General Surgery

Meredith shields a patient during an earthquake

General surgery is a surgical specialty that focuses on abdominal organs, such as the intestines, esophagus, stomach, liver, pancreas, duodenum, kidneys, bile ducts and organs annex; Endocrine organs, such as the thyroid gland, parathyroid glands and the adrenal glands; blood vessels, such as the abdominal aorta and other abdominal related problems such as hernias and abscesses.

Notable General Surgeons

• Dr. Richard Webber (Attending General Surgeon at Grey Sloan Memorial Hospital and Chief Medical Officer of the Catherine Fox Foundation)
• Dr. Miranda Bailey (Attending General Surgeon and former Chief of Surgery at Grey Sloan Memorial Hospital)
• Dr. Jo Wilson (former Attending General Surgeon at Grey Sloan Memorial Hospital)
• Dr. Meredith Grey (Former Chief of Surgery and Former Head of General Surgery at Grey Sloan Memorial Hospital)
• Dr. