Oral and Maxillofacial Surgery

  9. Orthopaedic Surgery

  10. Otolaryngology

  11. Pediatric Surgery

  12. Plastic and Maxillofacial Surgery

  13. Urology

  14. Vascular Surgery

What type of suggestions should a medical doctor (MD) forward to improve training programs in health care and medical education?
What do you have to do in case you need to be a surgeon?
What questions should a medical doctor or surgeon ask an anesthetist?
What are the different types of surgery?
What are the surgical specialties?
    Q: What is neurosurgery?
    Q: What is a neurosurgeon?
    Q: Who sees a neurosurgeon?
    Q: What might neurological care involve?
    Q: What areas of care are available?
    Q: Who is a neurosurgeon?
    Q: What does neuroscience care involve?
    Q: Where is the neuroscience patient cared for?
    Q: What medical conditions require brain surgery?
    Q: What risks are associated with brain surgery?
    Q: How is brain surgery done?
    Q: What are other names for brain surgery?
    Here are further guidelines.
Cardiothoracic surgery
    Q: Who are usually included in the Cardiovascular Thoracic Surgery Department team?
    Q: What is an MCh in cardiovascular and thoracic surgery?
    Q: How many MCh's in cardiovascular and thoracic surgery are required in the state?
    Q: What skills and knowledge are needed for an MCh in cardiovascular and thoracic surgery?
    Q: What are the duties and responsibilities of a person with an MCh in cardiovascular and thoracic surgery?
    Q: What equipment does cardiovascular and thoracic surgery need?
    Q: What other resources does cardiovascular and thoracic surgery need?
    Here are further guidelines.
Oral and maxillofacial surgery
Eye Surgery
OB/GYN Surgery
Paediatric surgery
Plastic Surgery
    How many plastic surgeons are required in the state?
    What specific skills and knowledge should be imparted to plastic surgeons?
    What specific cases do plastic surgeons treat?
    How should plastic surgery research in the state go ahead?
    How many plastic surgery operations were done in the state over the past 10 years?
    What was the diagnosis and treatment?
    How many total cleft lip and cleft palate children have been born in the state over the past 10 years?
    At what were they operated on?
    What was the outcome of the operation?
    How is cleft palate surgery done?
    How is cleft lip surgery done?
Orthopaedic surgery
General surgery

Do all cases of appendicitis need surgery?
Do all cases of cholecystitis or gallstones need surgery?

Dr. Qureshi's technique

Q: What are the advantages of laparoscopy?
A: It is less invasive, cost effective, results in fewer infections, and shorter hospital stay. Also, early return to work, minimal postoperative complications, and cosmetic advantages, too.

Can appendicitis be managed with endoscopic/Laparoscopy removal without general anesthesia?
Q: What does the surgeon use to close the wound?
Q: What is the difference between sutures, staples and Steri-Strips?
Q: Do all sutures dissolve?
Q: Is it painful to have sutures and staples removed?
Q: How is the wound bandaged?
Q: How should I care for my wound?
Q: Is it normal for the wound to itch?
Q: How do I take care of my wound at home?
Q: When can I take a shower?
Q: Does it take a long time for the wound to heal?

Do you have a question?
Can you make me wiser? How?
Can you make us wiser? How?
Would you like to add anything?

Who among you has done laparoscopic surgery?
How many surgeries have you done so far?
What was the diagnosis?
What were the indications?
What were the results?
Were there any post- procedure complications?
What were these complications?
What is been done to prevent these complications?
Who is the manufacturer of the equipment?
What is the material of the existing equipment?
What is been done to enhance the efficiency of a laparoscopy?
What is been done to train others?
Who has the responsibility to fund this research and development?
Surgical Skills

Do you know various surgical skills?
What are various surgical skills?

What is a surgical technique?
A systematic surgical procedure by which a medical condition is treated.

What questions should you answer in case you introduce new surgical technique?
Is this a new surgical technique or already listed in surgical skills practiced by others on human beings?

New Surgical Technique

Is there any specific name for this new surgical technique?
What is the name of this new surgical technique?
Have you discussed with other doctors the benefits, complications, and harms due to this new surgical technique?
For what type of patients is diagnosis and treatment with this new surgical technique useful?
How is this surgical technique going to improve the condition of the patient?
How is this surgical technique performed, from beginning to end?
For what medical condition is this surgical technique the only option of treatment?
What issues is this medical condition causing the patient?
What complications can occur due to this surgical technique?

Why was there a need to elaborate on these facts?

On September 12, 2013, Department of Surgical Gastroenterology SKIMS started sophisticated pancreatic surgery, pancreaticoduodenectomy with portal venous resection and later reconstruction. A team of surgeons headed by Prof. Omar Javed Shah was the first of its kind in Kashmir.
The above questions were not answered in the academic deliberations.
Here are further guidelines.

