Talk:Surgery

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[edit] Wobbly Hands

I've heard that surgeons have to retire at 60 years-old because they can't keep their hands perfectly still anymore at that age. Is this true? It seems to make sense, older people do seem to have this problem. If this is true, I think it warrants inclusion on this page.

Answer: No, this is not true. Obviously some older people may have this problem, but others will not. In the United States, the Age Discrimination in Employment law prevents forced retirement of older surgeon-employees at hospitals, etc., at some specified age, provided they can continue to do their job, with or without "accommodation." In fact, one "young" surgeon (about 50 years old at the time) had a nervous breakdown in the middle of surgery and walked out, leaving his assistant to finish. While that has nothing to do with wobbly/shakey hands, it does show there are other things for a patient to worry about.

Another answer: No, as a pre-med student, some of the finest surgeons I have met are considered "old". They are extremely skilled and experienced. Think of it this way; have you ever tried to hold your hands perfectly still? No matter how hard you try, gravity will make your hands shake no matter how old you are. Even with mild tremors, an experienced surgeon will still be as effective as he/she was when at a younger age.

[edit] Napoleonic Wars?

"The first surgeons were battlefield doctors in the Napoleonic Wars". This seems improbable. The article itself hints that there were surgeons already in antiquity.
S.

Yes, this is a wrong assertion. Even the ancient egyptians practiced successful brain surgery. Successful,in that their patients survived the procedures, at least sometimes. One ancient skull shows three healed trepannings, with rounded edges, and one fresh trepanning, with recent, square edges, indicating the patient died during, or soon after, surgery.

Where is Ben Carson on your list of noted surgeons?! What about Levi Watkins, the Cardiovascular surgeon?! And what about the surgical pioneer--the first surgeon to successfully perform open-heart surgery on a patient--Dr. Daniel Hale Williams? Your list is corrupt and incomplete

Wouldn't many surgeons object to surgery being called a sub-branch of medicine? In hospitals medicine and surgery are the two largest branchs of healthcare (with say occupational health, alternative healthcare etc being the others). BozMo(talk)

I'm sure some surgeons would object as you suggest. However, if you want to become a surgeon today, you have to qualify in – yes, medicine: a branch of health science concerned with restoring and maintaining health and wellness. The distinction that you draw is actually between surgery and "general" medicine (also termed "internal" medicine in some countries). --Soundray 23:38, 16 May 2004 (UTC)

[edit] An ancient Practice

Inserted modern to clarify that Napolean's battlefield doctors were not the first surgeons...for surgery is an ancient practice dating back to prehistorical times, as the archeological evidence shows.icut4u

Actually, it turns out this is a gray area. It depends on how you define surgery, in an operating theatre with an intent to heal. Surgery was primarily done at the location of the patient and as a last resort or kind of experiment, up to the 1840's. Until then it was considered extremely painful and a shot in the dark. Winning the lottery had better chances than surgery, because of infection. So the Napoleonic Wars were really the first period where you could speak of 'an operating theatre' where the patients were brought to the surgeon, and he was helped by assistents and/or nurses. Amputation had a poor survival rate due to gangrene, but some did survive to fight another day. Before this, the 'surgeon' was a man with dental skills (pulling teeth), childbirth (caesarians ended in the death of the mother) skills, or blood letting. Jane 15:42, 12 May 2006 (UTC)

As you say it depends on how you define surgery...Amputations were performed well before the Napoleonic Wars with patients being brought to the doctor so in that sense surgery probably has been performed since egyptian days or earlier. Homish 01:12, 29 January 2007 (ADST)

[edit] Practice and reputation section

The Practice and reputation section is full of non-NPOV and either needs to be brought up to encyclopaedic standard or removed. --Daveb 14:26, 23 May 2005 (UTC)

