You may have heard of a 'General Surgeon'. Or maybe you have met one of your family members or friends. Who exactly is a General Surgeon? What does he do? How are they different from other doctors? Let's talk about all this in simple, Sinhala language that you can understand.
Who exactly is a General Surgeon?
Simply put, a general surgeon is a doctor as well as a surgeon. That means he can diagnose diseases, treat them, and if necessary, perform surgery. The special thing is that these people are not limited to just one part of the body. Just like our family doctor, but they can also perform surgery.
For example, some doctors specialize in the heart (a `Cardiologist`) or the brain (a `Neurologist`). But a general surgeon works in a much broader area. For example, they can treat your abdominal organs (`abdominal organs`), tumors in other parts of your body, or multiple injuries from accidents all at once. They are the ones who play a key role in caring for the patient before surgery (`preoperative`), during surgery (`operative`), and after surgery (`postoperative`). They are often the ones who work as a team with other doctors and nurses.
General surgery is one of 14 surgical specialties recognized by the American College of Surgeons.
What does a general surgeon treat?
I've said before that a general surgeon is like a "family doctor who can also do surgery." So they treat a wide variety of conditions. And, those treatments include a variety of surgeries and procedures. However, if a general surgeon feels they are not completely confident in treating a particular condition, they will definitely refer you to a specialist. That is also their responsibility.
What are the common conditions treated?
Here are some of the conditions that a general surgeon often treats:
- Traumatic injuries: Imagine they treat serious injuries caused by an accident or a fall while walking on the road.
- Physical abnormalities: These may be congenital defects or tumors that develop later in life.
- Breast cancer: Breast cancer, which can occur in both men and women, is treated with surgery.
- Upper GI tract diseases: These are diseases that affect our esophagus, stomach, and small intestine. For example, if something like gastritis becomes severe, you may need to have an endoscopy or even surgery.
- Biliary tract: This includes the gallbladder, bile ducts, pancreas, and liver. Gallstones are often removed surgically by a general surgeon.
- Endocrine conditions: For example, surgery is performed to treat tumors in the thyroid gland or adrenal glands.
- Vascular conditions: They also intervene in some vascular problems.
- Critical illness and terminal illness: Sometimes they are involved in surgeries that patients in intensive care units need, or in some things that are done to reduce the pain of patients at the end of their lives.
How do you become a Surgeon General?
Becoming a general surgeon is not an easy journey. First, they have to become a doctor. That means they have to study for four years in a medical school and get a ``medical degree``. Only then do they begin training to become a surgeon.
To do this, they must complete a surgical residency program of at least five years . This training is carried out in a phased manner. That is, only after successfully completing one year are they eligible for the next year.
Even after completing this training, they still have to pass two board exams to become a certified general surgeon.
1. The first is the qualifying exam . This is a written test with multiple choice questions.
2. Only after passing this will you be eligible to sit for the ``certifying exam`` . This is an oral test.
Only after passing both of these exams does one become recognized as a "Certified General Surgeon." So imagine how much dedication and hard work this requires!
What does a surgeon general study?
A general surgeon learns in depth about the nine principal components of general surgery during his training. They are:
- The gastrointestinal tract: This refers to almost every part of our digestive system.
- The abdominal and pelvic organs: The organs inside the abdomen, such as the liver, kidneys, and pancreas.
- Breasts, skin and soft tissues: They also learn about things on the surface of the body.
- Head and neck: They also treat some conditions that occur in these areas.
- Cardiovascular system: Basic knowledge about the heart and blood vessels.
- Endocrine system: The system of glands that produce hormones.
- Surgical oncology: This means the treatment of cancer through surgery.
- Trauma: This includes injuries to the musculoskeletal system, head injuries, and hand injuries.
- Critical care and emergency surgeries: Things like life-saving surgeries that need to be done immediately.
During their training, they must spend at least four and a half years out of five years working with patients. And at least three years working in the nine major areas mentioned earlier. They cannot train for more than 12 months in a single surgical specialty or more than 6 months in a non-surgical medical specialty. That means their training must be very broad.
What does a Surgeon General do?
When a general surgeon completes his training and goes to work, the surgeries and treatments he routinely performs may vary depending on the hospital he works at, whether it's in a big city or a more remote area.
Imagine, in a large, well-equipped hospital, there may be surgical specialists who perform certain specific surgeries. For example, a cardiac surgeon may perform heart surgeries, and a neurosurgeon may perform nerve surgeries. However, in a hospital where there are not that many specialists, a general surgeon may have to perform many of these tasks. Therefore, their role is very important.
What are the most common surgeries?
Here are some of the types of surgeries you can expect a general surgeon to perform regularly:
- Anti-reflux surgery (Nissen fundoplication): A surgery to stop stomach acid from flowing up into the throat due to conditions such as gastritis.
- Appendix removal (Appendix removal / Appendectomy): When an infection (appendicitis) occurs in a small part of the body called the appendix, it is surgically removed.
- Bariatric (weight loss) surgery: Surgery to help people who are severely obese lose weight.
- Breast surgery: Surgery for breast tumors, such as breast cancer.
- Exploratory surgery (Laparotomy or Laparoscopy): When a disease cannot be identified, the body is opened or a camera is inserted to look inside.