Operating Rooms of the Future
Surgical Emergencies
In case of any surgical recommendations, get second and third consultation immediately from supervisors before any surgical recommendations.

Surgical Instruments
How many surgical instruments are there for human surgery?
There are hundreds of surgical instruments for human surgery.

Can you name various surgical instruments?
Instruments used in general surgery.

What are six classes of surgical instruments by functions?
Six classes of surgical instruments by function.
1. Cutting surgical instruments
2. Grasping or holding surgical instruments
3. Haemostatic forceps surgical instruments (instruments used to stop blood flow)
4. Retractors surgical instruments
5. Clamps and distractors surgical instruments
6. Accessories and implants surgical instruments

What minimum resources are required by physician surgeon medical emergency and physician surgeon elective surgery in general surgery emergency or elective surgery?
1. Surgical needle holder
2. Surgical needle with thread
3. Scalpel
4. Haemostatic forceps
5. Suction tips and tubes
6. Dressing (medical)
7. Surgical table
8. Physician for assistance
9. General anesthesia (anesthetist)
10. Guide, for example Doctor Asif Qureshi at www.qureshiuniversity.com/surgeryworld.html from a distance.

If any juniors or students are around, this must be recorded.

In various surgeries other than general surgery emergency or elective, these surgery resources are required plus some extra surgical instruments.
Nowadays, computer and Internet with guidelines at www.qureshiuniversity.com/surgeryworld.html are essential.

What are several classes of surgical instruments?
There are several classes of surgical instruments:
Graspers, such as forceps
Clamps and occluders for blood vessels and other organs
Retractors, used to spread open skin, ribs, and other tissue
Distractors, positioners and stereotactic devices
Mechanical cutters (scalpels, lancets, drill bits, rasps, trocars, Ligasure, Harmonic scalpel, surgical scissors, rongeurs etc.)
Dilators and specula, for access to narrow passages or incisions
Suction tips and tubes, for removal of bodily fluids
Sealing devices, such as surgical staplers
Irrigation and injection needles, tips and tubes, for introducing fluid
Powered devices, such as drills, dermatomes
Scopes and probes, including fiber optic endoscopes and tactile probes
Carriers and appliers for optical, electronic, and mechanical devices
Ultrasound tissue disruptors, cryotomes, and cutting laser guides
Measurement devices, such as rulers and calipe

Cardiothoracic surgery, neurosurgery, orthopedic surgery, plastic surgery, other categories have some extra instruments compared to general surgery emergency or elective surgery.
Inside operating room
Is there a difference between operating room equipment and surgical instruments?
Yes, there is.

What are examples of operating room equipments?
What are examples of surgical instruments?
Operating Room Equipment
Operating room management
Operating Room Skills
Operating Room Skills Checklist
Surgical instruments
Surgical Documentation
Surgical Procedures
Elective surgery
Surgical Skills
What is emergency surgery?
How should emergency surgeries be classified?
What cases need emergency surgery?
What cases need an emergency operating room (OR)?
What cases need elective surgery?
What cases need an elective operating room (OR)?
What are examples of emergency surgeries?
Is there a difference between operating room equipment and surgical instruments?
What are examples of operating room equipments?
What are examples of surgical instruments?
Emergency Operating Room

Proposed operation

Urgency of case (choose)

Immediate (e.g. haemorrhage or laparotomy for septic shock)

Emergency (e.g. laparotomy for patient with organ dysfunction, tender obstruction, peritonitis)

Urgent (e.g patient with sepsis not as severe as above such as mild appendicitis)

Scheduled (e.g. non-elective but non-critically ill patient with obstruction, perianal abscess without systemic sepsis, diagnostic laparoscopy)

Delay from time of booking (in hours)

Time of day (choose)

Cause of delay


Goals & Objectives

After 30 minutes of orientation, the JMS should be able to:

Discuss the principles of aseptic technique
Demonstrate surgical scrub, gowning, and gloving
Identify hazards in the surgical setting
Identify the role of the scrub person, circulating nurse, and medical student
Discuss ways the JMS can participate in the care of the patient and thereby become an active, useful member of the surgical team


Lockers are available for your use during the hours between 0700-1800 while you are in the operating room.
You must bring your own lock.
Locks must be removed by 1800.
Any locks not removed between 1800-0700 are subject to being cut and contents removed for later disposition.

Surgical Operating Suites


All persons who enter the semirestricted and restricted areas of the surgical suite should be in hospital laundered surgical attire intended for use only within the surgical suite at UTMB.

All possible head and facial hair, including sideburns and neckline, should be covered when in the surgical suite. All persons entering an operating room or centerwell area should wear a mask.

All personnel entering the suite should have all jewelry confined or removed. Watches and plain wedding bands are acceptable. Earrings must be covered by the scrub cap. Nail polish and artificial nails should not be worn within the suite.

