Computer-assisted Surgery: From 1 Different Sources
(image-guided surgery, surgical navigation) a technique by which a virtual image or map of the patient is created from CT scans, MRI scans, X-rays, or ultrasound scans and loaded into a computer. Special instruments connected to the computer are then applied to certain reference points on the patient. The computer can then produce a picture of the location of the instrument within the patient.
See MINIMALLY INVASIVE SURGERY (MIS).... keyhole surgery
See RECONSTRUCTIVE (PLASTIC) SURGERY.... plastic surgery
(Further information about the subject and the terms used can be found at http:// www.hfea.gov.uk/glossary)
This technique is used when normal methods of attempted CONCEPTION or ARTIFICIAL INSEMINATION with healthy SEMEN have failed. In the UK, assisted-conception procedures are governed by the Human Fertilisation & Embryology Act 1990, which set up the Human Fertilisation & Embryology Authority (HFEA).
Human Fertilisation & Embryology Act 1990 UK legislation was prompted by the report on in vitro fertilisation produced by a government-appointed committee chaired by Baroness Warnock. This followed the birth, in 1978, of the ?rst ‘test-tube’ baby.
This Act allows regulation monitoring of all treatment centres to ensure that they carry out treatment and research responsibly. It covers any fertilisation that uses donated eggs or sperm (called gametes) – for example, donor insemination or embryos (see EMBRYO) grown outside the human body (known as licensed treatment). The Act also covers research on human embryos with especial emphasis on foolproof labelling and immaculate data collection.
Human Fertilisation & EmbryologyAuthority (HFEA) Set up by the UK government following the Warnock report, the Authority’s 221 members inspect and license centres carrying out fertilisation treatments using donated eggs and sperm. It publishes a code of practice advising centres on how to conduct their activities and maintains a register of information on donors, patients and all treatments. It also reviews routinely progress and research in fertility treatment and the attempted development of human CLONING. Cloning to produce viable embryos (reproductive cloning) is forbidden, but limited licensing of the technique is allowed in specialist centres to enable them to produce cells for medical treatment (therapeutic cloning).
In vitro fertilisation (IVF) In this technique, the female partner receives drugs to enhance OVULATION. Just before the eggs are released from the ovary (see OVARIES), several ripe eggs are collected under ULTRASOUND guidance or through a LAPAROSCOPE. The eggs are incubated with the prepared sperm. About 40 hours later, once the eggs are fertilised, two eggs (three in special circumstances) are transferred into the mother’s UTERUS via the cervix (neck of the womb). Pregnancy should then proceed normally. About one in ?ve IVF pregnancies results in the birth of a child. The success rate is lower in women over 40.
Indications In women with severely damaged FALLOPIAN TUBES, IVF o?ers the only chance of pregnancy. The method is also used in couples with unexplained infertility or with male-factor infertility (where sperms are abnormal or their count low). Women who have had an early or surgically induced MENOPAUSE can become pregnant using donor eggs. A quarter of these pregnancies are multiple – that is, produce twins or more. Twins and triplets are more likely to be premature. The main danger of ovarian stimulation for IVF is hyperstimulation which can cause ovarian cysts. (See OVARIES, DISEASES OF.)... assisted conception
See “residential care services”; “assisted living facility”.... assisted living
The act of intentionally killing oneself with the assistance of another who provides the knowledge, means or both.... assisted suicide
Surgery done in a clinic or a hospital without an overnight stay either before or after the operation. Improvements in surgery – especially the introduction of MINIMALLY INVASIVE SURGERY (MIS) – as well as more e?ective methods of ANAESTHESIA have simpli?ed many procedures and reduced the physical and mental stress on patients. Patients undergoing day surgery should be accompanied home by a friend or relative. Occasionally a patient may develop complications that require a post-operative stay in hospital.... day surgery
A branch of surgery that treats deformities, injuries or diseases of the TEETH and JAW, as well as other areas of the face and mouth. Surgeons doing this work are usually quali?ed dentists who have done further training in oral and maxillofacial surgery.... oral surgery
An operation to remove a cancer, plus adjacent tissue and lymph nodes.... radical surgery