Removed. --Daveb 09:22, 3 Jun 2005 (UTC)
Hey, I contributed most of that section---except for the last sentence, which was definitely way too POV. Anyway, what was POV about the rest of the section? Every single factual assertion in it is true, at least with regard to surgeons in the United States.
Have you ever worked in the healthcare industry? Do you personally know any surgeons? Have you ever watched a television or a movie with a surgeon as an important character? If you feel that some assertions are untrue if applied to non-American surgeons, please be specific and perhaps we can compromise by adding geographic limitations to qualify my statements.
Otherwise, I'll put the parts that I contributed back into the article in a few days.
--Coolcaesar 01:22, 4 Jun 2005 (UTC)
Let's see:
  • Among all physicians, surgeons tend to be the most highly respected and the highest paid. Really? Do we have a reference to support that statement?
  • This could be attributed to the fact that they literally hold a person's life in their hands, while MRI scans and small incisions are the closest that most physicians will get to seeing the insides of their patients. "Hold person's life in their hands" any more so than an intensivist, anesthesiologist, interventional cardiologist, other proceduralist?
  • Surgery requires a sound grasp of anatomy, fast diagnostic instincts, steady hands, and superhuman stamina, since one cannot simply drop everything to visit the restroom while performing a heart transplant. Superhuman stamnia? As someone who has spent countless hours at the operating table, I can assure you that the feat is hardly superhuman!
  • The top surgery programs in the world reportedly test the stamina of new students by asking them to observe an entire operation from start to end; anyone who leaves early leaves the program. I have never seen or heard of this in practice; again, do you have any real reference to support this statement?
  • Unfortunately, because they are members of an elite group, surgeons have a universal reputation for arrogance. Could you define "elite group"? And again, could you somehow support the "universal reputation for arrogance"?
  • The stereotype of the "arrogant surgeon" has become a stock figure in entertainment scripts set in hospitals. I will agree that such a figure is often used in fictional entertainment, though what you see on TV is hardly basis for making sweeping and unsupported statements in an encyclopedia.
Summary: Let's stick to the facts.
Cheers, --Daveb 05:45, 4 Jun 2005 (UTC)

[edit] List of Surgeons

I'm not really happy with the current list of surgeons just growing unchecked; my opinion is that every Joe Random Surgeon gets added to the list, without any basis for notoriety. I'm not sure how to approach it, though — can we maybe agree on some criteria to list people, or maybe only keep it down to (say) 5 or so really notable and/or historic surgeons? Wikipedia isn't a list dump. Dewet 16:15, 31 May 2005 (UTC)

I'm agree with keeping only a bunch of notable surgeons in this article, but I don't think that the list should be completely removed. I propose to create a new article called List of surgeons or something like that to move the entire current list, leaving in this article only the really notable surgeons. Wikipedia isn't a paper enciclopedia, it don't have space problems. --surueña 20:54, 2005 May 31 (UTC)
I also think that the List of surgeons is the way forward. Yes, Wikipedia isn't a paper encyclopedia in terms of space, but it also is not a repository of links in terms of content. But I'll take a stab at it now. Dewet 06:31, 1 Jun 2005 (UTC)
Yes, I had not explained myself correctly. I wanted to say that IMHO this article about surgery shouldn't have a so long list of surgeons, only a few very notable cases, and a long list is OK but if moved to other article. But I forgot to said that that new list should have some added value and not be only an alphabetical list of surgeons, that list already exists at Category:Surgeons (and with no maintenance problems). I don't know how, but maybe in this new article they could be ordered by date showing their achievements. --surueña 07:55, 2005 Jun 1 (UTC)
Good idea. I also thought about the ordering, and considered doing it by country/continent, although it probably would be more useful to do it chronologically. If no-one else tackles this, I'll take a look at it sometime later on... Dewet 08:00, 1 Jun 2005 (UTC)
OK, I've made a few alterations; I have no knowledge of the profession, so I chose a handful of people who have an article with some details, seeming notable (IMO) in some fashion. Dewet 07:51, 1 Jun 2005 (UTC)

[edit] Common surgical procedures

Why are only the obstetric ones listed here? I am curious what the other most common procedures are...

