What is a Major Surgery?

Mary McMahon
Mary McMahon

There are varying definitions of major surgery, and what constitutes the difference between major and minor surgery. As a general rule, a major procedure is any surgery in which the patient must be put under general anesthesia and given respiratory assistance because he or she cannot breathe independently. In addition, major surgery usually carries some degree of risk to the patient's life, or the potential for severe disability if something goes wrong during the surgery.

A patient being given inhalational anaesthesia before major surgery.
A patient being given inhalational anaesthesia before major surgery.

Several other features can be used to distinguish major surgery from minor surgery. For example, in a major surgical procedure, significant resection or changes to the anatomy are involved, as in situations where organs are removed, or joints are rebuilt with artificial parts. Any penetration of the body cavity is treated as major surgery, as are extensive orthopedic surgeries on the extremities. Neurosurgery is generally considered major because of the risks to the patient, even though patients are not necessarily under general anesthesia during procedures on the brain.

Characteristics of a major surgery include a patient being put under anesthesia and given assistance with their breathing.
Characteristics of a major surgery include a patient being put under anesthesia and given assistance with their breathing.

Some examples of major surgical procedures include knee replacement, cardiovascular surgery, and organ transplants. These procedures carry definite risks from the patient such as infection at the site of the surgery, hemorrhage, or complications from the general anesthetic used. To reduce the potential for complications, major surgery takes place in a sterile operating room where very precise procedures are observed to reduce the risk of contamination and the patient is monitored by an anesthesiologist and a medical team for any signs of distress.

A scalpel is a small, sharp knife that is used for performing surgeries.
A scalpel is a small, sharp knife that is used for performing surgeries.

Recovery from major surgery can take several days or weeks. In the first few days, the patient is often hospitalized so that he or she can be monitored, and physical therapy may be offered to get the patient active, which reduces the risk of post surgical complications. After the patient is released, he or she may have to continue taking certain medications, and observing precautions during the healing period.

Recovery from major surgery can take several days or weeks.
Recovery from major surgery can take several days or weeks.

Preparation for major surgery can also be extensive. The patient usually needs to consult with a surgeon to talk about the procedure, the recovery time, and important aftercare instructions, and he or she will need to undergo a series of tests to confirm fitness for surgery. In emergency surgery where such lengthy preparations may not be an option, surgeons have to use their best judgment to make appropriate decisions for patients who are in critical need of surgery. A patient with abdominal bleeding, for example, may not be able to sign consent forms or to review documentation related to the surgery which would be needed to stop the bleeding.

Major surgery involves significant changes to the anatomy and sometimes carries risks to the patient's life.
Major surgery involves significant changes to the anatomy and sometimes carries risks to the patient's life.
Any type of brain surgery carries a risk of infection, cognitive impairment or other permanent damage to the brain.
Any type of brain surgery carries a risk of infection, cognitive impairment or other permanent damage to the brain.
Major surgery typically calls for an explanation of risks and signing of consent forms, but this isn't always possible in an emergency situation.
Major surgery typically calls for an explanation of risks and signing of consent forms, but this isn't always possible in an emergency situation.
Head injuries sustained during a horseback riding incident may necessitate brain surgery.
Head injuries sustained during a horseback riding incident may necessitate brain surgery.
Any type of surgery carries inherent risks, due in part to the twin dangers of anesthesia and infection.
Any type of surgery carries inherent risks, due in part to the twin dangers of anesthesia and infection.
Major surgery requires that doctors and nurses follow very specific sterilization protocols.
Major surgery requires that doctors and nurses follow very specific sterilization protocols.
Supplemental oxygen may be used after major surgery to ensure the patent's saturation levels remain high enough.
Supplemental oxygen may be used after major surgery to ensure the patent's saturation levels remain high enough.
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a wiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments

anon986388

While it's true that many brain surgeries aren't under general anesthesia, many are. I had a brain surgery to remove a brain tumor and I was under general anesthesia. While there is no pain to the brain itself, there is much pain to the outside skull and outer tissues. I was in a lot of pain when I woke up and had a morphine drip. I also had a lot of pain when my brain cavity began to fill with fluid where the previous brain tissue had been removed. It caused a lot of pressure and was quite painful.

anon250869

Illych is correct -- there is no pain in the brain, and it is a widespread practice to keep the patient 'awake' during such a surgery. The doctors may sometimes administer medications that make the patient not able to remember the experience. Every case and practice is different.

Illych

@softener - Believe it or not, there's no pain in the brain. The patient is usually lightly sedated beforehand and then their scalp is numbed, allowing the surgeon to make the incision.

There are a few reasons why keeping the patient awake might be a good option, the main one being that the patient is able to respond while the operation is being performed. Depending on the area of the brain they're operating, they might ask the patient to try to move occasionally to make sure they're not getting to any areas that might affect motor function. The same can apply for speech. So in many ways it can make major surgery safer.

Also, patients who have not been under general anesthesia tend to heal faster than those who have.

softener

I'd heard of some patients not being under general anesthesia during procedures on the brain but I found it hard to believe. How is this possible? For what reasons wouldn't they put the patient under general anesthesia anyway? Wouldn't it be painful?

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