Surgery has been something that has been around for many years, and has been a benefit to humanity in every aspect. From heart surgery, to brain surgery, to total knee replacement, surgery is helping us do things that will keep us healthy for just a little bit longer. For so many surgeries that are possible to get done, there has to be some way to categorize surgery, in which we call surgical specialties. There are many different surgical specialties that doctors can choose from to specialize in.
General surgery is one of many different surgery specialties that exists. “General surgery is the surgical specialty that focuses on the abdominal organs”(Whitlock). The general surgeon will diagnose, provide the pre-operation, the operations, and the post-operation care to the patient undergoing the surgery. These surgeries can be done on things such as the head, neck, skin, soft tissues, extremities, abdominal wall, and also the vascular, endocrine, and gastrointestinal systems. If an emergency were to happen in general surgery, the most common emergency surgery done with involve the abdomen, specifically the appendix. Some conditions, including trauma that occurs will require a wide range of experience and skill to get the patient stable. The person wanting to become a general surgery can choose exactly where they would like to specialize, they can choose just general surgery, or they could choose something specifically in the subject of general surgery, such as focusing on the abdomen or the GI tract, as many small hospitals have a need for surgeons trained in that area. After the student has received a medical degree, normally the student will become more educated on conditions that relate to general surgery. Although general surgery focuses on multiple conditions, thoracic surgery is a surgery that manages conditions occurring in the chest. Thoracic surgery specifically focuses on cancers of the lung, coronary artery disease, the esophagus, chest wall, congenital anomalies, diseases of the diaphragm, abnormalities of the great vessels and heart valves, and tumors of the mediastinum. Also, management of the breathing airways and injuries to the chest are also conditions focused on by a thoracic surgeon. “A thoracic surgeon possesses the knowledge, experiences, and technical skill to diagnose accurately, to operate upon safely, and to manage effectively patients with intrathoracic abnormalities that are appropriate for surgical treatment”(“What are the Surgical Specialties?”). Thoracic surgeons treat conditions that deal with the chest, but that excludes the heart. Thoracic surgeons need the knowledge of cardiorespiratory physiology and oncology, as well as the capability to use certain methods and devices to provide the type of treatment needed. Some of the devices and methods that thoracic surgeons need to know how to use include cardiac assist devices, management of cardiac dysrhythmias, respiratory support systems, extracorporeal circulation, as well as other invasive and noninvasive techniques. A cardiothoracic surgeon is technically a thoracic surgeon, but is also trained to perform surgery on the heart.
Cardiothoracic surgery is almost exactly like a thoracic surgeon, but surgeons specialized in this type of surgery are allowed to perform surgery on the heart. The types of surgery that can be performed by a cardiothoracic surgeon include thoracic surgery, oesophageal surgery, cardiac surgery, congenital surgery, and transplantation of the heart, as well as heart failure surgery. The main focus in cardiac surgery are operations dealing with coronary artery bypass grafting and valve operations. In thoracic surgery, the most common operations are most likely a pneumonectomy or a lobectomy. The amount of time that is spent clinically is split between many factors, most of the time is spent in intensive care and high dependency units. Most cardiothoracic surgery is planned and non-emergency. There is still a chance of having emergency work that is done outside of the surgeons normal working hours. A surgery that takes up a long demanding timeframe is the heart transplant surgery, and is mostly done at night, because it is so demanding. The amount of patients is low, but the patients are seen over a long time. To contrast between surgeries, a cardiothoracic surgery involves less emergency work than that of an orthopedic or general surgery. Fewer cardiothoracic surgeons are required because most of the conditions previously taken care of by a cardiothoracic surgeon can be done by a cardiologist. Cardiothoracic surgery and neurosurgery deal with some very vital parts of the human body. Neurosurgery can involve the brain, spinal cord, as well as the central nervous system. Neurosurgery covers all aspects of any brain surgery that needs to be done, ranging from the pre-operative imaging to even removing tumors in the brain. A neurosurgeon, also known as a brain surgeon, has received most of the training through general surgery. Typically, a residency for a neurosurgeon starts as a general surgeon resident for five years, then moves on to additional years that focuses on the neurosurgery part. There are many different reasons to have neurosurgery and the main one is trauma. If there is severe trauma to the head, the brain tends to swell, and surgery needs to be done to relieve the pressure and to provide more room for the brain to swell without causing any more damage. Another main reason for neurosurgery is cancer. A tumor is one of the things that may need to be removed, and/or needs to have a reduction in the size. This procedure of reducing the size of a tumor is called debulking. “Spinal surgery is the largest sub-specialty, accounting for more than 50% of the operative workload of some departments”(“Surgical Specialties”).
Orthopedic surgery focuses on the joints, along with the soft tissues, including ligaments, nerves, and muscles, as well as focusing on bones. As well as the other types of surgeries, orthopedic surgery has its number of different areas available to specialize in, such as, the hip or knee, ankle and foot, the spine, upper limb, lower limb, joint reconstruction, bone tumors, rheumatoid surgery, sports and exercise surgery, and pediatric orthopedics. The workload for an orthopedic surgery is very physical and demanding. Trauma is the main reason for orthopedic surgeons to work late at night and the on-call commitment is very demanding. Many of the practices done involve surgical procedures, but some conditions can be treated through the use of casts, splints, braces, and even physical therapy. If there are any abnormalities that deal with the musculoskeletal system, an orthopedic surgeon will see the patient as early as birth to the lifetime of the patient. Theses problems include tumors, trauma, infections, congenital deformities, degenerative conditions, and also metabolic disturbances. Orthopedics also can involve treatment of other muscular problems such as cerebral palsy, paraplegia, or stroke. The field of orthopedic surgery has become a very broad specialty. After a standard residency, a few additional years may be required to get the qualifications needed to perform effectively. These specialties include sports medicine, spine surgery, trauma surgery, joint replacement, oncology, and hand surgery. Orthopedic oncology’s main focus is cancerous tumors that affect the musculoskeletal system, and can be treated through radiotherapy and chemotherapy, along with excision of the tumor, and replacement of the bone or joint. Orthopedic surgeons also focus on pediatric orthopedics which can treat orthopedic problems in children, such as cerebral palsy, scoliosis, and dislocation of the hips, and other varieties of work that is seen in children.
The amount of surgical specialties is the result of one surgeon not being able to do every type of surgery that is possible. The reason why medical school is so long and extensive, is because these surgeons need to learn the inside and outside of the specialty that they specialize in. Although, there are many different specialties that one can choose from, only one can be specialized in because of the extensive schooling that is required. It takes a team of surgeons to get the surgery done correctly and effectively.