- Gallbladder removal (Cholecystectomy): Removal of the gallbladder when problems such as gallstones occur.
- Hernia repair surgery: Repairing a hernia, where parts of the intestine, such as the intestines, protrude through a weak spot in the abdominal wall.
- Prostate removal (Prostatectomy): A surgery performed in men to treat conditions such as prostate cancer.
- Spleen removal (Splenectomy): The spleen may need to be removed due to certain blood diseases and accidents.
- Uterus removal (Hysterectomy): A surgery performed to treat certain conditions related to the uterus in women.
What are the surgical methods?
Nowadays, general surgeons are trained to work with the latest technology (`technology-assisted operative techniques`). This means that instead of using large incisions in the old way, they use small incisions and camera-assisted surgeries. These methods cause less discomfort to the patient and can also help them recover faster.
There are mainly three methods:
1. Endoscopy
2. Laparoscopic surgery
3. Robotic surgery
What is Endoscopy?
This is a very strange procedure. Endoscopy is a procedure that allows a surgeon to perform small operations inside your body without cutting your skin or tissue. Imagine, they use long, thin instruments. These are passed through a long, flexible tube called an endoscope. At one end of this tube is a small video camera.
This `endoscope` is passed through your throat (`upper endoscopy`) or rectum (`colonoscopy`). The images seen from the camera are displayed on a `screen`. The doctor uses these tiny instruments to perform the surgery while looking at the screen.
Simply put, this is an examination or minor surgery that involves inserting a camera into the abdomen without making any major incisions.
The most common things done through endoscopy are:
- Removal of small polyps or tumors (polypectomy).
- Taking tissue samples for testing (biopsy).
- Cutting and releasing a tight muscle (`myotomy`).
What is laparoscopic surgery?
Laparoscopic surgery is also a minimally invasive surgery technique . In this, the surgeon accesses your abdominal organs through a few small "keyhole" incisions, less than half an inch in size .
A camera-equipped tube called a laparoscope (also a type of endoscope) is inserted through one of the holes and the inside is looked at. The images from the camera are projected onto a screen. Long, thin surgical instruments are then inserted through other holes and the surgery is performed while looking at the screen. This method allows the patient to recover faster and leaves less scarring.
The most common surgeries performed laparoscopically by general surgeons are:
- Appendectomy is a surgery for appendicitis.
- Surgery for gallstones (Cholecystectomy).
- Gastric bypass surgery is a weight loss surgery.
What is robotic surgery?
Robotic surgery is an advanced form of laparoscopic surgery. It uses a laparoscope and long, thin instruments through small keyholes. The difference is that these instruments are manipulated by robotic arms.
But this does not mean that a robot will perform the surgery on its own. The surgeon operates the robotic arm from a computer console in the operating room. This allows for very precise and delicate surgeries. General surgeons can learn about robotic surgery during their regular training, or they can do additional training (fellowship).
What is the difference between a general surgeon and a regular doctor?
This is a question that many people ask. Every surgeon is a physician. But not every physician is a surgeon. Surgeons are people who are doctors and then receive additional training and certification to perform surgery. Simply put, surgery is a procedure that is performed on the inside of a person's body, such as organs, tissues, and bones, to treat injuries or diseases.
A General Practitioner (or Primary Care Physician - PCP) is a doctor who practices general medicine, rather than a specialty. They usually do not perform surgery.
On the other hand, a general surgeon is a doctor who has chosen to specialize in surgery. They are not limited to a single surgical specialty, but work in the broad field of "general surgery."
How long does it take to become a Surgeon General?
Just think, in a country like America, it takes four years to get a bachelor's degree. Then it takes another four years to get a medical degree. Then it takes five years to get a surgical residency. That's 13 years! And then it takes time to pass those board exams I mentioned earlier. So, you have to study for at least 13 years to become a general surgeon. Isn't that a big commitment?
What is the difference between a General Surgeon and a Pediatric Surgeon?
This is also an important point. Every pediatric surgeon is a general surgeon. But not every general surgeon is a pediatric surgeon.
Simply put, a pediatric surgeon is someone who has trained as a general surgeon and then received additional specialized training to treat children. It's like a pediatrician, but this doctor can also perform surgery.
A general surgeon is like a regular doctor with an extra power. That power is the ability to treat a variety of illnesses in the operating room.
It takes a lot of training, knowledge, and skill to become someone like this. But it's a very satisfying career. Because no two days are the same. There are always new challenges, new experiences.
Finally, things to remember (Take-Home Message)
Okay, so I think you now have a good idea about a surgeon general.
- A general surgeon is a specialist doctor who is trained to perform a wide range of surgeries. They are not limited to just one part of the body.
- They treat many things, such as stomach problems, accidents, breast tumors, and hernias.
- They take care of the patient before, during, and after surgery.
- They can perform surgeries using new techniques like `Endoscopy` and `Laparoscopy`, using minimal incisions.
- Becoming a general surgeon requires extensive education and training.
- If you need surgery, your doctor may refer you to a general surgeon. Don't worry, they are there to help you.
If you have any further questions, talk to your doctor. Stay healthy!
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