Surgery using a rigid endoscope passed into the body through a small incision. Further small openings are made for surgical instruments so that the operation can be performed without a long surgical incision. Minimally invasive surgery may be used for many operations in the abdomen (see laparoscopy), including appendicectomy, cholecystectomy, hernia repair, and many gynaecological procedures. Knee operations (see arthroscopy) are also often performed by minimally invasive surgery.... minimally invasive surgery
An operation to correct deformity of the jaw and the severe malocclusion that is invariably associated with it. The bones of the jaw are repositioned under general anaesthesia, and often require splinting (see splinting, dental) until they heal.... orthognathic surgery
Establishment which provides accommodation and care for older or disabled persons who cannot live independently but do not need nursing care. Residents are also provided with domestic assistance (meals, laundry, personal care).... assisted living facility / assisted care living facility
The use of information technology to assist health care professionals in diagnosis. This usually involves a dialogue between a computer system and a clinician. The systems are generally regarded as support systems for clinicians; the final responsibility for decision-making resides with the clinician.... computer-assisted diagnosis
The application of computer technology to therapy.... computer-assisted therapy
The Royal College of General Practitioners has issued guidelines on the use of computer-generated prescriptions for drugs other than controlled drugs. The guidelines include rules on giving the patient’s name, address and date of birth with the responsible prescribing doctor’s name at the bottom, along with his or her surgery address and telephone number. The prescription has to be signed by the doctor. Several other requirements are included to minimise the risk of prescription-tampering, fraud or the inclusion of identi?able con?dential information. Full details of the guidelines appear in the British National Formulary, published every six months.... computer-generated prescriptions
Also known as ‘date rape’, this is an unwelcome phenomenon in which an intending rapist undermines a potential victim’s resistance by giving her a hypnotic drug such as benzodiazepine. The British National Formulary warns that ?unitrazepam (Rohypnol®) tablets may be particularly subject to abuse – perhaps given to the unsuspecting victim in an alcoholic drink so the sedative e?ect is greatly enhanced.... drug assisted rape
See “assisted living facility”.... group senior assisted housing
See SUICIDE.... physician-assisted suicide
Reconstructive surgery on the skin and underlying tissues that have been damaged or lost as a result of disease or injury. Congenital malformations are also remedied using reconstructive surgery. Surgeons graft healthy skin from another part of the body to repair skin damaged or destroyed by burns or injuries. New techniques are under development for growing new skin in the laboratory to be used in reconstructive surgery. Surgeons also repair damage using skin ?aps prepared in another part of the body – for example, a skin ?ap from the arm may be used to repair a badly injured nose or face. Reconstructive surgery is also used to repair the consequences of an operation for cancer of, say, the neck or the jaw. Plastic surgeons undertake cosmetic surgery to improve the appearance of noses, breasts, abdomens and faces.... reconstructive (plastic) surgery
An operation to repair arteries that are narrowed, blocked, or weakened. Arterial reconstructive surgery is most often performed to repair arteries that have been narrowed by atherosclerosis. It is also used to repair aneurysms and arteries damaged as a result of injury. (See also angioplasty, balloon; coronary artery bypass; endarterectomy.)... arterial reconstructive surgery
A type of mammoplasty.... breast enlargement surgery
Removal of the lens from the eye, performed to restore sight in people whose vision is impaired by a cataract. The lens is usually replaced with a plastic implant during the operation, although for young people and those with other eye disorders, a contact or spectacle lens fitted after the operation may be preferable.... cataract surgery
See otorhinolaryngology.... ear, nose, and throat surgery
See otorhinolaryngology.... ent surgery
Any operation that is carried out to investigate or examine part of the body to discover the extent of known disease or to establish a diagnosis. Advances in imaging techniques, such as MRI, have reduced the need for exploratory surgery.... exploratory surgery
See blepharoplasty.... eyelid surgery
