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Six basic surgical operations
2024-01-08

Good visualization of the surgical field is a prerequisite for a successful operation. There are many factors that contribute to a good or bad visualization of the surgical field, such as the patient's position, the illumination of the surgical field, and good anesthesia to ensure muscle relaxation. Therefore, the surgeon should personally check the patient's position, lighting equipment and anesthesia before the start of surgery.
 
The choice of incision is an important step in revealing the surgical field. In general, for resection of superficial lesions, the incision is usually made directly on the surface of the lesion.

Dissection is an important step to visualize the deeper tissues and excise the lesion. The dissection should be carried out in accordance with the normal tissue gap, which is not only easy to operate but also less damaging. However, this is often not possible when there are adhesions and scars in the tissues, in which case dissection is more difficult and vigilance must be exercised at all times. According to the different methods of anatomical separation, it can be divided into blunt and sharp separation.

Whether or not hemostasis can be perfected is not only an important measure to ensure visualization and prevent blood loss during surgery, but also an important link involving the safety of the patient, the healing of the incision and the reduction of complications after surgery. Hemostasis requires rapid and reliable. Hemostasis in surgery, most of the application of hemostatic forceps on the bleeding point for rapid and correct clamping, clamping the tissue should be less, avoid large clamping, and then use silk ligation or electrocoagulation hemostasis. For larger deep vessels, it is often used to separate out a section of it, ligate its ends, and then cut it off.

The proximal end is then sutured through, and the suture must be at the distal end of the ligated line, otherwise puncturing the vessel will cause bleeding. For more extensive capillary blood seepage, gauze pads can be used to stop bleeding by compression, and if necessary, hot saline gauze can be used for compression or hemostatic powder, gelatin sponge, hemostatic cotton, hemostatic gauze pressure and so on.

Mainly used in vascular ligation and trauma suture. If the knot is not tied correctly, so that the ligature line slips off, can cause postoperative secondary hemorrhage, bringing unnecessary pain to the patient, and even life-threatening.
Square knot: the most commonly used one in surgery, used for ligating general blood vessels and various sutures.
Surgical knot: Because the first line is repeated around twice, the friction surface is large, and it is not easy to loosen by tying the second knot, so it is firm and reliable. It is used for ligating large blood vessels.
Triple knot: It is made by tying a square knot and then adding a first single knot. Even if one knot is loosened after ligation, there is no harm, but more ligature threads are left in the tissue. Used to tie important tissues such as arteries or intestinal cords.

Suturing is a basic operation to ensure good healing by aligning or reconstructing the channel of a cut or severed tissue or organ and restoring its function.

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