Protective barriers (gloves, masks, protective eyewear, and face shields) are provided by the hospital and should be utilized to reduce the risk of exposure to potentially infective agents.

Shoes should be dedicated to the OR and shoe covers are not required. If shoe covers are necessary, the wearer should remove them before leaving the operating room to avoid tracking blood and debris through the department.


A five (5) minute anatomical timed scrub will be used for all surgical hand scrubs.

Fingernails must be free of polish/enamel and of medium length. No jewelry is permitted on the hands and arms while performing as a member of the surgical team. **Remember to put your mask on prior to starting you scrub.** Wash hands and arms with solution to 2 inches above the elbow. Clean fingernails with file. Take sterile brush in right hand. Wet brush with water and soap. Scrub fingernails of left hand. Start scrubbing fingers of left hand, one at a time, treating each finger as four-sided; palm, knuckles, and back of hand. Repeat with right hand.

Scrub right wrist and continue up arm to 2 inches above elbow. Repeat with left arm. Discard brush. Rinse both hands and arms under running water keeping hands above level of elbow so that water runs off the elbows and not the hands.

Gloving Procedure - Open

Avoid contact of sterile gloves with ungloved hands during closed-glove procedure.

For closed-glove method, never let the fingers extend beyond the stockinette cuff during the procedure. Contact with ungloved fingers constitutes contamination of the glove. For open-glove method, touch only the cuff of the glove with ungloved hand, and then only glove to glove for other hand. If contamination occurs during either procedure, both gown and gloves must be discarded and new gown and gloves must be added.

When removing gloves after a procedure is finished, the gloves are removed after the gown is removed inside out, using glove-to-glove, then skin-to-skin technique.

Gloving Procedure - Closed

Points to Remember about Aseptic Technique

Adherence to the Principles of Aseptic Technique Reflects One's Surgical Conscience.

1. The patient is the center of the sterile field.

2. Only sterile items are used within the sterile field.
A. Examples of items used.
B. How do we know they are sterile? (Wrapping, label, storage)

3. Sterile persons are gowned and gloved.
A. Keep hands at waist level and in sight at all times.
B. Keep hands away from the face.
C. Never fold hands under arms.
D. Gowns are considered sterile in front from chest to level of sterile field, and the sleeves from above the elbow to cuffs. Gloves are sterile.
E. Sit only if sitting for entire procedure.

4. Tables are sterile only at table level.
A. Anything over the edge is considered unsterile, such as a suture or the table drape.
B. Use non-perforating device to secure tubing and cords to prevent them from sliding to the floor.

5. Sterile persons touch only sterile items or areas; unsterile persons touch only unsterile items or areas.
A. Sterile team members maintain contact with sterile field by wearing gloves and gowns.
B. Supplies are brought to sterile team members by the circulator, who opens wrappers on sterile packages. The circulator ensures a sterile transfer to the sterile field. Only sterile items touch sterile surfaces.

6. Unsterile persons avoid reaching over sterile field; sterile persons avoid leaning over unsterile area. A. Scrub person sets basins to be filled at edge of table to fill them.
B. Circulator pours with lip only over basin edge.
C. Scrub person drapes an unsterile table toward self first to avoid leaning over an unsterile area. Cuff drapes over gloved hands.
D. Scrub person stands back from the unsterile table when draping it to avoid leaning over an unsterile area.

7. Edges of anything that encloses sterile contents are considered unsterile.
A. When opening sterile packages, open away from you first. Secure flaps so they do not dangle.
B. The wrapper is considered sterile to within one inch of the wrapper.
C. In peel-open packages, the edges where glued, are not considered sterile.

8. Sterile field is created as close as possible to time of use.
A. Covering sterile tables is not recommended.

9. Sterile areas are continuously kept in view.
A. Sterility cannot be ensured without direct observation. An unguarded sterile field should be considered contaminated.

10. Sterile persons keep well within sterile area.
A. Sterile persons pass each other back to back or front to front.
B. Sterile person faces a sterile area to pass it.
C. Sterile persons stay within the sterile field. They do not walk around or go outside the room.
D. Movement is kept to a minimum to avoid contamination of sterile items or persons.

11. Unsterile persons avoid sterile areas.
A. Unsterile persons maintain a distance of at least 1 foot from the sterile field.
B. Unsterile persons face and observe a sterile area when passing it to be sure they do not touch it.
C. Unsterile persons never walk between two sterile fields. D. Circulator restricts to a minimum all activity near the sterile field.

12. Destruction of integrity of microbial barriers results in contamination.
A. Strike through is the soaking through of barrier from sterile to non-sterile or vice versa.
B. Sterility is event related.

13. Microorganisms must be kept to irreducible minimum.
A. Perfect asepsis is an idea. All microorganisms cannot be eliminated. Skin cannot be sterilized. Air is contaminated by droplets.



Cautery Units, Defibrillators, OR Beds, numerous pieces of equipment All equipment must be checked for electrical safety before use!!

