Background & Scope

General surgery is a surgical specialty that deals with the diagnosis, treatment, and management of a wide range of diseases and conditions, both acute and chronic, that affect the organs and tissues of the body. It is one of the oldest and most versatile surgical specialties, with a broad scope that includes the management of diseases of the abdomen, skin, endocrine system, breast, and vascular system, among others.

The scope of general surgery is broad and encompasses many different types of procedures. Not all general surgeons perform all general surgery procedures; many of the following fall within surgical subspecialties:

• Abdominal surgery: This includes surgeries that involve the organs of the abdomen, such as the stomach, intestines, liver, gallbladder, and pancreas. Procedures such as appendectomy, cholecystectomy, and hernia repair are examples of abdominal surgery.

• Endocrine surgery: This type of surgery involves the glands that produce hormones, such as the thyroid, parathyroid, and adrenal glands.

• Breast surgery: This includes procedures such as lumpectomy, mastectomy, and breast reconstruction.

• Vascular surgery: This includes surgeries that involve the blood vessels, such as the aorta, carotid artery, and peripheral vessels. Procedures such as carotid endarterectomy and aortic aneurysm repair are examples of vascular surgery.

• Trauma surgery: This includes the management of injuries and wounds resulting from accidents, such as lacerations, and internal injuries.

• Surgical oncology: This includes the surgical management of cancer, including biopsies, tumor resection, and lymph node dissection.

• Minimally invasive surgery: This includes laparoscopic and other endoscopic procedures which use small incisions and specialized instruments to access the surgical site.

• Bariatric surgery: This includes surgical procedures for the weight loss for the morbidly obese as well as the attendant medical and support care aimed at the best and most lasting results.

General surgeons are trained to manage a wide range of diseases and conditions, and they often work in collaboration with other specialists, such as oncologists, radiologists, and anesthesiologists. They also play an important role in the management of critically ill patients, both in the operating room and in the intensive care unit.

Qualifications, Training, and Certifications

General surgery is a highly specialized field that requires a significant amount of education and training to practice. The qualifications, training requirements, and available certifications for general surgery are designed to ensure that surgeons have the necessary knowledge, skills, and experience to provide safe and effective care to their patients.

To become a general surgeon, after medical school, a general surgery resident must complete a five-year surgical residency program that includes supervised training in a variety of surgical specialties, such as trauma surgery, pediatric surgery, hand, surgical critical care, and surgical oncology. After completing the surgical residency, a general surgery resident is eligible to take the American Board of Surgery (ABS) certification exam. The ABS certification exam is a rigorous and comprehensive exam that tests the knowledge, skills, and judgment of the candidate. Successful completion of the exam results in certification as a general surgeon.

Once certified, general surgeons are required to maintain their certification through continuing medical education (CME) and recertification exams. The ABS currently requires surgeons to complete a certain number of CME hours every year to maintain certification and to pass the recertification exam every 10 years to become recertified.

In addition to the ABS certification, general surgeons may also choose to seek additional certifications in subspecialties such as surgical critical care, colon and rectal surgery, and surgical oncology. These certifications are offered by various surgical societies and are intended to demonstrate the surgeon's expertise and dedication to a specific area of surgery.

Conditions, Diseases, Treatments, and Procedures

General surgery is a broad and versatile surgical specialty that encompasses a wide range of diagnoses, treatments, diseases, conditions, and injuries. General surgeons are trained to manage a diverse range of conditions, and they often work in collaboration with other specialists to provide comprehensive care for their patients.

Some of the diagnoses, treatments, diseases, and conditions that are commonly managed by general surgeons include:

• Abdominal conditions: General surgeons are trained to manage a wide range of conditions that affect the organs of the abdomen, such as the stomach, intestines, liver, gallbladder, and pancreas. Common procedures include appendectomy, cholecystectomy, hernia repair, and colectomy.

• Endocrine conditions: General surgeons are also trained to manage conditions that affect the endocrine system, such as thyroid cancer, parathyroid disease, and adrenal tumors; some do and some do not treat these conditions once in practice. Procedures may involve the removal of glands that produce hormones, such as the thyroid, parathyroid, and adrenal glands.

• Breast conditions: General surgeons are trained to manage a wide range of breast conditions, including benign and malignant tumors; more commonly general surgeons subspecialized in surgical oncology are the ones fully qualified and experienced with procedures such as lumpectomy, mastectomy, and breast reconstruction are commonly performed.

