Abdomen Informally known as the belly. The Greek word laparos is used in surgery to refer to the abdomen, e.g. laparotomy: cutting open the abdominal cavity.
Abscess Accumulation of pus under pressure between the tissues of the body. To prevent it getting worse, a ripe abscess must be opened. This rule of thumb in surgery is expressed by the Latin aphorism ‘ubi pus, ibi evacua’, ‘where there is pus, evacuate it’. Cutting open an abscess and draining the pus is a surgical procedure. An accumulation of pus in an existing cavity is known as an empyema. See Pus, Incision, Drain.
Acute Sudden or immediate (not to be confused with urgent). Opposite of chronic, persistent, not sudden. Hyperacute means very sudden. Subacute means quickly, but not sudden.
Amputation Partial or complete removal of a limb. From the Latin word amputare, to prune.
Anaesthesia Medical specialisation that deals with local, regional or general anaesthesia of a patient for an operation. An anaesthetist is a medical specialist qualified to administer anaesthesia.
Anamnesis Literally ‘from memory’. Asking a patient about the nature, severity, development and duration of symptoms. If a doctor finds out about a patient’s symptoms from others, it is called hetero-anamnesis. Anamnesis is the first part of the examination of a patient. It is followed by a physical examination and, if necessary, supplementary tests. See Symptom.
Anatomy Literally ‘to discover by cutting’. Description of the macroscopic structure of a living being. Deviations from the normal anatomy of the body can be caused by natural differences (anatomical variations) or by an illness or disorder (pathological anatomy).
Antisepsis, antiseptic The use of antiseptics (disinfectants) to remove bacteria from the skin, mucous membrane or a wound. The first disinfectants were wine and cognac. Carbolic acid was used later, but that was too harmful to bodily tissues. Today, chemicals containing iodine or chlorine are used. Simply washing with soap and water also disinfects to a certain extent, explaining why surgeons wash their hand so often. Not to be confused with asepsis/aseptic.
Arteriosclerosis Inflammatory disease of the arteries. The inner wall of the artery is affected by accumulations of cholesterol, causing an inflammation. That creates scar tissue in which calcium carbonate can be deposited. It eventually leads to narrowing (stenosis) of the artery, which can gradually or suddenly be completely blocked (occlusion).
Artery Blood vessel that carries blood from the heart under high pressure (blood pressure). Arteries are shown in red in anatomy books, because the oxygen-rich blood is bright red in colour. The pulmonary arteries are exceptional, because the blood they transport from the heart to the lungs is oxygen-poor.
Artificial ventilation Taking over a patient’s breathing artificially. That may involve placing a mask over the mouth and nose, inserting a tube into the windpipe via the mouth or nose (intubation), or making an opening at the front of the neck to provide direct access to the windpipe (tracheotomy). Ventilation can be provided with a hand-held balloon or a mechanical ventilator. The simplest form of ventilation is by artificial (mouth-to-mouth) respiration.
Asepsis, aseptic Not to be confused with antisepsis/antiseptic. See Sterile.
Assistant Someone who assists. A medical assistant is a health professional who supports the work of doctors and other health professionals. During operations, the other members of the team supporting the surgeon are known as surgical assistants, and may include both surgeons and paramedical staff.
Atherosclerosis See Arteriosclerosis.
Autopsy Examination of a dead body. See Obduction.
Biopsy Removal of a piece of tissue for further testing, for example under a microscope. An excisional biopsy means removing all the affected tissue. With an incisional biopsy, only part of the affected tissue is removed, leaving the rest in place. See also Excision, Incision.
Blocked arteries See Arteriosclerosis.
Bloodletting Draining blood. Used until well into the nineteenth century to treat all kinds of complaints. Beneficial effects based completely on superstition. See Fleam.
Cachexia Severe malnutrition, emaciation.
Cancer Malignant disease whereby cells in the body isolate themselves from the normal control mechanisms and multiply and spread autonomously at the expense of the body. A cancerous tumour is invasive, i.e. it actively breaks through the barriers of the body. Cancer of the skin, mucous membrane or gland tissue are referred to as carcinoma, of the blood cells as leukaemia, and of all other tissues as sarcoma.
Cardiosurgery Heart surgery. Not to be confused with cardiology, the branch of medicine that treats heart disorders without surgery.
Chirurgeon See Surgeon.