Anesthetic Waste


Leaded aprons and shields available for use during procedures.

Laser Safety

Protective eyewear for patient and operating team. Doors remain closed with sign - "Danger, Laser in Use." Sterile water available in the room and on sterile field. Smoke evacuation system is to be employed when applicable. Surgery high filtration masks should be worn during procedures that produce a plume.

General Safety

Apply good body mechanics at all times when transferring patients. Operating room beds and gurneys will be locked before patient transfer. Operating safety belts will be used for all patients. Never disconnect or connect electrical equipment with wet or moist hands. Discard all needles, razors, scalpel blades and broken glass into special identified containers.


Precautions should be followed to reduce the risk of exposure to bloodborne pathogens. Each healthcare worker should assess their possible risks and take precautions to reduce these risks. Universal Precautions are designed to protect healthcare workers from occupational exposure and should be followed when potential for exposure might occur.

Universal blood and/or body fluid precautions should be consistently used for ALL patients. Fundamental to the concept of Universal Precautions is treating all blood and/or body fluids as if they were infected with bloodborne pathogens and taking appropriate protective measures, including the following:

1) Gloves should be worn for touching blood and/or body fluids, mucous membranes, non-intact skin, or items/surfaces soiled with blood and/or body fluids. Gloves should be changed after contact with each patient and hands washed after glove removal. Though gloves reduce the incidence of contamination, they cannot prevent penetrating injuries from needles and other sharp instruments.

2) Gowns or aprons should be worn during procedures that are likely to generate splashes of blood and/or body fluids onto clothing or exposed skin.

3) Masks and protective eyewear should be worn during procedures that are likely to generate droplets of blood and/or body fluids into the mucous membranes of the mouth, nose, or eyes.

4) Needles and sharps should be placed directly into a puncture-resistant leakproof container which should be as close as possible to the point of use. Needles should not be recapped, bent, broken, or manipulated by hand.

5) Hands and skin surfaces should be washed after contact with blood and/or body fluids, after removing gloves, and between patient contact.

6) Gloves should be worn to cleanup blood spills. Blood spills should be wiped up and then an EPA registered tuberculocidal disinfectant applied to the area. The disinfectant should have a one minute contact time and the area rinsed with tap water. If glass is involved, wear double gloves or heavy gloves. Pick up the glass with broom and dust pan, tongs, or a mechanical device.

7) Healthcare workers with exudative lesions or weeping dermatitis should not perform direct patient care until the condition resolves.

8) Disposable resuscitation devices should be used in an emergency.

9) Occupational Exposures: Definition
- Puncture wounds
- Needlesticks/Cuts
- Splashes into the eyes, mouth, or nose
- Contamination of an open wound

10) Occupational Exposures:
- Wash the area immediately with soap and water
- If splashed in the eyes mouth or nose have them properly flooded or irrigated with water
- Notify supervisor as soon as possible
- Call Employee Health Center at (409) 772-5582 for information regarding blood and/or body fluid exposure management



Scrub Nurse/Technician

A. Preoperative

Checks the card file for surgeon's special needs/requests. Opens sterile supplies.

Scrubs, gowns, and gloves and sets up sterile field. Obtains instruments from flash autoclave if necessary. Checks for proper functioning of instruments/equipment. Performs counts with circulator.

B. Preincisional

Completes the final preparation of sterile field. Assists surgeon with gowning/gloving. Assists surgeon with draping and passes off suction/cautery lines.

C. During the Procedure

Maintains orderly sterile field.

Anticipates the surgeon's needs (supplies/ equipment). Maintains internal count of sponges, needles and instruments. Verifies tissue specimen with surgeon, and passes off to circulator.

D. Closing Phase

Counts with circulator at proper intervals.
Organizes closing suture and dressings.
Begins clean-up of used instruments.
Applies sterile dressings.
Prepares for terminal cleaning of instruments and nondisposable supplies.
Reports to charge nurse for next assignment.

Circulating Nurse

A. Preoperative

Assists in assembling needed supplies.
Opens sterile supplies.
Assists scrub in gowning.
Performs and records counts.
Admits patient to surgical suite.

B. Preincisional

Transports patient to procedure room.
Assists with the positioning of the patient.
Assists anesthesia during induction.
Performs skin prep.
Assists with drapes; connects suction and cautery.
C. During the Procedure

Maintains orderly procedure room.
Anticipates needs of surgical team.
Maintains record of supplies added.
Receives specimen and labels it correctly.
Maintains charges and O.R. records.
Continually monitors aseptic technique and patients needs.

D. Closing Phase

Counts with scrub at proper intervals.
Finalizes records and charges.
Begins clean-up of procedure room.
Applies tape.
Assists anesthesia in preparing patient for transfer to PACU.
Takes patient to PACU with anesthesia and reports significant information to PACU nurse.
Disposes of specimen and records.
Reports to charge nurse for next assignment.

