Surgical Team Health Article

Definition

The surgical team is a unit providing the continuum of care beginning with preoperative care, and extending through perioperative (during the surgery) procedures, and postoperative recovery. Each specialist on the team, whether surgeon, anesthesiologist or nurse, has advanced training for his or her role before, during, and after surgery.

Purpose

Surgery, whether elective, required or emergency, is done for a variety of conditions that include:

• cosmetic procedures
• diagnostic and exploratory procedures
• treatment of acute, chronic, and infectious diseases of tissue or organs
• transplantation of organs
• resposition and enhancement of bone, ligaments, tendons, or organ conduits
• replacement or implantation of artificial or electronic devices

The crucial elements of surgery—surgical and operative procedures, pain control, patient safety, and blood and wound control—require individual expertise and high levels of concentration and coordination. Through a team effort, the patient is treated and monitored as he or she undergoes significant acts of bodily invasion and pain control that make up the surgical experience. These surgical acts are true for the most benign and superficial operations, as well as the most intense.

Demographics

According to the Centers for Disease Control and Prevention and the National Center for Health Statistics, 40 million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. Leading surgeries included:

• digestive system surgeries: 12 million
• musculoskeletal system surgeries: 7.4 million
• cardiovascular system surgeries: 6.8 million
• eye surgeries: 5.4 million

Description

The makeup of the surgical team depends upon the type of surgery, the precise procedures, and the location and the type of anesthesia utilized. The team may include surgeons, anesthesiologists, and nursing and technical staff who are trained in general surgery or in a particular surgical specialty. Intense surgeries require larger teams and more comprehensive recovery care. Even though minimally invasive procedures (e.g., laparoscopy or endoscopy) are conducted with small instruments and a video camera probe, they require specialized expertise and high technology knowledge. These procedures utilize smaller teams, create less extensive wounds, and yield quicker healing, but often require more operating time and may result in operative injuries.

Types of surgery

Many surgeries are categorized as general surgery, and are associated primarily with accidents, emergencies, and trauma care. Hospitals have general surgeons that staff their emergency rooms or trauma centers. As surgical technology and knowledge have advanced, other surgical specialties have developed for each function and organ of the body. They involve special surgical techniques and anesthesiology requirements, and sometimes require subspecialtists with in-depth knowledge of organ function, operative techniques, complex anesthesiology procedures, and specialized nursing care.

The basic surgical specialties include:

• General surgery—General surgeons manage a broad spectrum of surgical conditions that involve almost any part of the body. They confirm the diagnoses provided by primary care or emergency physicians and radiologists, and perform procedures necessary to correct or alleviate the problem.
• Cardiothoracic surgery—A major surgical specialty with very high demands. The cardiothoracic surgical team oversees the preoperative, operative, and critical care of patients with pathologic conditions within the chest, including the heart and its valves, cancers of the lung, esophagus, and chest wall, and chest vessels.
• Neurosurgery—Neurosurgical teams specialize in surgery of the nervous system, including the brain, spine, and peripheral nervous system, and their supporting structures.
• Oral and maxillofacial surgery—Head and neck surgical teams provide treatment for problems of the ears, sinuses, mouth, pharynx, jaw, and other structures of the head and neck.
• Reconstructive and plastic surgery—Reconstructive surgery is performed on abnormal structures of the body due to injury, birth defects, infection, tumors, or disease. Cosmetic surgery is performed to improve a patient's appearance.
• Transplantation—Transplant surgical teams specialize in specific organ transplant techniques, such as heart and heart-lung transplants, liver transplants, and kidney/pancreas transplants. These highly intricate surgeries require very advanced training and technological support.
• Urology and renal transplantation—Also known as gastrointestinal surgery. The team specializes in problems of the digestive tract (stomach, bowels, liver, and gallbladder) with intensive use of or coordination with transplant team members.
• Vascular surgery—Vascular surgery offers diagnosis and treatment of such arterial and venous disorders as aneurysms, lower extremity revascularization, and other problems.
• Pediatric surgery—Pediatric surgical teams are specially trained to treat a broad range of conditions affecting infants and children. They work closely with specially trained anesthesiologists, and are experts in childhood diseases of the head, neck, chest, and abdomen, with training in birth defects and injuries. Many pediatric surgeons work to increase the use of minimally invasive techniques with children.