Yes, the section as it currently exists makes no sense. A statement about the eight most common surgical procedures in the U.S. is followed by a list of five procedures, with no indication of why the other three are omitted. And the list is followed by this sentence: "According to 1996 data from the US National Center for Health Statistics, 40.3 million inpatient surgical procedures were performed in the United States in 1996, followed closely by 31.5 million outpatient surgeries." Why is that sentence even in this section? It has nothing to do with the topic of common surgical procedures; it's just a random (and rather out of date) statistic. Pat Berry 23:43, 31 March 2006 (UTC)

[edit] Ancient Egyptian Dentistry

"Researchers have also uncovered an Ancient Egyptian mandible, dated to approximately 2750 BC, having two perforations just below the root of the first molar, indicating the draining of an abscessed tooth." - I'm sure I read something in a New Scientist recently about Ancient Egyptian dentistry being massively over-estimated, and that apparent evidence of surgery was in fact just an abscess having increased in size, or similar. Anyone want a look? I think it might have been in the 'Histories' section... --HiddenInPlainSight 09:56, 23 August 2005 (UTC)

[edit] Templates for surgical subjects

This page has a lot about what one might call the social side of surgery, history, accomplishments, most common procedures, eminent surgeons etc. It lacks the scientific side of surgery - what do surgeons actually do and how do they make decisions. On the Talk:Orthopedic surgery page I have posted a template for description of ortho conditions and another for description of ortho procedures. They indicate how orthopaedic surgeons organize their thinking about their subject. Are they relevant here? Are these templates more widely applicable to surgery subjects? Have I missed finding a well accepted wiki template for these subjects? --Mylesclough 03:38, 9 October 2005 (UTC)

[edit] Michael Woodruff

I have requested a peer review for the article on Michael Woodruff, a pioneering transplant surgeon. I'm looking for as much feedback and this page seemed like a good place to find people interested in the subject. So, if anyone reading this would please participate at Wikipedia:Peer review/Michael Woodruff/archive1 it would be greatly appreciated. Thank you very much. Cool3 18:35, 10 May 2006 (UTC)

Public domain pictures and diagrams of many forms of surgery are available on the NIH NCI website. See:

Hope that helps, — Catherine\talk 04:39, 28 August 2006 (UTC)

[edit] Prehistoric Pakistan

This citation does not refer to the Ancient India. Drilling and cleaning teeth 9000 years ago (which stopped 1500 years later) apparently predated the Indus Valley Civilization (c.3000 BC) by some 4000 years. (Igny 15:16, 30 September 2006 (UTC))

I have removed the following paragraph, waiting for a clarification and references. I also added citation needed throughout the text.

In 2001, archaeologists studying the remains of two men from Mehrgarh, Pakistan, made the discovery that the people of Indus Valley Civilization, even from the early Harappan periods (c. 3300 BC), had knowledge of medicine and dentistry. The physical anthropologist that carried out the examinations, Professor Andrea Cucina from the University of Missouri-Columbia, made the discovery when he was cleaning the teeth from one of the men (see History of medicine). Later research in the same area found evidence of teeth having been drilled, dating back 9,000 years. [1]

[edit] Prosthetic Surgeon

Is there such thing as a Prosthetic Surgeon? A surgeon that deals mainly with all forms of prosthesis? Zachorious 12:02, 16 October 2006 (UTC)

There is orthopedic surgery which deals with prosthesis also. But it could be like the difference between the orthodontists and the technicians who make the crowns/artificial jaws/etc. (Igny 12:57, 16 October 2006 (UTC))

Some surgeons perform a lot of amputations, and have to prepare a suitable stump to take a prosthesis: they are often vascular or trauma specialists, rather than orthopaedic surgeons. Most of the medical practitioners involved with amputees are not surgeons, but specialists in rehabilitation medicine, known in the USA as "physiatrists." Modern prostheses are no longer carved from wood, and may incorporate advanced technology: the technicians ("prosthetists") who make or modify them are qualified to degree level. Bio-engineers are also involved. NRPanikker 02:11, 14 October 2007 (UTC)

[edit] Remove circumcision from the list

Circumcision is listed among the most common non-obstetric surgeries. That contradicts the very definition of the word:

Surgery [...] is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment.