Chronic Persistent, not sudden. See Acute.
Circulatory system The system of blood circulating through the blood vessels, under pressure (blood pressure) and driven by the heart. Shock is a failure of the circulatory system.
Circumcision Literally ‘to cut around’. Full circumcision is the complete removal of the foreskin from the penis. See also Excision, Incision.
Complication Undesired (and unintentional) harmful consequence of a disease, disorder or operation. Not to be confused with a side effect, which is also an undesirable consequence of a course of treatment, but is not unexpected. Complications are inherent to a form of treatment, surgical or non-surgical, and can therefore usually not be attributed to human error. See Morbidity.
Conservative Treatment without surgical intervention or any other direct access to the body, for example, with drugs. See Expectative, Invasive.
Curative Treatment aimed at complete cure of a disease, even if that may reduce the quality of life. In contrast to palliative, where treatment is no longer aimed at complete recovery. See Palliative.
Cure To restore to health without leaving scars on the body. See Healing.
Diagnosis Identifying what is wrong with a patient: the nature, cause and severity of the illness.
Dislocation Displacement of a bone from a joint. Also referred to as a luxation. A fracture dislocation is a combination of a dislocation and a fracture. See Reposition.
Divide Cutting or burning through a structure or organ in a surgically responsible manner. An intestine can be divided using a surgical stapling machine. A blood vessel is divided by cutting through it and tying it off with a ligature. See Ligature.
Drain Noun: A tube or strip inserted through an opening in the body to allow something to drain, e.g. air from the chest cavity (thorax drain) or pus from an abscess cavity. Mostly made of rubber or silicone. A special kind of drain is a urinary catheter, which is inserted into the bladder through the urethra. Verb: To drain fluid, more specifically used for an incision in an abscess to allow the pus to escape. The whole surgical intervention is known as ‘incision and drainage’, I & D for short. Sometimes a drain is left behind in the incision or inserted through a secondary incision (counterincision) to allow any pus that is still in the abscess or may form later to escape. See Abscess.
Dys-, dis- Prefix meaning ‘abnormal’ or ‘troubled’. Dysphagia means difficulty in swallowing. Dyspareunia means literally ‘troubled interaction’ and is used for physical problems with sexual intercourse.
Ec-, ex- Prefix meaning ‘out’. A tumourectomy, for example, is the removal of a tumour. See Excision.
Elective Not compulsory, optional. An elective operation is a surgical procedure for which there is a reasonable alternative. That means that it can be planned and there is sufficient time to postpone it or not perform it at all if necessary.
Embolism Something carried along in the bloodstream and which can cause damage in the circulatory system. A blood clot from thrombosis in the lower leg, for example, can close off part of the lung (pulmonary embolism). The same can occur with fatty tissue from bone marrow after a fracture. Air in the carotid arteries in the neck (air embolism) during carotid surgery can cause a cerebral infarction.
Embryological Relating to the development of an organism before birth. Once an embryo is sufficiently recognisable as the animal it will become, it is known as a foetus.
End-of-life care Stopping all treatment to combat a fatal disease and aiming to bring the patient’s life to an end as comfortably as possible. See Palliative.
Enema Rinsing the bowels via the anus. Despite their widespread and enthusiastic application to alleviate a broad variety of ailments, both in the past and today, there is very little evidence that enemas are effective and their excessive use can cause side effects, which may be minor but can also be more serious.
Evidence-based Making decisions and acting on the basis of results published in the medical literature. In contrast to ‘expert opinion’, deciding and acting on the basis of what an alleged expert in the area concerned would do or not do. Evidence can have varying degrees of reliability. The greater the total number of patients from which a certain conclusion can be drawn, the more reliable the evidence. Evidence can lead to national guidelines to provide a framework for those providing treatment.
Excision Cutting out. Removing something in full by cutting it away completely. See also Incision, Circumcision, Biopsy, Resection.
Expectative Watchful waiting, not (yet) giving treatment and monitoring the patient closely. See Conservative, Invasive.
Exposure Freeing (if necessary by dissection) a structure or abnormal tissues, including their immediate surroundings, to give a clear view of the surgical field, including the whole structure and how it is related to those around it.
Fast track Form of post-operative care aimed at restoring the patient’s normal functions as soon as possible. This includes eating and drinking, getting out of bed and walking around, and removing tubes and catheters.
