INTRODUCTION TO THE GENERAL PRINCIPLES OF SURGERY AJADI ADETOLA DEPARTMENT OF VETERINARY MEDICINE AND SURGERY

HISTRORICAL BACKGROUND Knowledge of anatomy Haemorrhage Pathophysiology of surgical diseases Pain Infection Diagnosis of surgical diseases

HISTORICAL BACKGROUND Prof. Ambroise Pare’s (1510-1590) presented the ligature theory Prof. Williams T. G. Morton(1819- 1868) used sulphuric ether on a patient with congenital vascular tumor of the neck Joseph Lister (1827- 1912) pioneered the antisepsis and aseptic technique Conrad Roentgen (1845- 1923) discovered the x-ray William Stewart Halstead (1852- 1922) was credited with the modern principles of surgery

SURGERY: DEFINITIONS Surgery: The branch of medicine that deals with the diagnosis and management of injury, defects, deformities and diseases of animals using instrumental, operative or manipulative means Veterinary surgery: A specialty that deals with the diagnosis and treatment of elective and therapeutic conditions of companion, farm or laboratory animals using restraints, manual, instrumental or operative means

SURGERY: CLASSIFICATION Degree of invasiveness Degree of infection Part of body involved Objective of the surgery Need of patients Need of surgeons Type of practice

DEGREE OF INVASIVENESS Minor surgery: Procedures in which only the skin or mucous membrane and connective tissues are incised Major surgery: an invasive procedure involving opening into the body cavities Minimally invasive surgery: Surgery of the body cavities done with only small incision or no incision , such as through a cannula, laparoscope or endoscope

DEGREE OF INFECTION Aseptic surgery: surgery performed in an environment free from micro-organisms so that infection or suppuration does not prevail. Antiseptic surgery: a system of surgical practice which insists upon the use of antiseptics in the performance of operation and dressing of wounds.

OBJECTIVES OF THE SURGERY Palliative surgery: aimed at ameliorating or reducing clinical sign e.g. arthrodesis Prophylactic surgery: aimed at preventing untoward effect to the patient or handler e.g. dehorning Curative surgery: aimed at completely removing the cause of the disease e.g. removal of calculi, tumor extirpation Diagnostic surgery: aimed at investigating the cause of the disease through exploration and biopsy collection e.g. arthroscopy, exploratory laparotomy Cosmetic surgery: aimed at improving the appearance of the patient to conform to standards e.g. tail docking, ear cropping Reconstructive surgery: aimed at correction, restoration and improvement in the shape of body structures that are injured or deformed e.g. skin flaps Extirpative surgery: aimed at altering a disease process e.g. amputation, eye enucleation

SURGEONS NEED Minor surgery: a surgery that does not involve major body cavities and thus can be carried out outside of the theater, does not require strict asepsis, general anesthesia and extensive instrumentation e.g. castration Major surgery: a surgery that involves major body cavities and thus must be carried out in the theater, requires strict asepsis, general anesthesia and extensive instrumentation e.g. ovariohysterectomy

PATIENTS’S NEED Elective surgery: operative procedures that are optional, non-urgent and performed only when circumstances are favourable to the patient, client and the surgeon e.g. castration Required surgery: an operative procedure that is needed to deal with a pathological condition within a few weeks e.g. tumor resection Urgent surgery: an operative procedure that must be carried out within 1-2 days to deal with a pathological condition e.g. repair of ruptured diaphragm Emergency surgery: an operative procedure that must be undertaken immediately to treat acute, potentially life threatening conditions e.g. caesarian operation, repair of ruptured visceral

PART OF BODY INVOLVED Orthopaedic surgery: surgery involving the musculoskeletal systems Soft tissue surgery: surgery involving the skin and the underlying connective tissue Ophthalmic surgery: surgery involving the eye and the associated soft tissue surgery Urologic surgery: surgery involving the urinary tract

USES OF SURGERY To ameliorate or reducing clinical sign e.g. arthrodesis To prevent untoward effect to the patient or handler e.g. dehorning To remove the cause of surgical disease e.g. removal of calculi, tumor extirpation To investigate the cause of the disease through exploration and biopsy collection e.g. arthroscopy, exploratory laparotomy To improve the appearance of the patient in order to conform to standards e.g. tail docking, ear cropping To correct, restore and improve the shape of body structures that are injured or deformed e.g. skin flaps To alter disease process e.g. amputation, eye enucleation

COMPARISON BETWEEN VETERINARY MEDICINE AND SURGERY Requires very little instrumentation Does not involve operative means Only deals with the diagnosis and treatment of diseases Does not involve specialized skills Require minimal use of restraints which is mainly physical Does not required any asepsis does not require any specialized room Requires the use of instrument Involves operative means Involves both the diagnosis and treatment of diseases, injury, defect and disorders Involves specialized skills Involves the use of both physical and chemical restraints Required strict compliance with asepsis does is involve specialized room