As such, circumcision can not be listed among surgeries. It is a "treatment" to injure as much as phlebotomy or trepanation -- that is, it actually causes an injure. Circumcision is, in fact, a mutilation, that is:

an act or physical injury that degrades the appearance or function of the (human) body.

- Stormwatch 04:20, 7 November 2006 (UTC)

Answer: No. A circumsicion is 100 percent a surgery. It involves using manual means invasively. The goal of medicine is to improve the quality of life. This includes treating conditions both medicinally and surgically. Although the pubis (foreskin) is not considered a medical condition, the quality of life is improved when it is removed. According to your view on mutilation, cutting your hair can be considered mutilating yourself. Is hair a medical condition? No. It is cut because it improves the quality of life. —This unsigned comment was added by 68.194.1.254 (talk • contribs) 2006 November 20 04:36 UTC.
Care to explain how removing living, functional, protective, and erotically sensitive tissue could ever improve the quality of life? The opposite is true: circumcision is seriously detrimental, physically [2] and psychologically [3] (occasionally deadly [4]). And even in the case of phimosis, there are alternative therapies with none of the side effects. [5] Therefore: circumcision is a mutilation, not a surgery.
Also, your comparison doesn't make sense - hair is made of dead cells. And check a dictionary: you've used a word in a VERY wrong way. [6] - Stormwatch 15:28, 21 November 2006 (UTC)
The objection goes as follows: The presence of a foreskin is neither a disease nor an injury. Surgery is defined in the article's lead sentence as the "[...] specialty that treats diseases or injuries, [...]" Thus either circumcision, the removal of the foreskin, cannot be surgery under that definition, or the definition is incomplete. This cannot stand. I propose to change the lead sentence to read that surgery "[...] is the medical specialty that performs operative manual and instrumental procedures, often used to treat diseases or injuries, or for religious or cultural reasons." Blackworm 13:04, 27 October 2007 (UTC)

Circumcision should be removed for another reason: You do not need to be trained or educated to do it, see this video: http://youtube.com/watch?v=llxSytDu0ek --Validside 05:27, 25 May 2007 (UTC)

In many cases, cosmetic surgery treats neither a disease nor an injury. Removal of duplicate organs from a live person for transplant involvers surgery, but is not a treatment for that person. Many biopsies are done for the sake of diagnosis, but are not treatment in themselves. The definition of surgery may need to be expanded. H Padleckas 05:03, 30 October 2007 (UTC)

I more than support the view of H Padleckas and the examples cited above should be ample reason for expansion of the definition he suggests. The definition is not set in stone! The process has nothing to do with the qualifications of the person who carries out the procedure: tooth extraction, now carried out by dental surgeons used to be carried out by barbers, and emergency surgery, like severing a limb to avoid gangrine etc sometimes by an unqualified person, when no qualified person was available.

LouisBB 15:29, 1 November 2007 (UTC)

Thank you LouisBB, for taking a look at the Surgery article as I was expanding it. I have rewritten the introductory section to expand the definition of surgery somewhat to accomodate the situations I mentioned above, although I admit it is hard to come up with an exact definition. I so wrote this at the start of the "Overview of modern surgery" section I recently added, where I tried to dicuss what surgery is again. Perhaps an exact definition of surgery would be: Surgery is that medical work which surgeons and other doctors call surgery. H Padleckas 03:42, 3 November 2007 (UTC)

[edit] The Father of Surgery

A simple google search reveals the following fathers of surgery.

Do we need an article about that? (Igny 16:26, 3 December 2006 (UTC))

Person who chooses Surgery, should be hardworking.

[edit] History

History is a small part of the topic of "surgery" as a whole - theres a lot to be said on surgery that isn't history. This really deserves its own article. So I've split off History of surgery and summarised it here in summary style.