Fistula Two small wounds connected to each other by a tunnel through the body’s tissues. It can link one cavity to another, or a cavity and the outside world. An anal fistula, for example, connects a wound in the rectum to another in the skin. Latin for tube, pipe or flute.
Fleam Special knife used for bloodletting by, for example, making an incision in the fold of the elbow. The special form of the blade is designed to ensure that the cut does not go too deep. See Bloodletting.
Fluctuation Effect whereby pressing one side of a swelling filled with fluid causes it to be pushed outwards on the other side. As this does not occur with a swelling filled with solid material, checking for fluctuation will clarify whether the swelling is liquid or solid. A mature abscess, for example, will be liquid, while a swelling without an abscess will be solid. See Pus, Incision, Drain.
Fracture Broken bone.
Gangrene Dying off of living tissue, such as the skin around a wound, a toe or a whole limb. The dead (part of a) limb can dry out and shrivel up. That leads to black mummification and, in the best scenario, to rejection by the body. The dead tissues can also rot and discharge fluid and pus that can enter the bloodstream. Wet gangrene is therefore more dangerous than dry. Gangrene can be caused by the obstruction of an artery or by a wound infected with aggressive bacteria. Some bacteria produce gas, exacerbating the spread of the gangrene. This is known as gas gangrene.
Gout Inflammatory disease caused by an accumulation of uric acid crystals in the joints. A typical symptom is a painful, inflamed big toe. The term ‘gout’ was formerly used for any painful complaint of unknown cause.
Gynaecologist Medical specialist concerned with obstetrics and the surgical treatment of the female reproductive organs.
Haematuria Blood in the urine.
Healing Healing and curing are two forms of ‘making people better’ but, unlike curing, healing leaves its marks on the body in the form of scars. See Cure, Surgeon, Surgery.
Hemi- Prefix for half, used mainly to indicate a right or left half. Hemiparesis means half-paralysed, on the right or left side of the body. A hemicolectomy is the surgical removal (-ectomy) of half (hemi-) of the large intestine (colon). Not to be confused with the prefix haema- or haemo-, relating to blood.
Hernia Rupture in tissue that should normally provide strength, with the consequence that something else protrudes through the hernia. A crack in one of the intervertebral discs in the spine can cause a hernia in the neck or back, while a rupture of the abdominal wall can lead to an abdominal hernia.
Homeopathy Form of quackery, like bloodletting. See Bloodletting.
Idiopathic Without a clearly identifiable cause. Not to be confused with ‘e causa ignota’ (e.c.i.), Latin for ‘of unknown cause’.
Ileus Stagnation of the passage of the contents of the intestines through the small intestine. Causes vomiting and a swollen abdomen. A mechanical ileus, obstruction of the small intestine, is caused by a constriction, a tumour or a blockage from the inside, such as a hairball. A paralytic ileus occurs when the natural movement of the bowels (peristalsis) stops, causing the contents of the intestines to come to a halt. Ileus is not to be confused with colon obstruction, which interrupts the flow of faeces through the large intestine.
Incidence Figure indicating how often a certain disease occurs in a specific population group, mostly expressed as the number of new cases per 100,000 per year. Not to be confused with prevalence. See Prevalence.
Incision Literally ‘cut into’. The simple action of making a cut with a scalpel. An incision into the abdominal cavity is also known as a section, as in caesarean section. See also Excision, Circumcision, Biopsy, Drain.
Incontinence Not being able to retain faeces or urine.
Indication In surgery, a reason to perform an operation.
Infarction Mortification of all or part of an organ as a result of an obstruction in an artery (or a branch of an artery) that supplies it with oxygen-rich blood. An infarction in part of the brain is known as a stroke. An infarction in all or part of a limb is called gangrene. See Ischaemia.
Infection See Inflammation.
Inflammation A reaction in the body’s tissues characterised by the activation of inflammatory cells and pain, redness, swelling, heat and loss of function in the affected area. An infection is an inflammation caused by a virus or another living pathogen, such as a bacterium, yeast, fungus or parasite. Most infections provoke an inflammation, but not all inflammations are caused by an infection.
Intermittent claudication Oxygen deprivation in the muscles of the lower leg when walking, due to narrowing of the arteries supplying blood to the legs; and which causes pain that stops immediately during rest. See Ischaemia.
