A.

Purpose
Diagnostic Confirms or establishes a diagnosis; Example – biopsy of a
mass in a breast.
Palliative Relieves or reduces pain or symptoms of a disease; it does not
cure; Example - resection of nerve roots.
Ablative Removes a diseased body part; Example - removal of a
gallbladder (cholecystectomy)
Constructive Restores function or appearance that has been lost or reduced;
Example – breast implant
Transplant Replaces malfunctioning structures; Example – hip
replacement
B. Degree of Urgency
Emergency Surgery Is performed immediately to preserve function or the life of
the client. Example – surgeries to control internal hemorrhage
Elective Surgery Is performed when surgical intervention is the preferred
treatment for a condition that is not imminently life
threatening (but may ultimately threaten life or well being) or
to improve the client’s life. Example – cholecystectomy for
chronic gallbladder disease, plastic surgery procedures such
as breast reduction surgery
C. Degree of Risk
Major Surgery It involves a high degree of risk, for a variety of reasons: It
may be complicated or prolonged, large losses of blood may
occur, vital organs may be involved, or postoperative
complications may be likely. Example – organ transplant,
open heart surgery, removal of kidney
Minor Surgery It involves little risk, produces few complications, and is
often performed in a “day surgery”. Example – breast biopsy,
removal of tonsils, knee surgery.
The degree of risk involved in a surgical procedure is affected by the client’s age, general health,
nutritional status, use of medications, and mental status.
Age Very young and elder clients are greater surgical risks than
children and adults.
The physiologic response of an infant to surgery is substantially
different from an adult’s.
The blood volume in an infant is small, and its fluid reserves
limited.
The older adult often has fewer physiologic reserves to meet the
extra demands caused by surgery.
The older adult may be poorly nourished, which can impair
healing.
General Health Surgery is least risky when the client’s general health is good.
Common health problems that increase surgical risk and may
lead to the decision to postpone or cancel surgery are
malnutrition, cardiac conditions, blood coagulation disorders,
 renal diseases, diabetes mellitus, liver diseases, etc.
Nutritional Adequate nutrition is required for normal tissue repair.
Status Obesity contributes to postoperative complications such as
pneumonia, wound infection and wound separation.
Obese and underweight client are vulnerable to pressure ulcer
formation due to positioning required for surgery.
A malnourished client is at risk for delayed wound healing,
wound infection and fluid and electrolyte alterations.
Medications The following medication can increase surgical risk:
Anticoagulants increase blood coagulation time.
Tranquilizers may interact with anesthetics, increasing the risk
of respiratory depression.
Corticosteroids may interfere with wound healing and increase
the risk of infection.
Diuretics may affect fluid and electrolyte balance.
Mental Status Clients with dementia may have difficulty understanding
proposed surgical procedures and may respond unpredictably to
anesthetics.
Extreme anxiety also increases surgical risk and interferes with
the client’s ability to process information and respond
appropriately to instructions.
Terminology
 Excision surgery names often start with a name for the organ to be excised (cut out) and
end in-ectomy.
 Procedures involving cutting into an organ or tissue end in -otomy. A surgical procedure
cutting through the abdominal wall to gain access to the abdominal cavity is a laparotomy.
 Minimally invasive procedures involving small incisions through which an endoscope is
inserted end in -oscopy. For example, such surgery in the abdominal cavity is called
laparoscopy.
 Procedures for formation of a permanent or semi-permanent opening called a stoma in the
body end in -ostomy.
 Reconstruction, plastic or cosmetic surgery of a body part starts with a name for the body
part to be reconstructed and ends in -oplasty. Rhino is used as a prefix for “nose”,
so rhinoplasty is basically reconstructive or cosmetic surgery for the nose.
 Reparation of damaged or congenital abnormal structure ends in -rraphy. Herniorraphy is
thereparation of a hernia, while perineorraphy is the reparation of perineum.
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