Laparoscopic cholecystectomy

Chronic Pain Following Inguinal Hernia Surgery

Diaphragmatic Hernias

Epigastric Hernias

General Surgery

Lipoma

Anal fissure

Hemarrhoids

Rectal bleeding

Groin pain

Fistula

Robotic Inguinal Hernia Repair

Sports Hernia Repair

Concurrent Laparoscopic & Open Sports Hernia Repair

Laparoscopic Sports Hernia Repair

Open Sports Hernia Repair

Lumbar Hernia Repair

Minimally Invasive / Laparoscopic Hernia Repair

Laparoscopic Abdominal Wall Reconstruction for Incisional Hernia

Laparoscopic Hiatal Hernia Repair

Laparoscopic Inguinal Hernia Repair

Open Repair of Complex Incisional Hernias

Robotic Hernia Repair

Robotic & Robotic TAR for Incisional Hernia Repair

Core Surgical PC

Joseph Iraci, MD General Surgery New York

General surgery is a surgical specialty that focuses on the treatment of a wide range of conditions affecting various parts of the body. General surgeons are trained to perform surgical procedures on different organs, including the abdomen, digestive tract, breast, skin, soft tissues, and more.

The scope of general surgery is broad and encompasses both elective (planned) and emergency procedures. General surgeons are skilled in evaluating patients, making diagnoses, and determining the appropriate surgical interventions. They often work closely with other medical specialists and healthcare professionals to provide comprehensive care to patients.

What is general surgery?

Some common conditions and procedures within general surgery include:

<ul>
	<li>Gallbladder removal (cholecystectomy)</li>
	<li>Hernia repair</li>
	<li>Appendectomy (removal of the appendix)</li>
	<li>Bowel surgeries (e.g., for diverticulitis, bowel obstruction)</li>
	<li>Thyroid and parathyroid surgeries</li>
	<li>Removal of benign and malignant tumors</li>
	<li>Breast surgery (e.g., lumpectomy, mastectomy)</li>
	<li>Skin and soft tissue surgeries (e.g., removal of skin lesions, abscess drainage)</li>
	<li>Gastrointestinal surgeries (e.g., for reflux disease, peptic ulcers)</li>
	<li>Colorectal surgeries (e.g., for hemorrhoids, colorectal cancer)</li>
</ul>

What are the common conditions treated by general surgeons?

Some common risks and complications associated with general surgery include:

<ul>
	<li>Infection: Surgical site infections can occur after any surgery. They may manifest as redness, swelling, warmth, increased pain, or drainage from the incision site. In severe cases, systemic infections can develop.</li>
	<li>Bleeding: Bleeding can occur during or after surgery. While surgeons take steps to control bleeding during the procedure, post-operative bleeding may require intervention. Excessive bleeding may necessitate a blood transfusion or additional surgical intervention to stop the bleeding.</li>
	<li>Blood clots: Surgery increases the risk of developing blood clots, particularly in the legs (deep vein thrombosis) or lungs (pulmonary embolism). Blood thinning medications, compression stockings, and early mobilization are commonly used to prevent blood clots.</li>
	<li>Anesthesia-related complications: General anesthesia carries its own set of risks. These can include allergic reactions, medication reactions, respiratory problems, or adverse reactions to anesthesia. Anesthesia providers monitor patients closely to minimize these risks.</li>
	<li>Organ or tissue damage: During surgery, there is a potential risk of unintentional injury to nearby organs or structures. Surgeons take great care to avoid such damage, but in certain cases, injury to adjacent structures may occur, requiring further intervention or repair.</li>
	<li>Adverse reactions: Some patients may experience adverse reactions to medications, anesthesia, or other substances used during surgery. These reactions can range from mild allergic responses to severe systemic reactions, requiring prompt medical attention.</li>
	<li>Pain and discomfort: Pain and discomfort are common after surgery. While medications are usually prescribed to manage pain, individual pain tolerance and response to medications may vary. Adequate pain management is important for recovery and overall comfort.</li>
	<li>Scarring and cosmetic changes: Surgical incisions may result in scars, which can vary in size, shape, and appearance. Although surgeons strive to minimize scarring, the healing process and individual factors can influence the final outcome. In some cases, cosmetic changes may occur due to the surgical procedure.</li>
	<li>Complications specific to the surgical procedure: Different surgeries carry their own specific risks and potential complications. For example, bowel surgeries may carry a risk of bowel leakage or obstruction, while breast surgeries may involve risks such as changes in breast sensation or implant-related complications.</li>
</ul>

Before the treatment, it is critical to have an in-depth conversation with your surgeon to understand the potential risks and complications specific to your surgery. Your surgeon will give you pre-operative instructions, walk you through the informed consent process, and take any precautions necessary to reduce risks before and after surgery.

What are the risks and complications associated with general surgery?

One of the most common general surgery emergencies is acute appendicitis. Appendicitis occurs when the appendix, a small organ located in the lower right abdomen, becomes inflamed and infected. The condition typically presents with severe abdominal pain, fever, nausea, and vomiting. If left untreated, the appendix can rupture, leading to potentially life-threatening complications like peritonitis (inflammation of the abdominal lining). Prompt surgical removal of the appendix (appendectomy) is necessary to treat acute appendicitis and prevent complications.

What is the most common general surgery emergency?

General surgery often requires general anesthesia. General anesthesia involves the use of medications to induce a state of unconsciousness, ensuring the patient feels no pain and remains unaware during the surgical procedure. It typically involves a combination of intravenous medications and inhaled gases to maintain anesthesia. The anesthesiologist closely monitors vital signs, oxygen levels, and depth of anesthesia throughout the surgery. In some cases, regional anesthesia techniques such as epidural or spinal anesthesia may be used, especially for specific procedures or when general anesthesia carries higher risks.

