General surgery is a foundational specialty in medicine, encompassing a broad range of procedures involving the gastrointestinal tract, abdominal organs, endocrine glands, breast, skin, and soft tissues. It forms the backbone of surgical care in many health systems. The principles of general surgery revolve around patient safety, surgical anatomy, asepsis, sound judgment, and technical skill.
Hepatopancreatobiliary (HPB) Surgery
Liver, pancreas, and biliary tract diseases
Bariatric and Metabolic Surgery
Surgical management of obesity
Surgical Oncology
Multidisciplinary cancer treatment
Minimally Invasive & Robotic Surgery
Advanced laparoscopic procedures
The practice of general surgery is grounded in strong principles that prioritize patient safety, sound technique, and ethical care. Adherence to these core principles ensures high-quality surgical care across diverse conditions.
Bariatric surgery, also known as metabolic surgery, is a specialized field within general surgery focused on the treatment of obesity and its associated comorbidities such as type 2 diabetes, hypertension, and sleep apnea. As global obesity rates rise, bariatric surgery has become an increasingly important intervention for sustainable weight loss and metabolic improvement. The success of bariatric procedures relies on a firm grasp of the principles underlying surgical technique, patient selection, multidisciplinary care, and long-term follow-up.
Proper patient selection is a cornerstone of successful bariatric surgery.
Preoperative evaluation includes nutritional, psychological, and medical assessments.
Bariatric surgery requires a team-based approach involving:
Common bariatric procedures:
Laparoscopic Sleeve Gastrectomy (LSG)
Most common globally, resection of 75-80% of the stomach, primarily restrictive
Roux-en-Y Gastric Bypass (RYGB)
Combines restriction and malabsorption, effective for GERD and diabetes control
One-Anastomosis Gastric Bypass (OAGB)
Simpler than RYGB but associated with bile reflux risk
Bariatric surgery is a powerful tool in the management of morbid obesity and its related diseases. Success is rooted in careful patient selection, multidisciplinary care, surgical expertise, and a commitment to long-term follow-up.
Breast oncoplastic surgery combines oncologic principles with plastic surgery techniques to ensure both complete tumor resection and optimal aesthetic outcomes. This multidisciplinary approach has transformed breast cancer management by allowing wider excisions without compromising cosmetic results. It empowers breast surgeons to offer breast-conserving treatments to more patients while maintaining body image and quality of life.
Classified into two main approaches:
Level I (Simple Oncoplasty)
Tumor excision <20% of breast volume, minimal reshaping
Level II (Advanced Oncoplasty)
Tumor excision >20% of breast volume, complex reconstruction
Other Techniques
Batwing mastopexy, Round block technique, Grissoti flap, LD flap, TDAP flap
Breast oncoplastic surgery represents a paradigm shift in the management of breast cancer, offering oncological safety with aesthetic preservation. It requires careful planning, technical skill, and multidisciplinary collaboration.
Laparoscopic surgery, also known as minimally invasive surgery (MIS), has revolutionized the practice of general surgery and many surgical subspecialties. Unlike traditional open surgery, laparoscopic procedures are performed through small incisions using a camera and specialized instruments, offering significant benefits such as reduced pain, faster recovery, and improved cosmetic outcomes. However, the effectiveness and safety of laparoscopic surgery depend on strict adherence to specific principles that govern its practice.
Laparoscopic surgery offers a paradigm shift from traditional open techniques, bringing multiple patient-centered advantages. It requires adherence to established principles including safe access, precise visualization, and effective team collaboration.
Abdominoplasty, traditionally a cosmetic procedure, has evolved as a valuable adjunct in the management of complex abdominal wall hernias, particularly giant ventral hernias. These hernias often involve significant loss of domain, skin redundancy, and weakened musculature. Combining functional repair with aesthetic improvement enhances abdominal wall reconstruction and patient satisfaction. This essay outlines the principles, indications, techniques, and types of abdominoplasty used in the treatment of giant ventral hernias.
Standard Abdominoplasty
Removal of excess skin and fat with muscle plication
Fleur-de-lis Abdominoplasty
Combines vertical and horizontal resection for massive weight loss patients
Extended Abdominoplasty
Extends laterally for more extensive tissue removal
Abdominoplasty in giant ventral hernia repair offers both functional and aesthetic benefits. Its success relies on meticulous patient selection, preoperative planning, surgical expertise, and comprehensive postoperative care.
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