Obviously now it's created it needs more material added :) FT2 (Talk | email) 10:55, 19 June 2007 (UTC)

[edit] Division into Surgery and Surgeon articles

Although the existing sections in this Surgery article are good, even the fundamentals of modern surgery are hardly covered in this article. Surgery is an important and rather broad topic in modern medicine. I think this article can and should be greatly expanded to cover an overview of modern surgery. Previously Surgeon redirected to this article. Two former sections called "Surgeon titles" and "Noted surgeons" were only about surgeons, not about surgery itself. In order to make room for such an expansion of this Surgery article to cover the topic of surgery itself, I moved these two sections out of this Surgery article to a new article I formed called Surgeon.

Before I moved about 3600 bytes of this article to the new Surgeon article, this article was about 15700 bytes long. It is now about 12100 bytes long. A maximum article length of about 32 KB or less has been mentioned as desirable, although articles can exceed this length. The new surgeon article is not very long, less than 4000 bytes. Either before or after my move to form the new Surgeon article, I now concede there was enough room for a significant expansion of the Surgery article, which I really think would be a good idea. If anybody thinks this move should be reversed, go ahead and recombine Surgeon with Surgery. We would still have about 15 - 16 kB for a serious expansion of this Surgery article. H Padleckas 09:39, 30 August 2007 (UTC)

Surgery has been greatly expanded, and I think the articles should stay separated now. H Padleckas 02:36, 7 November 2007 (UTC)
Offline, I'm close to finishing a serious expansion of this surgery article - a large section called "Overview of modern sugery". When I add my expansion, I will need your help in reviewing it to make sure it is technically sound. H Padleckas 05:15, 30 October 2007 (UTC)
Where are you working on this? On a user sub-page? Chris Cunningham 12:09, 31 October 2007 (UTC)
Offline = On the hard drive of my own computer. Offline, I am still working on overhauling the introductory section. Yesterday, I have already added the large section called "Overview of modern surgery", mentioned above, to which I plan to make a few more rather minor edits to. Go ahead and review the new section and see if it needs any corrections. H Padleckas 20:43, 31 October 2007 (UTC)
Could you copy this into a sub-page of your user page so that it can be worked on online? This is the conventional approach taken to large edits. Chris Cunningham 16:09, 1 November 2007 (UTC)
I was considering using a sub-page of my user page to write the large section "Overview of modern surgery" for this article. In the end, I just wrote it offline on my hard drive almost completely and decided to upload it directly into this Surgery article. I just recently expanded (rewrote to some extent) the Surgery introductory section and uploaded it directly into the article. Twice before, I have written somewhat lengthy and complicated new articles before first on sub-pages to my user page, and then when they were ready with diagrams and all, I moved them to permanent article status. So I know how to do that. However, I usually write articles or longer sections offline and when they are practically ready, I upload the new contents directly into the article page. I am finished with the introductory section here and almost finished with the new "Overview of modern surgery" section. See soon my new Talk section at the bottom of this Talk page also. H Padleckas 05:24, 3 November 2007 (UTC)

[edit] Brief definition of surgeons

The previous wording read that surgeons are usually physicians. To an Australian physician (sensu stricto) trained in the British terminology, this sounded like a contradiction in terms. Outside North America, the English word 'physician' still retains its older meaning of specialist in internal medicne (archaic = 'physic'). I have edited the entry on physician to this effect. Hence I substituted the more lengthy but quite neutral phrase 'medical practitioner'. However, clicking on this term still redirects to the article on physician.

There is also nothing in this article about the old division of the profession, and that surgeons & physicians once were clearly regarded as separate occupations. The Hippocratic oath enjoins its takers, in the 4th last paragraph, not to cut for the stone (ie, don't do surgery, probably for bladder stones); that is, at the time of the school of Hippocrates, surgery was a separate craft! Maybe the article could do with a note to this effect. --DavidB 12:49, 9 October 2007 (UTC)

The Hippocratic prohibition is not for surgery in general, but specifically for lithotomy, since there was a specific profession limited to that procedure: much as dentistry became later. NRPanikker 02:19, 14 October 2007 (UTC)