Medical Student

A. Preoperative

* Introduce self to nursing personnel.
** If "scrubbing in" on case, informs scrub person of glove and gown size.

B. Preincisional

* Assists with transfer of patient to OR bed.
* Brings patient a warm blanket.
* Performs patient catheterization if necessary.
* Performs skin prep.
** If "scrubbing in" on case, begin scrub early.
** If "scrubbing in" on case, assists surgeon and/or scrub person with draping when appropriate.

C. During the Procedure

* Answers physician pagers.
* Runs specimen to lab, when appropriate.

D. Closing Phase

* Assists with undraping of patient.
* Assists in preparing patient for transfer to PACU:
- Brings patient a warm blanket.
- Brings patient bed/stretcher into room.
- Assists with transfer of patient from OR bed to stretcher/bed.
For Surgeons
For Patients

Physician surgeon elective surgery
What should physician surgeon elective surgery know?
Annotation or definition of elective surgeries.
Basic abilities of a physician primary care, physician medical emergency room.
Surgical skills.
Questions that need answers before, during, and after surgical procedure.
Types of elective surgeries.
Operating room equipment
Operating room management
Operating room skills
Operating room skills checklist
Surgical instruments
Annotation or definition of elective surgeries.

Elective surgery
What is elective surgery?
What are the different types of Elective Surgery?
Which kind of surgeries are termed Elective?
How is the patient diagnosed and prepared for an elective surgery?
What is the post-operative procedure for an elective surgery?
What are the complications of an Elective Surgery?
Are all Elective Surgeries successful?
What is elective surgery?
Elective surgery is a term used for non-emergency surgery which is medically necessary, but can be delayed for at least 24 hours.
People who need emergency treatment will not be placed on the elective surgery list.
Elective surgery is usually performed in an operating theatre or procedure room under some form of anaesthesia by a surgeon.
Elective surgery is different to cosmetic surgery, which is not performed in public hospitals.

An elective surgery is a planned, non-emergency surgical procedure. It may be either medically required (e.g., ________ surgery), or optional (e.g., breast augmentation or implant) surgery.

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.

By contrast, an urgent surgery is one that can wait until the patient is medically stable, but should generally be done today or tomorrow, and an emergency surgery is one that must be performed without delay; the patient has no choice other than immediate surgery, if they do not want to risk permanent disability or death.

Elective surgeries may extend life or improve the quality of life physically and/or psychologically.

As a principle for elective surgery, patients are treated in accordance with their urgency category, but within each urgency category most patients are treated in the same order they are added to the waiting list. Elective surgery is different to cosmetic surgery, which is not performed in public hospitals.
Category Clinical description Meaning
Category 1 – Urgent Has the potential to deteriorate quickly to the point where it may become an emergency. Procedures that are clinically indicated within 30 days
Category 2 – Semi urgent Causes pain, dysfunction or disability.
Unlikely to deteriorate quickly.
Unlikely to become an emergency.
Procedures that are clinically indicated within 90 days
Category 3 – Non-Urgent Causes minimal or no pain, dysfunction or disability.
Unlikely to deteriorate quickly.
Does not have the potential to become an emergency.
Procedures that are clinically indicated within 365 days
Here are further guidelines.
What should physician surgeon elective surgery know?
You have to know everything of these entities.
  1. General surgery elective surgeries

  2. Thoracic surgery elective surgeries

  3. Colon and rectal elective surgeries

  4. Obstetrics elective surgeries

  5. Gynecologic elective surgeries

  6. Neurological elective surgeries

  7. Ophthalmic elective surgeries

  8. Oral and maxillofacial elective surgeries

  9. Orthopaedic elective surgeries

  10. Otolaryngology elective surgeries

  11. Pediatric elective surgeries

  12. Plastic and maxillofacial elective surgeries

  13. Urology elective surgeries

  14. Vascular elective surgeries

These abilities are must in addition to be basically a physician with abilities of diagnosis and treatment in various healthcare settings.

You can ask assistance of computer, Internet with http://www.qureshiuniversity.com/surgeryworld resources.

Surgical incision
Alert for all physicians.

In what situations in surgical emergencies or elective procedures is incision not required?
If there is any stab wound that caused prolapse of intestines, do not do any incision.
Do not do any laparotomy.
Do not cut any site or location in this situation.
Relocate the intestines to their original location and suture the stab wound.
Critical monitoring of the individual is required.

In what situation is surgical incision required?
See surgical incisions details.

What are the types of surgical incisions?
Head and neck
Abdomen and pelvis

Head and neck

Wilde's incision

Descriptions of Common Neurosurgical Operations

Burr Holes and Craniotomy
Anterior Cervical Discectomy and Fusion
Lumbar Microdiscectomy
Lumbar Decompressive Laminectomy
Carpal Tunnel Release
Ulnar Nerve Decompression or Transposition


I do not recommend Median sternotomy procedures unless the likely advantage to patient is discussed and verified.

