Editing Surgery (section)

===Intraoperative phase===
The intraoperative phase begins when the surgery subject is received in the surgical area (such as the [[operating theater]] or surgical [[Hospital#Departments or wards|department]]), and lasts until the subject is transferred to a recovery area (such as a [[post-anesthesia care unit]]).<ref>[https://books.google.com/books?id=Qogt_LvTi-sC&pg=PA2 Page 2] in: {{cite book | vauthors = Spry C | title=Essentials of perioperative nursing | publisher=Jones and Bartlett Publishers | location=Sudbury, Mass | year=2009 | isbn=978-0-7637-5881-3 | oclc=227920274 }}</ref>

An incision is made to access the surgical site.  [[Blood vessel]]s may be clamped or [[Cauterization|cauterized]] to prevent bleeding, and retractors may be used to expose the site or keep the incision open.  The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then the peritoneum.  In certain cases, [[bone]] may be cut to further access the interior of the body; for example, cutting the [[human skull|skull]] for [[brain]] surgery or cutting the [[Human sternum|sternum]] for [[Thoracic surgery|thoracic (chest) surgery]] to open up the [[rib cage]]. Whilst in surgery [[Asepsis|aseptic technique]] is used to prevent infection or further spreading of the disease. The surgeons' and assistants' hands, wrists and forearms are washed thoroughly for at least 4 minutes to prevent germs getting into the operative field, then sterile gloves are placed onto their hands. An antiseptic solution is applied to the area of the person's body that will be operated on. Sterile drapes are placed around the operative site. Surgical masks are worn by the surgical team to avoid germs on droplets of liquid from their mouths and noses from contaminating the operative site.{{citation needed|date=May 2023}}

