Chapter 85: Other Specializations for Surgeon Part 1

Rolden: Then....

Obstetrics and Gynecology

Obstetrics and gynecology is a very broad and diverse branch of medicine. It includes surgery, management and care of pregnant women, delivering babies, gynecologic care, oncology, and primary health care for women. There are four sub-specialties in this field: gynecologic oncology, reproductive endocrinology and infertility, maternal fetal medicine, and female pelvic medicine and reconstructive surgery.

Obstetrician-gynecologists have extensive knowledge about the medical and surgical care of the female reproductive system and associated disorders. Surgical procedures include laser surgery, cervical biopsy, diagnostic laparoscopy, operative laparoscopy such as laparoscopic ovarian cystectomy, tubal ligation, diagnostic and operative hysteroscopy, dilation and curettage (D&C), and endometrial ablation. Inpatient surgical procedures include hysterectomies performed vaginally, abdominally, and laparoscopically.

Some obstetricians/gynecologists have a strong professional interest in a specific area such as urogynecology, pelviscopy, adolescent/pediatric gynecology, or infectious diseases.

General Surgery

A general surgeon is a physician who has been educated and trained in anatomy, emergency and intensive care, immunology, metabolism, pathology, physiology, shock and resuscitation, and wound healing.

General surgeons are trained to provide surgical care for the 'whole' patient (affecting almost any area of a patient's body) within a wide range of surgical conditions - which includes making a diagnosis as well as the preoperative, operative and postoperative care of a patient. They have knowledge and technical skills in taking care of medical conditions that relate to the head and neck, breast, skin, and soft tissues, abdominal wall, extremities, and the gastrointestinal, vascular, and endocrine systems.

A general surgeon's practice may vary depending on where the practice is. In rural areas, some surgeons may also perform gynecologic, urologic, orthopedic and ENT surgeries. In some academic centres, a general surgeon might limit his/her practice to one subspecialty.

Colorectal

A colorectal surgeon is a physician who specializes in treating diseases of the colon, anal canal, rectum, perianal area, as well as the entire gastric tract through medical and surgical means. Colorectal surgeons are also able to perform surgery on other organs and tissues (such as the liver, urinary, and female reproductive systems) involved with primary intestinal disease. Managing conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses, and fistulae (infections located around the anus and rectum) can be managed in the office.

Since colorectal surgeons care for patients with diseases that affect the lower gastrointestinal tract, they can perform endoscopic procedures to detect and treat conditions of the bowel lining, such as cancer, polyps (precancerous growths), and inflammatory conditions, and can also perform abdominal surgical procedures that involve the small bowel, colon, and rectum, including treatment of inflammatory bowel diseases, such as chronic ulcerative colitis, Crohn's disease, diverticulitis, and cancer.

Vascular

Vascular surgery became a surgical specialty in its own right in 2012. Vascular surgeons are educated and trained to deal with conditions and diseases affecting a patient's vascular system (veins, arteries, blood vessels). Examples of some common surgical procedures include: carotid endarterectomy, angioplasty and lower limb bypass surgery.

A vascular surgeon is able to treat many conditions that affect the blood vessels in every part of a patient's body (except for the heart and brain). According to the Heart and Vascular Institute, some of these conditions may include:

Aneurysm - a bulge or weak spot in an artery

Atherosclerosis - a hardening of the arteries, where plaque builds up on the artery walls

Carotid artery disease or peripheral artery disease (PAD) - arteries that bring blood to the neck or limbs become narrow or blocked

Compression disorders - nutcracker syndrome and thoracic outlet syndrome

Dialysis access - placement of a graft or fistula that allows a patient to receive dialysis treatment for kidney disease

Deep vein thrombosis (DVT) - a blood clot in a vein deep below the skin

Spider veins - small webs of veins just below the surface of the skin

Trauma to arteries and veins - caused by accidents or injuries

Varicose veins - large, swollen, twisted veins that can cause pain or aching in the legs

Venous ulcers and arterial and diabetic (neuropathic) wounds - non-healing wounds that result from poor blood flow, especially in the legs