• Vascular conditions: General surgeons are trained to manage conditions that affect the blood vessels, such as the aorta, carotid artery, and peripheral vessels. Subspeicalists in vascular surgery are the most common who perfom procedures such as carotid endarterectomy and aortic aneurysm repair. That said, all general surgeons handle routine intraoperative bleeding.

• Trauma: General surgeons are trained to manage injuries and wounds resulting from accidents, such as lacerations and internal injuries. They often work in collaboration with other specialists to provide comprehensive care for trauma patients, particularly with thoracic surgeons, neurosurgeons, and orthopaedic surgeons, anesthesiologists, and critical care physicians.

• Surgical oncology: Some general surgeons are specially trained to manage cancer, including tumor resection and lymph node dissection. They work closely with other specialists, such as oncologists, to provide comprehensive care for cancer patients.

• Minimally invasive surgery: General surgeons are trained to perform laparoscopic and other endoscopic procedures which use small incisions and specialized instruments to access the surgical site. These procedures are less invasive and have a shorter recovery period than traditional open surgery.

In addition to these procedures, general surgeons and surgical subspecialists also perform many other types of procedures, such as bariatric surgery, colorectal surgery, and surgery for gastric and esophageal disorders. They also manage injuries, infections, and may treat other acute and chronic conditions that affect the skin and soft tissues.

Related Medical Specialties

General surgery is a highly specialized field that requires a significant amount of education and training to practice. It is one of the oldest and most versatile surgical specialties, with a broad scope that includes the management of diseases of the abdomen, skin, endocrine system, breast, and vascular system, among others. However, it is not uncommon for general surgeons to collaborate with other medical specialties in order to provide comprehensive care for their patients.

Some of the related medical specialties to general surgery include:

• Anesthesiology: General surgeons often work closely with anesthesiologists to ensure the safe administration of anesthesia during surgical procedures. Anesthesiologists are responsible for managing the patient's pain and maintaining their vital functions during surgery.

• Radiology: General surgeons often work closely with radiologists to interpret imaging studies, such as CT scans, MRI, and ultrasound, which are used to diagnose and monitor a wide range of diseases and conditions.

• Oncology: General surgeons, specifically surgical oncologists, are trained to manage cancer, including performing biopsies, tumor resection, and lymph node dissection. They often work closely with oncologists, who specialize in the medical management of cancer, including chemotherapy and radiation therapy.

• Gastroenterology: General surgeons are trained to manage a wide range of conditions that affect the gastrointestinal system, such as gastric and esophageal disorders. They often work closely with gastroenterologists, who specialize in the diagnosis and treatment of disorders of the digestive system. For example, a colon cancer found on a gastroenterologist's colonoscopy might be removed by a general surgeon (or a surgical oncologist or a colon-rectal surgeon, by the way).

• Plastic Surgery: General surgeons may work with plastic surgeons in cases of reconstructive surgery such as breast reconstruction after a mastectomy. Plastic surgeons specialize in the reconstruction, restoration, or alteration of the human body.

• Vascular Surgery: General surgeons may collaborate with subspecialists in vascular surgery for conditions that affect the blood vessels, such as the aorta, carotid artery, and peripheral vessels. Vascular surgeons specialize in the surgical management of diseases of the circulatory system. In particular, vascular surgeons may be needed for unexpected and life-threatening bleeding.  

Medical-Legal Cases Involving General Surgery

One of the most common medical-legal cases involving general surgery are surgical errors. These errors can occur during the planning, execution, or follow-up of a surgical procedure. Other allegations can and include selecting the wrong procedure, causing injury to surrounding structures during surgery, failing to prescribe antibiotics, and failing to prescribe anticoagulants. 

In 2012, a general surgeon in New York was sued for performing the wrong procedure on a patient. The patient had come in for a gallbladder surgery but the surgeon ended up removing the patient's healthy appendix by mistake. The patient suffered complications and had to undergo additional surgeries to correct the error. 

In 2016, a general surgeon in California was sued for misdiagnosing a patient's abdominal pain as a stomach ulcer. The patient's condition was actually a rare form of cancer and the delay in diagnosis led to the cancer progressing to an advanced stage. 

In addition, complications arising from the treatment or surgery can also lead to medical-legal cases. These complications can include infection, bleeding, or wound dehiscence

In 2019, a general surgeon in Florida was sued for not recognizing and treating a postoperative infection in a patient who had undergone a hernia repair. The infection led to sepsis and multiple reoperations.