Podiatrists also perform surgery..... —Preceding unsigned comment added by 124.171.176.131 (talk) 09:40, 18 October 2007 (UTC)

[edit] Recent expansion of the Surgery article

On Aug. 28-29, 2007, I noticed that the Surgery article was deficient in the practical coverage of modern surgery, but had two sections called "Surgeon titles" and "Noted surgeons" which were not about surgery itself but only about surgeons. At that time, Surgeon redirected to Surgery meaning that the article covered both topics. On this Talk page, WikiProject Medicine rated Surgery as "Start-Class" on the quality assessment scale, meaning it could use significant further development. In order to make room for a significant expansion of Surgery which is a broad topic in itself, I divided the article into separate Surgery and Surgeon articles. I moved the two sections about surgeons ("Surgeon titles" and "Noted surgeons") to the new Surgeon article. I noted on this Talk page under Division into Surgery and Surgeon articles that I had so divided the article. On Aug. 30, 2007, I then wrote small sections called "Surgery article" on both the WikiProject Medicine Talk and WikiProject Clinical medicine Talk pages saying that the Surgery article was inadequate in the describing modern surgery and asked if anyone was working on expanding the Surgery article. The only response I received was from User:MastCell saying that I should "go for it" (and a link to "be bold"), effectively suggesting that I expand the article myself. After practically two months of waiting for someone to address the problem, no one had done anything of real substance.

I went ahead and wrote an expansion for Surgery in the form of a new section I call "Overview of modern surgery", which I uploaded to the article on Oct. 30, 2007. On Nov. 2, 2007, I expanded/clarified the Surgery introductory section. For now, I'm finished with the introductory section and almost finished with "Overview of modern surgery". I would like to note there is already a separate History of surgery article, so further expansion on the History of surgery can be done there. The "History" (of surgery) section in the Surgery article is well-developed, perhaps even longer than necessary, particularly since there already is a History of surgery article. About 5 kB remain in Surgery for further expansion until reaching the desirable but non-binding 32 kB limit. It is not possible to cover all aspects and types of surgery in depth in 32 kB and it is not my intention to do so. Instead, Surgery covers fundamentals common to multiple types of Surgery and serves as a tie-together article containing links to more specific topic articles on surgery, where details on specific kinds of surgery can be covered in depth.

I think the revised Surgery article, which covers a high-importance topic in medicine, will soon be ready for a peer review. Review of Surgery could even start now. Upon finishing a peer review, Surgery could be re-assessed to a higher rating by the WikiProject. When I get a chance, perhaps towards the end of November, I plan to archive much of this Talk page to Talk:Surgery or Surgeon/ Archive since it is getting a bit long and many discussions are old and moot or relevant only to Surgeons. The Surgeon article will also have a link to it. H Padleckas 06:01, 4 November 2007 (UTC)

I have edited and divided the above-mentioned "Overview of modern surgery" section I wrote to include two subsections in it. For the time being I am finished with this section and practically finished with this Surgery article as a whole. I consider that as a result of this major expansion, the Surgery article is ready for peer review and then re-assessment. If anybody wants to review and make any [beneficial] edits, please go ahead. H Padleckas 02:28, 7 November 2007 (UTC)

[edit] On Anesthesia

The article says: Anesthesia is administered to prevent pain from incision, other tissue cutting and suturing, etc. Although in theory it may sometimes be possible to operate without anesthesia, in most surgeries the pain would be unbearable and a patient would not hold sufficiently still for a surgeon to precisely operate.

Circumcision is listed in the article as a surgery. Infant male circumcision is routinely performed with no anesthesia, which seems to contradict the quoted section above. Does anyone have suggestions as to how we can bring the quote in line with reality in light of this fact? It seems horrifying to say "Anesthesia is administered only optionally if the patient is an infant male undergoing circumcision, since strapping the infant down is cheaper and culturally accepted" even though this is the truth. I'm sure someone can come up with a way to fix the quote without making the medical profession look like a bunch of charlatans, so therefore I encourage responses. Thanks! Blackworm (talk) 18:51, 5 December 2007 (UTC)