An operation to correct a heart valve defect or to remove a diseased or damaged valve. A heart valve may have to be repaired, widened, or replaced because it is either incompetent (leaky) or stenotic (narrowed). Widening of a valve may involve valvotomy or valvuloplasty. A damaged valve can be replaced by a mechanical one (fashioned from metal and plastic), a valve constructed from human tissue, a pig valve, or a valve taken from a human donor after death. A heart–lung machine is used during replacement.After heart-valve surgery, symptoms such as breathlessness may take weeks to improve and require medication to be continued. Some people need longterm treatment with anticoagulant drugs to prevent the formation of blood clots around the new valve.... heart-valve surgery
See minimally invasive surgery.... minimal access surgery
Any operation on the heart in which it is stopped temporarily and its function taken over by a mechanical pump. The main forms of open heart surgery are correction of congenital heart defects (see heart disease, congenital), surgery for narrowed or leaky heart valves (see heart-valve surgery), and coronary artery bypass surgery. Once the pump is connected, the heart is opened, and the defects repaired. Surgical hypothermia is used to keep the heart cool and help prevent damage to the heart muscle from lack of oxygen (see hypothermia, surgical).... open heart surgery
See arterial reconstructive surgery; plastic surgery.... reconstructive surgery
A surgical speciality concerned with operations on organs within the chest cavity. Sometimes, thoracic surgery is combined with heart surgery, in which case it is known as cardiothoracic surgery.... thoracic surgery
See traumatology.... trauma surgery
surgery performed for the purpose of weight loss in obese patients. Most procedures are restrictive, being designed to promote feelings of fullness and satiety after meals (see gastric banding; stomach stapling). See also gastric bypass surgery; jaw wiring.... bariatric surgery
surgical procedures that can be performed in a single day, without the need to admit the patient for an overnight stay in hospital. Modern techniques of surgery and anaesthesia now enable many surgical cases of minor and intermediate degrees of severity to be treated in this way: examples include many breast lesions, dilatation and curettage, and operations for hernia and varicose veins. Special units are established in many hospitals.... day-case surgery
(ESS) surgery of the *paranasal sinuses using endoscopes. Functional endoscopic sinus surgery (FESS) clears inflamed tissue from routes of sinus drainage and aeration to allow the other sinuses to return to normal.... endoscopic sinus surgery
(FGCS) surgery to alter the size or shape of the *vulva and/or vagina when these are a cause of significant distress or sexual dysfunction. FGCS includes labioplasty (reduction or alteration of the labia), clitoral hood reduction (excision of excess skin in the fold surrounding the clitoris), and hymenoplasty (partial or complete reconstruction of the hymen).... female genital cosmetic surgery
(FESS) see endoscopic sinus surgery.... functional endoscopic sinus surgery
any of several procedures of *bariatric surgery that allow food to bypass parts of the gut in order to reduce absorption of nutrients and calories. Such operations often lead to greater weight loss than restrictive procedures, such as *gastric banding and *stomach stapling, but there are significant long-term complications relating to chronic malabsorption and patients must remain under long-term specialist follow-up.... gastric bypass surgery
see computer-assisted surgery.... image-guided surgery
(LAUP) laser surgery to the palate, which is used in the treatment of *obstructive sleep apnoea.... laser-assisted uvulopalatoplasty
a surgical technique used for removing primarily high-risk nonmelanoma skin cancers, particularly basal cell carcinoma. The technique allows the surgeon to see beyond the visible tumour as the specimen is removed and the histology checked in stages. At each stage, if the tumour involves the margins, further tissue is resected until they are clear. There is an extremely high cure rate. [F. E. Mohs (1910–2002), US surgeon]... mohs’ micrographic surgery
any surgical procedure that has as its primary objective the correction of any refractive error. It includes such procedures as clear lens extraction, *LASIK, *LASEK, and photorefractive *keratectomy.... refractive surgery
a type of laparoscopic surgery in which the operating surgeon controls the instruments via a robot. The surgeon sits at a console away from the patient and controls the robot’s operating arms.... robotic surgery
(TORS) a form of robot-assisted surgery used for treating difficult-to-access tumours of the pharynx and larynx.... trans-oral robotic surgery
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