Work to correct the problem in body then proceeds.  This work may involve:
{{anchor|excision}}
* excision – cutting out an organ, tumor,<ref>Wagman LD. [http://www.cancernetwork.com/cancer-management-11/chapter01/article/10165/1399286 "Principles of Surgical Oncology"] {{webarchive|url=https://web.archive.org/web/20090515031925/http://www.cancernetwork.com/cancer-management-11/chapter01/article/10165/1399286 |date=15 May 2009 }} in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds) [http://www.cancernetwork.com/cancer-management-11/ Cancer Management: A Multidisciplinary Approach] {{webarchive|url=https://web.archive.org/web/20131004224102/http://www.cancernetwork.com/cancer-management-11/ |date=4 October 2013 }}. 11 ed. 2008.</ref> or other tissue.
* [[Segmental resection|resection]] – partial removal of an organ or other bodily structure.<ref>{{Cite journal |last1=Küçükkartallar |first1=Tevfik |last2=Gündeş |first2=Ebubekir |last3=Yılmaz |first3=Hüseyin |last4=Aksoy |first4=Faruk |date=2013-03-01 |title=A case of multiorgan resection for locally advanced stomach cancer |journal=Turkish Journal of Surgery/Ulusal Cerrahi Dergisi |volume=29 |issue=1 |pages=31–32 |doi=10.5152/UCD.2013.07 |issn=1300-0705 |pmc=4379777 |pmid=25931839}}</ref>
* reconnection of organs, tissues, etc., particularly if severed.  Resection of organs such as intestines involves reconnection.  Internal [[surgical suture|suturing]] or stapling may be used.  Surgical connection between blood vessels or other tubular or hollow structures such as loops of intestine is called [[anastomosis]].<ref>{{Cite web |title=magnetic compression anastomosis: Topics by Science.gov |url=https://www.science.gov/topicpages/m/magnetic+compression+anastomosis |access-date=2022-10-30 |website=www.science.gov}}</ref>
* reduction – the movement or realignment of a body part to its normal position.  e.g. Reduction of a broken nose involves the physical manipulation of the bone or cartilage from their displaced state back to their original position to restore normal airflow and aesthetics.<ref>{{Citation |last1=Alvi |first1=Sirhan |title=Nasal Fracture Reduction |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK538299/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30855883 |access-date=2022-10-30 |last2=Patel |first2=Bhupendra C.}}</ref>
* [[Ligature (medicine)|ligation]] – tying off blood vessels, ducts, or "tubes".<ref>{{Citation |last1=Sung |first1=Sharon |title=Tubal Ligation |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK549873/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=31751063 |access-date=2022-10-30 |last2=Abramovitz |first2=Aaron}}</ref>
* [[Medical grafting|grafts]] – may be severed pieces of tissue cut from the same (or different) body or flaps of tissue still partly connected to the body but resewn for rearranging or restructuring of the area of the body in question.  Although grafting is often used in cosmetic surgery, it is also used in other surgery.  Grafts may be taken from one area of the person's body and inserted to another area of the body.  An example is [[Vascular bypass|bypass surgery]], where clogged blood vessels are bypassed with a graft from another part of the body.  Alternatively, grafts may be from other persons, cadavers, or animals.<ref>{{Citation |last1=Prohaska |first1=Joseph |title=Skin Grafting |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK532874/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30422469 |access-date=2022-10-30 |last2=Cook |first2=Christopher}}</ref>
* insertion of [[Prosthesis|prosthetic]] parts when needed.  Pins or screws to set and hold bones may be used.  Sections of bone may be replaced with prosthetic rods or other parts.  Sometimes a plate is inserted to replace a damaged area of skull.  [[Artificial hip]] replacement has become more common.<ref>{{Citation |last1=Bori |first1=Edoardo |title=Hip prosthesis: biomechanics and design |date=2022 |url=https://www.sciencedirect.com/topics/engineering/hip-prosthesis |work=Human Orthopaedic Biomechanics |pages=361–376 |publisher=Elsevier |language=en |doi=10.1016/B978-0-12-824481-4.00032-9 |access-date=2022-10-30 |last2=Galbusera |first2=Fabio |last3=Innocenti |first3=Bernardo|isbn=978-0-12-824481-4 }}</ref>  [[Heart pacemaker]]s or [[Heart valve|valves]] may be inserted.  Many other types of [[Prosthesis|prostheses]] are used.
* creation of a [[stoma (medicine)|stoma]], a permanent or semi-permanent opening in the body<ref>{{Cite journal |last1=Whitehead |first1=Alia |last2=Cataldo |first2=Peter |date=2017-05-22 |title=Technical Considerations in Stoma Creation |journal=Clinics in Colon and Rectal Surgery |language=en |volume=30 |issue=3 |pages=162–171 |doi=10.1055/s-0037-1598156 |pmid=28684933 |pmc=5498162 |issn=1531-0043}}</ref>
* in [[Organ transplant|transplant]] surgery, the donor organ (taken out of the donor's body) is inserted into the recipient's body and reconnected to the recipient in all necessary ways (blood vessels, ducts, etc.).<ref>{{Cite journal |last=Zalewska |first=Kathy |title=National Standards for Organ Retrieval from Deceased Donors |url=https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/12548/mpd1043-nors-standard.pdf |journal=NHS Blood and Transplant |access-date=30 October 2022 |archive-date=17 October 2022 |archive-url=https://web.archive.org/web/20221017160645/http://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/12548/mpd1043-nors-standard.pdf |url-status=dead }}</ref>
* [[arthrodesis]] – surgical connection of adjacent bones so the bones can grow together into one. [[Spinal fusion]] is an example of adjacent [[vertebrae]] connected allowing them to grow together into one piece.<ref>{{Cite journal |last=Nouh |first=Mohamed Ragab |date=2012 |title=Spinal fusion-hardware construct: Basic concepts and imaging review |journal=World Journal of Radiology |language=en |volume=4 |issue=5 |pages=193–207 |doi=10.4329/wjr.v4.i5.193 |doi-broken-date=3 March 2025 |pmid=22761979 |pmc=3386531 |issn=1949-8470 |doi-access=free }}</ref>
* modifying the [[digestive tract]] in [[bariatric surgery]] for [[weight loss]].
* repair of a [[fistula]], [[hernia]], or [[prolapse]].
* repair according to the [[ICD-10-PCS]], in the Medical and Surgical Section 0, root operation Q, means restoring, to the extent possible, a body part to its normal anatomic structure and function. This definition, repair, is used only when the method used to accomplish the repair is not one of the other root operations. Examples would be [[colostomy]] takedown, [[herniorrhaphy]] of a [[hernia]], and the [[surgical suture]] of a [[laceration]].<ref>{{Cite journal |last1=Gillern |first1=Suzanne |last2=Bleier |first2=Joshua I. S. |date=2014 |title=Parastomal Hernia Repair and Reinforcement: The Role of Biologic and Synthetic Materials |journal=Clinics in Colon and Rectal Surgery |volume=27 |issue=4 |pages=162–171 |doi=10.1055/s-0034-1394090 |issn=1531-0043 |pmc=4226750 |pmid=25435825}}</ref>
* other procedures, including:
:*clearing clogged ducts, blood or other vessels
:*removal of calculi (stones)
:*draining of accumulated fluids
:*[[debridement]] – removal of dead, damaged, or diseased tissue
[[Blood transfusion|Blood]] or blood expanders may be administered to compensate for blood lost during surgery.  Once the procedure is complete, [[surgical suture|sutures]] or [[Surgical staple|staples]] are used to close the incision.  Once the incision is closed, the anesthetic agents are stopped or reversed, and the person is taken off ventilation and [[wikt:extubate|extubated]] (if general anesthesia was administered).<ref name="books.google.com">Askitopoulou, H., Konsolaki, E., Ramoutsaki, I., Anastassaki, E. ''Surgical cures by sleep induction as the Asclepieion of Epidaurus.'' The history of anesthesia: proceedings of the Fifth International Symposium, by José Carlos Diz, Avelino Franco, Douglas R. Bacon, J. Rupreht, Julián Alvarez. Elsevier Science B.V., International Congress Series 1242(2002), pp.&nbsp;11–17. [https://books.google.com/books?id=TM-8NIDPowoC&q=History+of+Hospital%2BAsclepieion&pg=PA11]{{Dead link|date=May 2023|bot=InternetArchiveBot|fix-attempted=yes}}</ref>