Surgeon Phoenix is a medical doctor who performs surgical operations. In the US, surgeons must have a medical degree and pass the United States Medical Licensing Exam (USMLE) or Comprehensive Osteopathic Medicine Licensing Examination (COMLEX).
They work in hospitals, clinics and surgical centers. Besides performing surgeries, they visit patients, check their condition, and liaise with other doctors and nurses.
After medical school, DOs and MDs complete a residency program in general surgery. This is typically five years in length, including an intern year. Following this, many surgeons complete a clinical surgical fellowship, which can range from one to two years in duration and allows individuals to further specialize in a particular field of surgery. General surgeons provide training in the core surgical disciplines, such as vascular surgery, pediatric and thoracic surgery, surgical critical care, surgical oncology, trauma and burns, solid organ transplantation and hepatobiliary/pancreatic surgery.
General surgeons who primarily focus on abdominal surgery treat diseases and conditions of the digestive tract, its organs and structures, the colon and its environs, the pancreas and its associated glands, and the liver and its associated tissues. According to the American College of Surgeons (ACS), common procedures include hernia repair, cholecystectomy, gallbladder removal and hepatitis C treatment, stomach ulcers, colon polyps, appendicitis, and bowel resection.
A subset of general surgery, hepatobiliary/pancreatic surgeons treat diseases and conditions of the liver and its associated organs, such as the gallbladder and biliary duct. Common procedures include hepatic resection, appendectomy, hernia repair, and gallstone treatment. This group also treats pancreatitis, gallstone hepatitis, and fatty liver disease.
Surgeons who specialize in ophthalmology, or eye surgery, diagnose and treat problems of the eyes and surrounding structures. The ACS states that they also provide vision services, such as the issuance of glasses and contact lenses. Common conditions addressed by this specialty include amblyopia (“lazy eye”), astigmatism, cataracts, glaucoma and macular degeneration.
Orthopedic surgeons address issues related to the bones, joints, muscles and associated nerves of the musculoskeletal system, and they can work in almost any setting that requires medical expertise, including hospitals, private practices, clinics and ambulatory care and same-day surgery centers. According to the ACS, some orthopedic surgeons further specialize in certain areas of their practice and others serve as surgical jacks-of-all-trades, particularly in rural and underserved communities. They are trained to perform a variety of procedures, both open and minimally invasive, such as endoscopy and laparoscopy. They are also trained to handle obstetrics and gynecology, plastic and reconstructive surgery and urology.
Trauma Surgery
Trauma surgery deals with patients who have sustained a physical injury, typically in an acute setting. Unlike other surgical subspecialties, which may treat only specific parts of the body (like orthopedics or urology), trauma surgeons treat all areas of the body and are trained in treating a wide variety of injuries, including skeletal injuries (think broken bones) as well as internal organ injuries.
In the United States and much of Europe, traumatic injuries are typically addressed by a multidisciplinary team of doctors, including cardiothoracic surgeons for vascular injuries, neurosurgeons for central nervous system injuries, pulmonologists for respiratory tract injuries and plastic and reconstructive surgeons for facial injuries. However, it’s common for trauma surgeons to manage musculoskeletal injuries and most often they will handle injuries to the abdomen and extremities.
The nature of trauma work, and the potential for dealing with life-threatening situations, makes this field a fast-paced one. It tends to attract surgeons who are more drawn to what they describe as “big operations” that involve large incisions, major exposure of vascular structures and repairing extensive damage in the body.
Most often, trauma surgeons will be called in to attend a patient’s care by ambulance or helicopter. Upon arrival at the emergency room, they’ll assess the patient and determine what surgical procedures are required to prevent long-term damage or death.
They will also need to prioritize which injuries require treatment, as most patients who arrive at trauma centers have multiple injuries requiring urgent attention. They will then need to determine the appropriate surgical techniques for each case, while collaborating with other members of the medical staff as necessary.