Invasive Treatment involving direct entry into the body via an operation or with a catheter, as with percutaneous coronary intervention (PCI). In contrast to treating an illness with drugs or by other non-invasive means. Minimally invasive treatment aims to minimise the disadvantages of an operation. See Expectative, Conservative.
Ischaemia Shortage of oxygen in all or part of an organ or limb caused by insufficient supply of oxygen-rich blood, for example due to narrowing of an artery. Symptoms include pain and loss of function, which occur or worsen as the organ or limb is used more intensively, as this increases the demand for oxygen. Extreme ischaemia leads to an irreversible infarction and the mortification of tissues. See Intermittent Claudication.
Laparotomy Opening the abdomen with an incision. Compare with laparoscopy, keyhole surgery in the abdomen. See -tomy, Abdomen.
Learning curve Decreasing probability of complications and death of a patient (morbidity and mortality) as a surgeon, a team or a hospital gain greater experience with a specific operation. Eventually, the risk of morbidity and mortality decreases to such an extent that gaining further experience no longer has an effect. The learning curve is then ‘completed’ or ‘achieved’. A typical learning curve requires more than a hundred patients to complete.
Ligature Tying off a bleeding blood vessel with a thread. There is a fixed procedure for placing a ligature. The surgeon first fixes a clamp to the bleeding wound. When the bleeding has stopped completely, an assistant passes a thread behind the tissue below the clamp and ties a knot in it. This calls for communication. The assistant says ‘yes’ when he is finished, after which the surgeon carefully opens the clamp. The assistant then says ‘thank you’ if the knot seems to have the bleeding under control, after which the surgeon removes the clamp completely and gives it back to the scrub nurse. The scrub nurse then gives the surgeon a pair of scissors, which he uses to cut off the ends of the thread.
Lithotomy position Lying on the back with both legs in the air. Provides a clear view of the perineum. Preferred position for operations on the anus, vagina, scrotum and penis. Since Louis XIV, also the preferred position for giving birth.
Lithotomy Surgical removal of a stone from the bladder (literally, stone-cutting). Those who performed the operation were formerly referred to as stone-cutters.
Local Used for a location in the body that does not belong anatomically to a described region, for example, the forehead, the little finger, the navel or the pancreas. See Regional.
Luxation Dislocation. See Dislocation, Reposition.
Lymph Tissue fluid. Clear fluid between the cells transported by the blood. Special small lymph vessels remove excess lymph fluid separately. Lymph fluid from the small intestine, known as chyle, also contains fats from food, giving it a milky colour. See Lymph nodes.
Lymph nodes Nodes no larger than half a centimetre, where lymph vessels come together. In groups they form lymph stations on the large network of lymph vessels in the body. See Lymph, Metastasis, Radical.
Macroscopic Visible to the naked eye, in contrast to microscopic, meaning too small to be seen with the naked eye.
Medical error See Complication.
Mesentery Attachment with which the small intestine is connected to the back of the abdominal cavity over its whole length and through which blood vessels run to and from the intestine. It is shaped like a fan, so that on the intestine side, it is six metres long, but only 30 centimetres where it is attached to the abdominal wall. It is also about 30 centimetres across from the point of connection at the back of the abdominal cavity to the intestine. That is long enough to allow the intestine to protrude from the abdomen onto the operating table when the abdominal cavity is cut open.
Metastasis Literally ‘displacement’. Occurs when cancer cells break loose from a tumour and form a new tumour elsewhere in the body. The metastasis can be direct, across the edges of a cavity or plane, or via the blood vessels to a more remote part of the body, for example, via the portal vein to the liver, via arteries to the bones or the brain, or via the lymph vessels to the lymph nodes.
Morbidity From the Latin word morbus, meaning disease. Used in surgery to describe the occurrence of complications. Can be expressed in the percentage chance that a specific complication will occur in the case of a certain procedure. See Complication.
Mortality Risk of death, from the Latin word mors, meaning death. In surgery death resulting from a disease or a surgical operation. Can be expressed as a percentage chance that a patient will die from a certain disease or procedure.
Narcosis See Anaesthesia.
Necrosis Dead tissue. Cutting away dead tissue is called necrotectomy.
Needle holder Surgical instrument used to hold the stitching needle firmly and guide it through the tissues.
Nervous system Collective name for the brain, the spine and the nerves.