Median sternotomy - This is the primary incision used for cardiac procedures. It extends from the sternal notch to the xiphoid process. The sternum is divided, and a finochietto retractor used to keep the incision open.

Thoracotomy - A division of the ribs from the side of the chest.

Abdomen and pelvis

Midline incision or midline laparotomy - The most common incision for laparotomy is the midline incision, a vertical incision which follows the linea alba. The upper midline incision usually extends from the xiphoid process to the umbilicus.

A typical lower midline incision is limited by the umbilicus superiorly and by the pubic symphysis inferiorly. Sometimes a single incision extending from xiphoid process to pubic symphysis is employed, especially in trauma surgery. Typically, a smooth curve is made around the umbilicus.

Pfannenstiel incision - The Pfannenstiel incision, a transverse incision below the umbilicus and just above the pubic symphysis. In the classic Pfannenstiel incision, the skin and subcutaneous tissue are incised transversally, but the linea alba is opened vertically. It is the incision of choice for Caesarean section and for abdominal hysterectomy for benign disease.

Chevron incision - This incision a cut is made on the abdomen below the rib cage. The cut starts under the mid-axillary line below the ribs on the right side of the abdomen and continues all the way across the abdomen to the opposite mid-axillary line thereby the whole width of the abdomen is cut to provide access to the liver. The average length of the incision is approximately 24 to 30 inches.

Cherney incision - Cherney described a transverse incision that allows excellent surgical exposure to the space of Retzius and the pelvic sidewall. The curvilinear skin and rectus fascial incision is made 2 finger breadths above the symphysis pubis and carried in Langer's lines from 2 fingerbreadths medial to one anterior superior iliac spine to the corresponding position medial to the opposite anterior superior iliac spine. The anterior rectus fascia is mobilized distally off the underlying rectus muscle bodies. The pyramidalis muscles are dissected free and sharply excised to expose the underlying rectus tendons. With an index finger, a plane is developed between the fibrous tendons of the rectus muscle and the underlying transversalis fascia. Using a sharp no.10 scalpel blade, the rectus tendons are transected transversely 1–2 cm distal to the superior edge of the pubic bone. Rectus muscle should never be cut. The rectus muscles are retracted and the peritoneum opened.The inferior epigastric vessels may need division. Closure is accomplished with 5 to 6 horizontal mattress sutures of permanent braided suture approximating the anterior rectus tendons to the intact distal anterior rectus fascia. Continuous monofilament suture closure of lateral edges of the rectus muscle to the anterior rectus fascia prevents hernia. Patients should wear a binder for at least 2 weeks. No incision provides wider pelvic exposure, and is relatively painless compared to midline incisions. Result is the most pleasing cosmetic result of any abdominal incision.

Gridiron's incision (Mc Burney's incision) - Described in 1894 by McBurney, used for appendectomy. An oblique incision made in the right lower quadrant of the abdomen, classically used for appendectomy. Incision is placed perpendicular to the spinoumblical line at Mc Burney's point, i.e. at the junction of lateral one-third and medial two-third of spino-umblical line.

Kocher’s incision - An oblique incision made in the right upper quadrant of the abdomen, classially used for open cholecystectomy. Named after Emil Theodor Kocher. It is appropriate for certain operations on the liver, gallbladder and biliary tract. This shares a name with the Kocher incision used for thyroid surgery: a transverse, slightly curved incision about 2 cm above the sternoclavicular joints;
Kustner’s incision - A transverse incision is made 5 cms above the symphysis pubis but below the anterior iliac spine. The subcutaneous tissue is then separated in the midline and the linea alba is exposed. A vertical midline incision is made through the linea alba. Care is taken to control and ligate any branches of the superficial epigastric vessels. This step of the incision is usually time consuming and is one of the limitations associated. This type of incision offers little extensibility and less exposure than a Pfannestiel incision.

Lanz incision - A variation of the traditional Mc Burney's incision, which was made at McBurney's point on the abdomen: The Lanz incision is made at the same point along the transverse plane and deemed cosmetically better. It is typically used to perform an open appendectomy. Variations exist on the method used to locate the incision. Some surgeons advocate that the incision is made approximately 2 cm below the umbilicus centered on mid clavicular-midinguinal line. Others imply use of McBurney's point to center the incision (1/3rd of the distance from the anterior superior iliac spine to the umbilicus). Maylard incision - A variation of Pfannenstiel incision is the Maylard incision in which the rectus abdominis muscles are sectioned transversally to permit wider access to the pelvis.[4] The Maylard incision is also called the Mackenrodt incision. The incision in the rectus muscles is performed with the help of cautery, scalpel or surgical stapler. It is important to identify the inferior epigastric vessels on the lateral surface of these muscles and ensure their isolation and ligation if the incision will span more than half the rectus muscle width. It is advisable not to separate the rectus muscles from the anterior rectus sheath to prevent their retraction, which in turn facilitates closure at the end of the procedure. Among the complications associated with this type of incision is delayed bleeding from the cut edges of the rectus muscles as well as the deep epigastric vessels. Furthermore depending on the patient's body habitus, this incision may not offer adequate exposure to the upper abdomen.