Many people don’t plan to need medical attention for a serious illness or accident, but every year millions do. While they are preparing for their routine surgery or getting their teeth cleaned, these people suddenly need to be treated for a serious or potentially life-threatening injury or condition. They need the skilled medical care of a trauma surgeon.
While most general surgeons will perform some level of trauma surgery, the specialty requires additional training in resuscitation and stabilization as well as a broad range of surgical techniques. It is this specialized knowledge that makes a trauma surgeon unique.
Vascular Surgery
Vascular surgery is the umbrella term for a broad group of open surgeries and minimally invasive procedures that involve your blood vessels. Your blood vessels are a network of arteries, veins and capillaries that carry oxygen-rich blood to and from your heart to nourish organs and tissues throughout your body. Diseases in your blood vessels, such as aortic aneurysms, can damage these vital pathways and raise your risk for serious complications like stroke, kidney failure, limb loss and heart attack. Vascular surgeons are specially trained to diagnose and treat these conditions.
Some patients can be treated with lifestyle changes and medications, but others will require surgical intervention. In general, vascular surgeons work to:
Repair aneurysms in the aorta and abdominal arteries. This can prevent rupture, which could be fatal.
Remove blockages from your arteries, such as plaque. This may reduce your risk for stroke and heart attack.
Create a new pathway for blood flow to reach your legs and feet, such as a bypass. This can help lower your risk of limb amputation due to ischemia (a lack of adequate blood flow to the legs).
Some surgeons are expert in endovascular techniques, which involves working inside your blood vessels using catheters and stents. This can be less invasive than traditional open surgery and is especially helpful in treating some aneurysms.
During the procedure, your vascular surgeon will make an incision near the affected area, whether it’s to access a blocked artery or to insert a stent. This will usually be in the groin, although it can also be in the neck or the leg. Your vascular surgeon will then either directly remove the damaged vessel or create a graft that allows blood to flow around it.
Aside from performing surgical procedures, vascular surgeons often specialize in medical management and the interpretation of noninvasive vascular imaging, including ultrasound and computed tomography (CT). They will work closely with other specialists, such as cardiologists, radiologists and neurologists, to ensure you receive the best care possible. This is because vascular diseases can be complex and affect multiple organ systems.
Critical Care Surgery
Although there are many advances in medicine and technology over the past century, critically ill surgical patients can still suffer from life threatening complications. Surgical intensivists are specially trained to care for these patients. They are experienced in the diagnosis and treatment of complex surgical problems, including multiorgan failure syndrome and advanced sepsis. They are also skilled in coordinating patient care among the primary care provider, critical care team and other specialists.
The advent of specialized care for critically ill surgical patients has led to the development of a new specialty known as acute care surgery. This field combines three essential components: trauma, critical care and emergency surgery. It is essentially a rearrangement of surgical services that have been historically under the purview of general surgeons.
Acute care surgery applies the principals of organized trauma care – multidisciplanary teams, evidence-based processes and procedures, and quality improvement – to patients with other time sensitive non-trauma surgical conditions such as shock, multiple organ failure and respiratory compromise. This expansion of responsibilities from the traditional on call role has resulted in overburdening of emergency surgeries and restrictions or cancellations of elective procedures.
This expanded scope has created the need for training of surgeons who have a broad range of skills and knowledge in all aspects of perioperative management. This is a rapidly expanding field. A number of fellowship programs now offer a formalized curriculum in surgical critical care. The goal of these programs is to produce fellows who are expert in all aspects of the perioperative period; skilled in complex techniques; capable of rapid decision making; and able to lead diverse teams of health care professionals.
At Yale-New Haven Hospital, the Section of General Surgery, Trauma and Surgical Critical Care has a strong commitment to clinical care, education and research. The division has three clinical missions: trauma care for all the patients admitted to the regional level 1 trauma center; emergency general surgery, which provides around the clock in-house coverage 365 days per year; and surgical intensive care, which manages patients with complex non-trauma surgical issues such as abdominal compartment syndrome and pancreatic necrosis.