Obduction Autopsy.
Obesity Excessive body weight that poses a health risk, compared with others of the same gender and race, and of the same age and height. Adults in the Western world are considered to be obese if their body mass index (BMI: weight in kilograms/square of their length in metres) is higher than 25. The BMI obesity limit for Asians, for example, is lower.
Occlusion Blockage of an intestine, a blood vessel, or any other hollow structure. A blocked artery can cause an infarction or gangrene. See Arteriosclerosis.
Operative report Documented record of a surgical procedure in a patient’s medical file. A report has to be made of every operation, describing the procedure from A to Z, from the position of the patient on the operating table and the disinfecting of the skin to the final stitch and the application of the dressing. The report should also note the names of the patient, the operating surgeon, the assistant and the anaesthetist, plus the date, indication and nature of the operation.
Orthopaedics Orthopaedic surgery. Literally ‘straightening a child’. Orthopaedics was originally a discipline that focused on fitting children with braces, splints, shoe inserts and orthopaedic footwear to correct deformities of the bones. Although this did not involve surgical procedures, orthopaedics has now become a specialised ‘cutting’ discipline, with operations being performed on the musculoskeletal structure of the body. The main activity of orthopaedic surgeons is currently replacing joints with prostheses.
Outcome (of care) The total results obtained by a doctor, team or care institution in treating a specific illness, including the negative consequences, such as morbidity and mortality, in both the short and longer term. A commonly used measure of outcome is the five year survival rate, i.e. the percentage of patients that are still alive five years after the operation.
Palliative Reducing pain without curing the cause. Palliative care is treatment aimed both at prolonging the life of terminally ill patients and improving their quality of life, but without the prospect of a complete cure. Compare with curative treatment. See End-of-life care, Curative.
Pathological Deviating from the normal, healthy situation. Pathology means ‘the study of illness’, but is also used to describe the department of a laboratory or hospital that conducts microscopic examination of tissues and autopsies.
Per primam In the first instance. Healing per primam is primary wound healing. See Wound healing.
Per secundam In the second instance. Healing per secundam is secondary wound healing. See Wound healing.
Perianal Around the anus, in the vicinity of the anus or related to the anus.
Perineum Literally the area around the opening through which we are born. The area between buttocks and the lower abdomen. Includes the pelvic floor, with the anus, vagina, scrotum and penis.
Peritoneum The inner lining of the abdominal cavity. An infection of the peritoneum is known as peritonitis.
pH value Chemical expression of the acidity of a liquid: pH7 is neutral, lower is more acidic, and higher is more alkaline. The optimal pH of the human body is 7.4.
Post-natal After giving birth. A post-natal depression is a psychological disorder, a form of depression, suffered by women after they have given birth.
Prevalence The number of cases of a certain disease in a population group at a given moment. Prevalence is mostly expressed as patients per thousand. See Incidence.
Primary See Per primam.
Primum non nocere Basic principle of medicine, meaning literally ‘first do no harm’. At least, do not make a situation worse than it already is. A surgeon sometimes has to make a situation worse, by performing an operation, to ultimately improve it. In such cases, the long-term advantages and disadvantages must be considered. A decision on whether to perform a surgical procedure cannot therefore always be made on the basis of primum non nocere. Surgeons could better work according to the principle of ‘do unto others as you would have them do to you’.
Probe Rod-shaped instrument used to probe the depth of a wound or fistula.
Prognosis Prospect. How an illness will end, the chances that it will end well or badly, the time required for recovery, the symptoms or complications that can be expected.
Prosthesis Temporary or permanent replacement of part of the body by something artificial, for example an artificial leg, false teeth, an artificial blood vessel, artificial ossicles in the ear, an artificial hip or shoulder.
Purgative A laxative to provoke diarrhoea, such as castor oil.
Pus Liquid produced by an infection, comprising dead inflammatory cells (white blood cells), bacteria, tissue and tissue fluid. Different pathogens cause different kinds of pus, with a characteristic smell, colour and texture. A typical subcutaneous abscess (boil) contains creamy, light yellow pus with a slightly cheesy smell. An abscess around the anus will smell strongly of faeces. Teeth abscesses have the most unpleasant smell. See Abscess, Drain.
