Types of Surgery

Breast Surgery

 Breast augmentation surgery

Hurley Medical Center offers breast augmentation surgery for
reconstructive purposes after breast cancer surgery (for
example), to correct a breast defect, to increase breast size, or
to achieve a younger, more natural appearance. Hurley’s
plastic surgeons and surgical team will thoroughly answer your
questions, address any concerns or apprehension you may
have, and help you decide if breast augmentation surgery is
right for you.
 Breast reduction surgery
Hurley Medical Center offers breast reduction surgery to
decrease breast size and lift the breasts. Hurley’s plastic
surgeons and surgical team works with you to determine your
goals and desired expectations for breast reduction, and to
help you decide if breast reduction surgery is right for you.
 Colon and Rectal Surgery

Our surgeons offer advanced surgical and minimally invasive

(laparoscopic) options. In fact, Hurley’s colorectal surgeons are
among the area’s most successful providers of laparoscopic
procedures. These minimally invasive options not only treat disease,
they also require a smaller incision (which improves cosmetic results),
help preserve normal bowel function, reduce post-operative pain
and the need for analgesic medication, and speed recovery. Not all
patients are candidates for laparoscopic or other minimally invasive
forms of surgery. You and your surgeon will be able to determine the
most appropriate treatment options for your particular condition.

Our surgeons address the following conditions:

 Anal cancer
  Anal condyloma
 Anal Fissure
 Anal Fistula
 Anal incontinence
 Anal sphincter repair
 Anorectal disease:
 Colon cancer
 Diverticular disease
 Hemorrhoids
 Hereditary colon and rectal cancer
 Inflammatory bowel disease (IBS)
 Polyps
 Rectal cancer
 Rectal prolapsed

Endocrine Surgery

The following are among the surgical procedures that our surgeons
perform:

 Thyroid surgery
 Minimally invasive parathryoidectomy
 Laparoscopic adrenalectomy
General Surgery

Surgery can be an effective treatment option for a wide range of

diseases and disorders. Whether you are facing a complex,
innovative surgical procedure or a technique that has been used
successfully thousands of times, rest assured that the board-certified
surgeons at Hurley Medical Center are among the region’s most
experienced physicians using state-of-the-art medical technologies.

When appropriate, we use minimally invasive surgical techniques.

This form of surgery can limit hospital stays, post-operative pain and
recovery time, and often use smaller incisions that result in less
scarring.
Gynecological Surgery

Hurley offers highly-trained, board certified surgical gynecologists

who specialize in treating conditions of the female genital tract.

If you have a gynecological condition that requires a surgical

procedure, you can count on our experienced, compassionate
team of gynecologists, surgeons, gynecologic oncologists,
urogynecologists, interventional radiologists, anesthesiologists, and
nurse specialists for the highest, most advanced level of medical
care.

Hurley’s gynecological surgical services and procedures include:

 Endometrial Ablation
 Gynecologic Cancer Surgery
 Interventional Radiology
 Tubal Ligation
 UAE
Head and Neck Surgery

Early identification and treatment of oral, head and neck disorders

means a higher rate of positive outcomes. We encourage you to see
an ear, nose and throat (ENT or otolaryngology) specialist if you are
experience problematic symptoms such as unusual lumps or sudden,
unexplained pain. In many cases, and with early detection of
problems, we can use minimally invasive techniques that result in
reduced pain and faster recoveries.

We regularly treat the following conditions:

 Nasal and sinus disorders, upper airway obstruction

 Throat, voice and swallowing problems, including
gastroesophageal reflux therapy and tonsillectomies
 Diseases of the nerves in the ears, oral cavity, esophagus, head
and face
 Benign and malignant tumors of the head and neck
  Facial deformities, including congenital (at birth) problems and
issues resulting from accidents or disease
 Structural problems related to hearing loss or impairment
Trauma Surgery

Level I verification is the highest credential possible from the

American College of Surgeons (ACS) for any trauma center. The
Hurley Trauma Center is affiliated with the University of Michigan
Health Center and provides immediate response by a highly
specialized, in-house team of trauma professionals 24 hours per day,
every day of the year.

