Surgeons are specialist physicians who have completed extensive training to follow a career in surgery. Many surgeons are highly specialized within one area or system of the body or apply transferable surgical skills and expertise to the treatment of a greater variety of disciplines or body systems. General surgeons deal largely with the organs of the abdomen, soft tissues and skin, and are usually the first involved with traumatic injury to the abdomen and soft tissues of the body. In trauma cases, they may work with orthopedic surgeons who specialize in damage to the bones and joints, with specialist gastrointestinal surgeons for complex abdominal surgery, cardiothoracic surgeons who specialize in the organs of the chest, or any other surgical specialties required.
General surgeons work in operating theatres, usually in acute emergency hospitals, or performing elective (planned) non-emergency surgery. They also hold clinics for pre-surgical assessment or follow-up of their patients. They are part of a large multidisciplinary team including surgeons, anesthetists, theatre practitioners and theatre nurses from all specialties, medical physicians and post-surgical therapists. In outpatient clinics, they may be assisted by a nurse or healthcare assistant for basic observations and to chaperone and aid in examinations.
General surgeons in acute care settings have an on-call rota so that there are always teams of people on hand to perform emergency surgical interventions at any time of the day or night. They will be called upon in cases of major trauma such as internal injury following a car crash or other accident, or for medical emergencies like a ruptured appendix or internal bleeding from any cause. In general, only the most urgent surgery will be performed at night.
They perform non-emergency but urgent surgery for conditions like cancerous tumours, clinically essential breast surgery such as mastectomy or lumpectomy, injuries from a trauma that don’t pose an immediate threat to the patient, gastroscopies, colonoscopies, treatment for gastric ulcers, and more.
In less urgent, planned surgical interventions, general surgeons may perform surgery to repair hernias, to eradicate or reduce rectal hemorrhoids (‘piles’), removal of cysts or benign tumors like lipomas, and endocrine surgery such as thyroidectomy. They are also able to prescribe medications and refer patients for further tests or procedures.
Prior to any procedure, a member of the surgical team will take time to explain what is going to happen, and the risks and benefits of the surgery. They will need informed consent from the patient, or in the case of anyone lacking the mental capacity to make the decision for themselves – for example, young children – the consent of their next of kin. Due to the nature of emergency surgery in cases of life threatening illness or injury, the person undergoing surgery may not meet their surgeon until after the procedure, and decisions can be made by the medical and surgical team to act in their patients’ best interests.