Radical Literally ‘roots and all’. Always used in surgery in combination with a resection or excision. Means that not only an organ or part of an organ are removed, but also the accompanying lymph nodes. Radical resection is also known as extirpation, which has the same literal meaning. See Total, Metastasis, Lymph nodes.
Regional Relating to a region of the body, i.e. which has its own artery and vein carrying blood to and from the organism. Examples are the upper abdomen, the neck or the lower leg. See Local.
Reposition Surgical action in the case of a dislocated fracture, involving pulling or pushing the fractured bones back into place. A dislocated joint can also be repositioned. A dislocated shoulder can be repositioned using Hippocrates’s method (placing a foot in the armpit and pulling on the extended arm) or the Kocher manoeuvre. See Dislocation.
Resection Literally ‘cut away’ or ‘take away’. In practice, comparable to excision (cutting out).
Resuscitate, resuscitation Literally means ‘revive’ or ‘restore to life’. All the actions required to keep a victim or patient alive in an emergency.
Risk factor A situation that causes a risk of an illness or complication occurring. Malnutrition, obesity, diabetes and smoking, for example, are four important risk factors for bad wound healing.
Scalpel Surgical knife. Formerly a one-piece knife, with blade and handle joined together. Almost completely replaced in modern surgery by a separate handle into which disposable blades can be clicked. See Fleam.
Scar See Wound, Wound healing, Healing.
Scrotum Sac containing the testicles.
Secondary See Per secundam.
Shock See Circulatory system.
Side effect See Complication.
Sign See Symptom.
Sinus A cavity with an opening to the outside. In contrast to a fistula, which joins two openings.
Stenosis Stricture of a bowel, blood vessel or any other hollow structure. Stenosis of an artery leads to symptoms during physical activity. See Arteriosclerosis.
Sterile 1. Not able to produce offspring. 2. Completely free of any pathogens, also known as aseptic. Not to be confused with antiseptic. Surgical instruments, operation jackets and gloves are sterilised with gamma rays or hot steam under high pressure.
Stoma Opening, mouth. Mostly used for an exit from the intestines on the skin of the abdomen. A better name is anus praeternaturalis, literally ‘beyond-natural anus’. A stoma from the small intestine is known as an ileostomy or jejunostomy, and from the large intestine as a colostomy.
Stroke Loss of function of part of the brain due to haemorrhaging or a cerebral infarction. The official medical term is cerebrovascular accident (CVA). See Infarction.
Subcutaneous tissue Also known as the subcutis or hypodermis. The layer of fat and connective tissues immediately below the skin. Obesity in females is typified by an increase in the thickness of this subcutaneous layer (in men, obesity is typified by the accumulation of mainly fat in the fatty tissues in the abdomen around the intestines). Superficial blood vessels, sensory nerves and lymph vessels run through the subcutaneous layer.
Surgeon Literally ‘hand-worker’, also chirurgeon (archaic). Medical specialist qualified to treat patients by performing operations. Restricts himself to diseases and disorders that can be treated surgically. Surgical specialisations are known as the ‘cutting’ disciplines.
Surgery ‘Hand-work’, from the Greek words kheir (hand) and ergon (work). Also the art of healing. Historically, strictly separated from medicine, which restricts itself to curing diseases without using the hands. In modern medicine, surgeons are of course also physicians and non-cutting doctors also use their hands. The difference between curing and healing, however, maintains the difference between the two approaches (cutting and non-cutting). See Healing.
Symptom A change in the body’s normal functions noticed by a patient. A doctor cannot thus observe symptoms, but can only be told about them by the patient. Asking about the nature, seriousness and development of the symptoms is the first stage in the doctor’s examination of the patient. This stage is known as anamnesis. Any abnormalities that the doctor observes or invokes in the patient are known not as symptoms but as signs. Identifying signs is the second stage and is known as the physical or clinical examination.
Syn- or sym- Prefix meaning ‘together’ or ‘at the same time’. Symposium means literally ‘drinking together’. Syndrome is the continual coincidence of different abnormalities and illnesses.
Syphilis Sexually transmitted chronic infection. Caused by the bacteria Treponema pallidum. Causes tissue destruction, for example, in the face, and eventually of the central nervous system. This wasting disease was ubiquitous in the nineteenth century and could not be effectively treated until after the Second World War with antibiotics.
Thoracotomy Cutting open the thoracic (chest) cavity. Another procedure for accessing the thoracic cavity is thoracoscopy, keyhole surgery in the chest. See -tomy, Thorax.