Trauma is a time-sensitive condition, and the Hurley Trauma Center

has the speed, efficiency and experience to deal with the most
intense demands of a critically injured patient.

Neurosurgery

Specializing in surgery on the brain and other parts of the nervous

system, Hurley Medical Center’s highly-experienced board certified
neurosurgeons perform a wide variety of surgeries, from minor
outpatient procedures to extremely complicated surgeries that
require extensive inpatient management and treatments.

Procedures we perform include:

 Brain tumors
 Complicated cerebral aneurisms requiring skull-based
approaches
 Microdiscectomies
 Minimally invasive spine surgeries

Name: Fernandez, Gracelie H.

BSN-3
The secret language of surgery

Roger Kneebone

Wed 6 Nov 2013 12.30 GMTFirst published on Wed 6 Nov

2013 12.30 GMT

For a newcomer, the operating theatre is an overwhelming place.

Sound is all around: beeps, alarms, the noise of people moving.
Speech, when it surfaces, uses an alien language peppered with
abbreviations and jargon. Photograph: Sean Smith/Guardian

The first time I took part in an operation I had no idea what was
going on. As a new medical student I hadn't learned the language
of surgery. I didn't even know there was a language of surgery. A
few years later, as a surgeon myself, this language had become
second nature and I didn't even know I was using it.

Of course there are many voices in the operating theatre. They don't
always say what they mean or mean what they say. And sometimes
the most important voices are those that don't use words at all.

For several years I've been leading research projects that investigate
how people communicate during surgery. At Medicine Unboxed in
Cheltenham, I'm going to explore how to read some of these
surgical voices and make sense of what they say.

Of course the story starts with the patient. What happens to their
voice during surgery? At first glance, it seems to have disappeared
altogether, especially if the operation needs a general anaesthetic.
In the anaesthetic room the patient gradually relinquishes
autonomy, leaving behind their personhood and their power to
speak for themselves as powerful drugs make them unconscious.

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But they haven't stopped communicating. Speech mutates into a

language of the unconscious body. Functions that we take for
granted and scarcely notice – our heart beating, our lungs
breathing, our blood circulating – are represented by wavy lines on
a screen or the beep of a machine. Words have turned into traces,
and the voice of the anaesthetised patient has become
transformed.

Throughout the operation the surgical team monitors this wordless

commentary, this constant unconscious broadcast of the body. Any
variation – a change in rhythm, a subtle inflection of pitch – will put
the team on high alert. The team has become fluent in the
language of unconsciousness.

When the operation is over, when the wound is closed and the
dressings are in place, the anaesthetist disconnects these machines
and hands back the power of speech.

Reading voices

In the operating theatre, different voices are in play. At the centre is

the scrub team – those who operate on the body itself. Around them
are other members of the group – equally important but differently
so – and all have different voices.

The surgeon's voice is often muted, soft, muffled by a mask. Intended

for the scrub team only, it may be inaudible beyond. Voices spread
out in ripples from the scrub team: requests for instruments,
instructions to others in the theatre. The anaesthetist, the operating
department practitioner, the runner nurse – all have their ways of
speaking, their vocabularies, their own vocal fingerprint.
The voices you hear depend on where you're standing. Like
conversation at a party, there are ebbs and flows, natural rhythms
and patterns. Often you can't make out the words, but you have to
interpret the many meanings within this soundscape of surgery and
recognise when they involve you. You develop new sensitivities, new
ways of reading what is said.

What do these voices convey? Some are the voices of people

talking in ordinary words. But others are different. Some are distorted
voices, pulled out of shape by their peculiar setting. Some are
transformed voices, expressed through machines instead of words.
And some are silent voices, conveying their message by what they
do not say.