McBurney incision - This is the incision used for open appendectomy, it begins 2 to 5 centimeters above the anterior superior iliac spine and continues to a point one-third of the way to the umbilicus (McBurney's point). Thus, the incision is parallel to the external oblique muscle of the abdomen which allows the muscle to be split in the direction of its fibers, decreasing healing times and scar tissue formation. This incision heals rapidly and generally has good cosmetic results, especially if a subcuticular suture is used to close the skin.

McEvedy's incision - McEvedy's original incision was a lateral paramedian incision which used to incise the rectus sheath along its lateral margin and gain access by pulling the rectus medially. This incision became obsolete because of very high incisional hernia rate. A modification was introduced by Nyhus which used a transverse (oblique) skin incision 3 cm above the inguinal ligament and a transverse incision (oblique) to divide the anterior rectus sheath. The rectus muscle was then pulled medially. This modification prevented the high incisional hernia rate.

Turner-Warwick's incision - This type of incision is placed 2 cm above the symphysis pubis and within the lateral borders of the rectus muscles. The sheath overlying the rectus muscles at the symphysis pubis is released, 4 cm transversely, and the incision angled up to the lateral borders of the rectus muscles. The lateral edges of the incisions remain medial to the internal oblique muscles. The sheath may be released off the aponeurosis with the help of traction applied using Kocker clamps. The pyramidalis muscles are typically left attached to the aponeurosis. The rectus muscles are separated and the incision is made in the midline. This type of incision is good for exposure of the retropubic space but offers limited access to the upper pelvis and abdomen.


I do not recommend Mini Asymmetric Radial Keratotomy and Radial keratotomy procedures unless the likely advantage to patient is discussed and verified.

Mini Asymmetric Radial Keratotomy -Used in eye surgery to cure keratoconus and correct astigmatism. It consists of a series of microincisions of variable depth, with a length between 1.75 and 2.25 millimeters, always made with a diamond knife, designed to cause a controlled scarring of the cornea, which changes its thickness and shape.

Radial keratotomy - Used in eye surgery: corneal microincisions made to flatten the cornea and correct myopia.

Surgical tables
What are the types of surgical tables?
There are at least nine types of surgical tables.
C-arm tables
Examination table
Examination table powered
Lithotripsy tables
Operating room tables
Procedure Chairs
Ultrasound tables
Urology tables
Surgical table with table accessories

What type of surgical table is required for this surgery procedure?

Position on surgical table:
What are the types of surgical positions?
Lithotomy (stirrups)
Jackknife (3500 or 6001)
Right lat decubitus (bean bag)
Left lat decubitus (bean bag)
There are at least 14 positions on a surgical table.

Here are further facts.
Supine position The most common surgical position. The patient lies with back flat on operating room bed.
Trendelenburg position Same as supine position but the upper torso is lowered.
Reverse Trendelenburg position Same as supine but upper torso is raised and legs are lowered.
Fracture Table Position For hip fracture surgery. Upper torso is in supine position with unaffected leg raised. Affected leg is extended with no lower support. The leg is strapped at the ankle and there is padding in the groin to keep pressure on the leg and hip.
Lithotomy position Used for gynecological, anal, and urological procedures. Upper torso is placed in the supine position, legs are raised and secured, arms are extended.
Fowler's position Begins with patient in supine position. Upper torso is slowly raised to a 90 degree position.
Semi-Fowlers position Lower torso is in supine position and the upper torso is bent at a nearly 85 degree position. The patient's head is secured by a restraint.
Prone position Patient lies with stomach on the bed. Abdomen can be raised off the bed.
Jackknife position Also called the Kraske position. Patient's abdomen lies flat on the bed. The bed is scissored so the hip is lifted and the legs and head are low.
Knee-chest position Similar to the jackknife except the legs are bent at the knee at a 90 degree angle.
Lateral position Also called the side-lying position, it is like the jackknife except the patient is on his or her side. Other similar positions are Lateral chest and Lateral kidney.
Lloyd-Davies position It is a medical term referring to a common position for surgical procedures involving the pelvis and lower abdomen. The majority of colorectal and pelvic surgery is conducted with the patient in the Lloyd-Davis position.
Kidney position The kidney position is much like the lateral position except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift.
Sims' position The Sims' position is a variation of the left lateral position. The patient is usually awake and helps with the positioning. The patient will roll to his or her left side. Keeping the left leg straight, the patient will slide the left hip back and bend the right leg. This position allows access to the anus.