What type of anesthesia is used for general surgery?

Managing pain after general surgery is an essential part of the recovery process. Your doctor will prescribe appropriate pain medications based on the type of surgery and your individual needs. Here are some general strategies to manage pain after surgery:

<ul>
	<li>Take pain medications as prescribed: Take the prescribed pain medications on time and in the recommended dosage. Don&#39;t skip doses, and inform your healthcare provider if the medication is not effectively controlling your pain.</li>
	<li>Use non-medication pain management techniques: In addition to medication, you can try non-medication pain management techniques, such as deep breathing exercises, relaxation techniques, applying ice or heat to the surgical site (if recommended), and maintaining proper positioning.</li>
	<li>Gradually increase activity: Gradually increase your activity level as advised by your healthcare provider. Gentle movement and walking can help reduce pain and promote healing. However, avoid excessive physical exertion or activities that may strain the surgical site.</li>
	<li>Apply local measures: Depending on the type of surgery and your surgeon&#39;s recommendation, you may be able to use over-the-counter or prescribed topical analgesics or numbing creams to alleviate pain at the incision site. Follow your surgeon&#39;s instructions for their use.</li>
	<li>Communicate with your healthcare provider: If you experience significant or uncontrolled pain, inform your healthcare provider right away. They can reassess your pain management plan and make adjustments as necessary.</li>
</ul>

How can I manage pain after general surgery?

After general surgery, it&#39;s important to be aware of potential complications that may require immediate medical attention. While complications are relatively rare, it&#39;s crucial to know the signs that may indicate a need for emergency care. Here are some situations in which you should seek emergency care after general surgery:

<ul>
	<li>Excessive bleeding: If you experience severe or persistent bleeding that doesn&#39;t subside with direct pressure, or if you notice a sudden increase in bleeding from the surgical site, it is essential to seek emergency care. Excessive bleeding can be life-threatening and requires immediate medical attention.</li>
	<li>Signs of infection: Watch out for signs of infection, which can include increasing pain, redness, swelling, warmth, or drainage from the surgical site. If you develop a fever, temperature above 100.4 &deg;F (ca. 38 &deg;C), or experience chills, it may indicate an infection. Prompt evaluation and treatment are necessary to prevent the infection from spreading.</li>
	<li>Difficulty breathing: If you experience sudden shortness of breath, chest pain, or difficulty breathing after general surgery, it could be a sign of a pulmonary embolism (a blood clot in the lung) or another serious respiratory problem. Seek immediate medical attention if you have any of these symptoms.</li>
	<li>Severe pain: While some pain and discomfort are expected after surgery, if you experience severe, uncontrolled pain that is not relieved by prescribed medications, it could indicate an issue such as a surgical complication, infection, or bowel obstruction.&nbsp;</li>
	<li>Persistent vomiting or inability to eat or drink: If you are unable to tolerate food or fluids, or if you have persistent vomiting that prevents you from staying hydrated, it may indicate a complication such as an intestinal obstruction or ileus. Seek medical attention to prevent dehydration and further complications.</li>
	<li>Worsening or new-onset symptoms: If you notice any new or worsening symptoms that concern you after surgery, such as sudden swelling, severe abdominal pain, or changes in bowel or bladder function, it is important to seek medical evaluation. These symptoms could indicate a surgical complication or other underlying issue.</li>
</ul>

It&#39;s essential to follow your surgeon&#39;s post-operative instructions and attend all follow-up appointments.&nbsp;

In what cases should I seek emergency care after general surgery?

Yes, it is common to have scars after general surgery. Whenever an incision is made during surgery, the body&#39;s natural healing process leads to the formation of a scar. The appearance and characteristics of the scar vary depending on the surgical technique used, individual healing abilities, and the location of the incision.

While it may not be possible to completely eliminate scars, there are steps you can take to help minimize their appearance:

<ul>
	<li>Follow post-operative wound care instructions: Proper wound care during the healing process is essential to promote optimal healing and minimize scar formation. Follow your surgeon&#39;s instructions on cleaning the incision, applying ointments or dressings, and keeping the area protected.</li>
	<li>Protect the incision from sun exposure: Sun exposure can darken scars and make them more noticeable. Protect the healing incision from direct sunlight by covering it with clothing or using sunscreen (after consulting your surgeon) when it&#39;s appropriate to do so.</li>
	<li>Gently massaging the scar tissue once it has healed can help improve blood circulation and break down scar tissue, potentially reducing the appearance of the scar.&nbsp;</li>
	<li>Silicone gel or sheets applied to the healing incision may help flatten and soften the scar. These products are available over-the-counter and can be used as directed. Consult your surgeon for recommendations on specific products.</li>
	<li>There are various scar creams and ointments available that claim to help minimize the appearance of scars. While the effectiveness may vary, some people find them helpful. Consult your surgeon for recommendations on suitable products.</li>
	<li>In some cases, your surgeon may recommend laser treatments, steroid injections, or other interventions to improve the appearance of the scar. These options are typically considered if the scar is particularly bothersome or affects functionality.</li>
</ul>

Everyone&#39;s healing process and scar formation are unique. Some scars may fade significantly over time, while others may remain more noticeable. If you have concerns about your surgical scar or its impact on your well-being, your surgeon is the best person to provide you with the specific guidance based on your individual situation.

Will there be scars after general surgery, and can they be minimized?

Joseph Iraci, MD

General Surgery

New York

Core Surgical PC

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