Reading voices isn't easy. For a newcomer, the operating theatre is

an overwhelming place. Sound is all around: beeps, alarms, the
noise of people moving. Sometimes music. And speech, when it
surfaces, uses an alien language, peppered with abbreviations and
jargon.

Once you get used to it, you can tell how things are going the
instant you step in. If all is well, there's a general buzz of conversation,
movement, activity. But if things are going badly, you sense the
tension without even knowing how. The most eloquent voice of all is
the voice of silence: the voice that says 'we've got a problem here
and we all need to focus on fixing it'.

In my conversation at Medicine Unboxed, I hope to unpick some of

these ideas, exploring what's different about surgical voices and
what they can and cannot say.

Roger Kneebone is professor of surgical education at Imperial

College London and a Wellcome Trust Engagement Fellow

Medicine Unboxed is a project that connects the public with

healthcare professionals in a scientific, political and ethical
conversation about medicine, illuminated through the arts. For more
information on this year's event in Cheltenham, 23-24 November, visit
our Facebook page, follow @medicineunboxed, or visit our Pinterest
boards to learn about the conference programme

Reaction:

I agree about this article because there are different voices are in
play. Because other surgeon voice is often muted, soft muffled by
mask, but as a nurse we must focus what is the needs of the surgeon
specially by giving instruments or even the anaesthetist there ways of
speaking these vocabularies or their own vocal fingerprint so as part of
scrub team be alert is an sensitive place that we must be careful of
what are going to do one of those is by giving the instruments and
sterility.

Also I appreciate the points this article raises about the non-verbal
signals being received from the patient during surgery and its
description of the skill involved in effectively communicating as a
team under pressure during surgery, I do take issue with this
paragraph:

Of course the story starts with the patient. What happens to their
voice during surgery? At first glance, it seems to have disappeared
altogether, especially if the operation needs a general anaesthetic.
In the anaesthetic room the patient gradually relinquishes
autonomy, leaving behind their personhood and their power to
speak for themselves as powerful drugs make them unconscious.

The patient's voice NEVER disappears during surgery and we most

definitely do NOT relinquish our autonomy to the surgeon in this
situation, no matter how much a worrying number of surgeons might
like to think of it in that way.
This voice should always be the loudest in the room, at all times,
whether we are anaesthetised as patients or not.
Surgeons may have to react to unpredictable emergencies, I
appreciate, but only those which occur whilst carrying out the
autonomous wishes of their patient. Without the patient's voice, how
would they even know what to do? Our voices should never be
silent, even during major surgery. It's our human right.

Summary:

There are many voices in the operating theatre, and sometimes

the most important are those that don't use words at all.
So the article says that there are different signals or voices in the
operating theater, one of the medical student says that as one of
the scrub team I didn't even know there was a language of
surgery. A few years later, as a surgeon myself, this language had
become second nature and I didn't even know I was using it. For
several years I've been leading research projects that investigate
how people communicate during surgery. At Medicine Unboxed
in Cheltenham, I'm going to explore how to read some of these
surgical voices and make sense of what they say. That is
according to the medical student.
As we go to reading voices In the operating theatre, different
voices are in play. At the centre is the scrub team – those who
operate on the body itself. Around them are other members of
the group – equally important but differently so – and all have
different voices.
Also the anaesthetist, the operating department practitioner, the
runner nurse – all have their ways of speaking, their vocabularies,
their own vocal fingerprint. I agree this about in the anaesthetist
because they have their own vocal fingerprint and their
vocabularies cause some anaesthetist are some voices you hear
depend on where you're standing.
Some are transformed voices, expressed through machines
instead of words. And some are silent voices, conveying their
message by what they do not say.
The article says that inside in the operating theater is so sensitive at
the first or newcomer is not easy to catch up directly what is going
inside but as part of medical we must give all our focus and be
attentive specially it’s a sensitive place.