What should be the position of the patient on the surgical table?

Document that should be ready before any surgery operation room scheduling facts
What is the date and time of surgery?
Date: ____________
Time of Surgery: ___________

What is the name, date of birth, identification mark of the patient?


Before anesthesia and surgery, ask patient name, date of birth, and identification mark.

What is name of physician surgeon medical emergency or physician surgeon elective surgery?


What best describes the surgery?


Who all are included during surgery in surgical procedure?
Physician surgeon medical emergency or physician surgeon elective surgery
Physician anesthetist medical emergency or elective.
Operating room nurse
Guide to all of them for example, Doctor Asif Qureshi www.qureshiuniversity.com/surgeryworld.html.

Surgical tables

What type of surgical table is required for this surgery procedure?
There are at least nine types of surgical tables.


Position on Surgical Table:

What should be position of patient on the surgical table?
Lithotomy (stirrups)
Jackknife (3500 or 6001)
Right lat decubitus (bean bag)
Left lat decubitus (bean bag)
There are at least 14 positions on surgical table.


Surgical incisions.

Alert for all physicians.

Is there any directive not to give surgical incision?
In what situations can surgical incision be or not be given?
See situations surgical incision cannot be given or should not be given.

What should be the postoperative bed location?
Surgical intensive care unit.
Postoperative ward.
Other location; specify.


How long will the surgical procedure last?
Case length (add 15 min for intubated patient): ____________


What resources are required for this surgical procedure, including surgical instruments?


What best describes pain block for this patient?
Pain block:
No block
Nerve block
Nerve catheter
Femoral block
Intrascalene block
Popliteral block
Sciatic block


What is the diagnosis of the patient?

What are the medical or surgical procedure details?


Surgical procedure
Questions that need answers before, during, and after surgical procedure.
What questions should be answered before, during and after surgical procedure?
Questions to be answered before the surgery.
Preoperative instructions
Questions to be answered in postoperative notes.
Questions to be answered in follow-up consultations.
If the expected procedure or surgery is likely to harm the patient, do not go ahead with surgery. If all the questions are not answered, do not go ahead with surgery.

Questions to be answered before the surgery.
  1. Where is the patient now?

  2. What is the name of the individual who needs doctor consultation?

  3. What is the date of birth of the individual who needs doctor consultation?

  4. What is your mailing address?

  5. What was your mailing address from birth until now?

  6. What is your Email address?

  7. Where do you live now?
    How long have you lived at this address?

  8. How long do you plan to live at this address?

  9. What is your contact information including current mailing address, telephone, e-mail, and any other details, and person to contact in case of emergency?

  10. Questions to be answered before the surgery.
    Who will do the expected procedure?

  11. What is the expected procedure?

  12. What is the expected date, time, and location of surgery?

  13. What is the diagnosis of the patient?

  14. Who verified the diagnosis of the patient?

  15. What prominent mark is on the face or body of the individual for identification?

  16. What is the profile of the patient’s primary care physician?

  17. How will this procedure help or enhance the life of the patient?

  18. Is the surgery really required?

  19. If surgery is really indicated, these questions must be answered. Why do you recommend this operation?

  20. What operation are you recommending?

  21. Is there more than one way to do this operation?

  22. Are there alternative to surgery?

  23. What are the details of the operation?

  24. What are the advantages of this operation?

  25. What are the risks of having this operation?

  26. What will happen if this operation is not done?

  27. Who can give a second opinion?

  28. What kind of anesthesia is required?

  29. How long is the operation?

  30. How long will it take to recover from the operation?

  31. How much experience has the doctor had in diagnosing and treating such cases?

  32. How much experience does the doctor have in this specific operation?

  33. Has this type of operation been discussed publicly?

  34. At what hospital will the operation be done?

  35. How long will the doctor be available in the hospital?

  36. Has the surgeon marked the site where he or she will operate with all the preoperative, operative, and postoperative guidelines?

  37. What is the gender of the patient?
    What best describes the patient?:
    Adolescent girl
    Adolescent boy

  38. What best describes the surgery?
    Cardiothoracic surgery
    Eye surgery
    General surgery
    OB/GYN surgery
    Oral and maxillofacial surgery
    Orthopedic surgery
    Pediatric surgery
    Plastic surgery

  39. Is this emergency surgery, urgent surgery, or elective surgery?
    What are examples of emergency surgery, urgent surgery, and elective surgery?

    Emergency surgery

    Urgent surgery

    Elective surgery

Preoperative instructions
Preoperative instructions

Questions to be answered in postoperative notes.
Inside operating room
Operative notes
Postoperative complications

Questions to be answered in follow-up consultations.
How did the patient improve or was helped by the specific procedure or surgery?
In general, how is your physical and mental health?
Postoperative follow-up
Last Updated: May 22, 2018