An Overview of Surgery

Empty Operation Room In Hospital
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Surgery is medical treatment provided through an opening in the body. Traditionally, this meant making a large incision to perform the procedure, but advances in technology allow for making a few small (less than 1 centimeter) incisions and using tiny tools and cameras. 

Learning that you need surgery can be a confusing and intimidating prospect, and you may have many questions. It can be helpful to understand basic surgical terminology.

More than one million Americans have a successful surgical procedure each week, according to the National Quality Forum. While planning to have surgery can be stressful, it is usually a step toward better health and wellness.

Common Surgical Terms

There are many terms that your doctor may use to describe a surgery.

Some relate to what prompts the surgery:

  • Elective surgery: This is a surgery that you either plan to have for treatment (e.g., a lumpectomy) or improvement of quality of life (e.g., a knee replacement), or for cosmetic purposes (e.g., a rhinoplasty).
  • Emergency surgery: This is a surgery that is done in order to treat an urgent medical need (e.g., appendectomy).

Others pertain to where the procedure will be performed:

  • Inpatient surgery: This is a procedure performed in the hospital with the expectation that the patient will stay overnight for at least one day.
  • Outpatient or same-day surgery: The procedure is performed in a hospital or surgery center with the expectation that the patient will go home after waking completely from anesthesia. This is also sometimes called ambulatory surgery.

Of course, there are a myriad more. If you hear a term you are unfamiliar with or confused by, ask your doctor to clarify it for you.

Types and Phases of Surgery

The way in which a procedure is performed can minimize related risks and impact recovery time. Depending on what you are having done, your doctor may perform:

  • Open or traditional surgery: The traditional approach of using a single, full-length incision to perform a procedure.
  • Minimally invasive (laparoscopic) surgery: In contrast to the one long incision used in open surgery, this newer surgical technique involves several small incisions. This type of surgery usually requires a shorter recovery period than the same procedure using a large incision.
  • Robotic surgery: A robot is used to perform surgery, with a surgeon guiding the robot’s steady “hands.” This technique is used most frequently when tiny, undesired movements can change the outcome of the procedure.

Surgery is often broken down into phases that help group the tasks that need to be completed at a given time. There are three primary phases, which are described in greater detail below, are:

  • Preoperative, or pre-op, is the phase that starts with contemplating surgery and lasts until the procedure.
  • The operative phase is the procedure itself, from entering the operating room until leaving.
  • The postoperative, or post-op, phase begins when the surgery is completed and the recovery begins.

The term perioperative refers to the entire surgery experience and includes all three phases.

Deciding on Surgery

For patients who are not sure they want surgery, a second opinion can be helpful. This involves talking to a second surgeon to see what they recommend as treatment.

It may seem illogical to see a surgeon about not having surgery, but for someone who wants to avoid surgery at all costs, talking to a surgeon may be more about exploring alternatives than planning a procedure. Medicare, Medicaid, and most insurance plans will pay for a second opinion.

For patients who do not want to have surgery, saying no is absolutely appropriate. There are times when a procedure may have benefits, but the patient is unwilling to undergo the procedure for his or her own reasons. Saying no to surgery is the right of every patient, and while it may lead to disagreements with family and friends, the decision belongs to the patient in the end.

For others, taking a less invasive approach may be preferred. Many patients view surgery as a last resort, rather than their first choice in treatments. For these patients, physical therapy, medication, lifestyle changes, and other types of interventions may be preferable.

Preop: Before Surgery

The time prior to an elective procedure is your best opportunity to plan and prepare to have the best possible outcome from your surgery. This is the period when you spend time researching the best surgeon for your condition, making sure to select the physician who is best able to perform your surgery.

You will meet with your surgeon and anesthesia provider. You will discuss the type of anesthesia you'll receive, the risks, where surgery will be done, and what you can expect to experience during your recovery.

This is when you will be given an opportunity ask questions, explore alternatives to surgery, and determine if surgery is the right choice for you.

Planning for Costs

If you choose to move ahead with surgery, the preoperative phase is also a time to prepare financially for your procedure. You will need to make sure you are making the most of your insurance coverage, if you have a plan, and are preparing for a paid or unpaid leave from work.

You can work with the hospital or surgery center to determine the expected cost of the procedure, making sure to include any hidden costs that may not be included in the initial bill—such as anesthesia—are taken into account.

Your insurance may pay a higher percentage of the bill at one facility and less at another; don’t hesitate to call your insurance provider and inquire about percentage rates of coverage.

If you do not have insurance, you will need to work closely with the hospital and surgeon to make financial arrangements.

Getting Physically Ready

Aside from choosing the right surgeon, preparing physically may be the most important thing a surgery patient can do to impact how successful the surgery is and how quickly the recovery phase ends. 

This means optimizing one’s health in every possible way. From quitting smoking to doing routine exercise and improving control of diabetes, going into surgery as healthy as possible can mean shorter hospital stays, better long-term success, and a faster return to routine activity.

Preparing Emotionally

For some, the thought of surgery can be daunting and overwhelming. You may need help overcoming this so you feel comfortable going into your procedure.

Children often need help preparing for surgery in a way that does not lead to fear and anxiety, and that is appropriate for their age and ability to understand health information.

Planning For Recovery

The preop phase is also the time to prepare for the return home from surgery. This may not be a concern if you are having a minor outpatient procedure, but will be if you need to spend several days in the hospital, will need help with everyday tasks once you're released, and so on. Your planning will be unique to your needs.

For some, it means finding a dog sitter; for others who have lifting restrictions, it will mean finding someone to help them carry things; someone with a driving restriction will need help running errands.

Operative: During Surgery

This part of the surgery is about anesthesia and the actual surgical procedure. This phase begins when you enter the operating room and ends when the procedure is finished and anesthesia is stopped.

Your planning will pay off in the operative phase when the surgeon who is an expert in providing the care you need and the anesthesia provider who understands your unique needs perform your procedure.

Postop: After Surgery

This phase begins when your procedure ends. You will be moved to the area of the facility where you will recover from surgery. This phase continues until you have recovered as much as possible from surgery.

For some that means going home and taking a nap; for others, rehabilitation in the form of physical therapy and occupational therapy, or something similar, may be needed.

Pain Management

While pain is often present after surgery, there are many ways to deal with, prevent, and treat pain that can dramatically improve your experience.

Surgical pain is typically managed by the surgeon, who will provide prescriptions (if necessary) and recommendations for pain relief when you are being discharged.

Adequate pain relief is important for preventing pneumonia, a common complication after surgery in patients who avoid coughing due to pain. There are other common issues after surgery, such as constipation, most of which can be avoided with other strategies.

Recovery Plans

Know where you plan to recover. For some, a stay at a rehabilitation facility is planned; for others, resting at a loved one’s home for a few days is all the help they need. Knowing how long your recovery will take and where it is likely to take place will help with anticipating the assistance that will be required.

The goal after surgery is typically to return to the same function you had prior to surgery, or even better function. An individual who avoided walking due to pain may find themselves taking long walks after recovering from knee replacement surgery, and cataract surgery patients may find themselves reading more books.

While you may be eager for such milestones, remember that reaching them can take time. Follow your doctor's instructions for resuming old and trying new activities.

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Article Sources

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  1. American Society of Colon and Rectal Surgeons. Laparoscopic Surgery - What is it?

  2. Getting a second opinion before surgery. Updated April 2018.

  3. American Society of Anesthesiologists. Preparing for surgery: Checklist.

  4. Cleveland Clinic. Pain control after surgery.

Additional Reading