Thorax Chest. See Thoracotomy.
Thrombosis Formation of a clot in a blood vessel. Thrombosis in a vein (venous thrombosis) leads to accumulation of tissue fluid, which is obstructed from flowing away. Thrombosis in an artery can lead to gangrene or an infarction.
Tissue A group of cells that all have the same function. Individual tissues have specific structures, functions and properties and usually have their own blood vessels to supply them with oxygen and nutrients. A body part usually consists of different kinds of tissue, such as skin, subcutaneous tissue, connective tissue, muscle tissue, nerve tissue, gland tissue, bone and cartilage.
-tomy The suffix -tomy means ‘cut’. A laparotomy entails cutting open the abdomen, a thoracotomy the chest (thorax) and a craniotomy the head (cranium). The suffix -ectomy means ‘cut out’. A tumourectomy is the cutting out of a tumour. A parathyroidectomy is removal of a parathyroid gland. Try saying that ten times in quick succession!
Total Complete. In surgery, this means including the outermost margins. See Radical.
Tourniquet A band tied tightly around a limb. If the pressure it creates is higher than the blood pressure, all bleeding from the limb will be stopped. If the pressure is low, the blood will be dammed up in the limb and the tourniquet can be used to facilitate the tapping of blood from a vein. See Bloodletting.
Transplantation Transfer of tissues by detaching them completely from the body. See Transposition.
Transposition Surgical method of transferring tissues without completely detaching them. See Transplantation.
Trauma Injury or wound (from ancient Greek) caused by an external impact. This is always taken literally in surgery. A car crash, a fall, a blow, a bullet, a knife or a punch are all examples of trauma. Traumatic thus means ‘causing an injury or wound’. Surgical tweezers have small pointed ends designed to grip the tissue firmly without bruising or crushing it, and are consequently called ‘atraumatic tweezers’. Traumatology is the branch of surgery concerned with wounds caused by trauma.
Triad Fixed combination of three symptoms or signs that can predict a certain diagnosis. The triad for a bad surgeon, for example, is firstly blaming complications on circumstances and not on his own (lack of) talent, secondly giving his own experience priority over scientific evidence, and thirdly, not showing respect for his operating team.
Tumour Literally a growth or a swelling. Can in theory refer to any swelling, but is in practice now only used for abnormal tissue growth. This can be benign (non-cancerous) or malignant (cancerous). A tumourectomy is the removal of a tumour. See Cancer, Resection, Excision, Total, Radical.
Urinary catheter See Drain.
Urologist Medical specialist concerned with the surgery of the kidneys, the urinary tracts, the bladder and the male genitals.
Vein Blood vessel that transports blood to the heart. The adjective is venous. In anatomy books, veins are depicted in blue. The oxygen-poor blood is a dark-red colour, which has a blue tint when seen through the thin wall of a vein. Veins have venous valves, to stop the blood from flowing back downwards. Pulmonary veins are special blood vessels that also transport blood to the heart but, because this blood comes from the lungs, it is oxygen-rich. The portal vein carries blood from the intestines to the liver, not the heart.
White blood cells Leucocytes – collective name for different cells that can be active in the blood and outside the blood vessels, where they can move to any tissue of the body.
Wound Open breach of a barrier in the body. An opening in the skin is usually referred to simply as a wound; an opening in mucous membrane is referred to as an ulcer. A wound has edges and a wound bed. The healing of a wound depends on the presence of bacteria in the wound, the amount of dead tissue, the supply of blood to the edges of the wound and the wound bed, and the patient’s nutritional condition. A healed wound leaves a scar, as extra connective tissue is required to bridge the opening.
Wound healing The recovery of a wound, leaving a scar. Primary wound healing is bridging the wound opening with connective tissue. It can only occur if the wound is clean, the edges of the wound are sufficiently pressed together for several days, and there is an adequate supply of blood to the wound bed and the edges of the wound. In the case of secondary wound healing, the wound initially remains open and will gradually fill up with new tissue known as granulating tissue. The skin or the mucous membrane will then close over this new tissue. See Wound.
X-ray image intensifier Fluoroscopy. Method that uses X-ray imaging to show fractures live on a monitor. The X-ray machine can be used during an operation. Those present in the operating room will then have to wear lead jackets to protect themselves from the radiation.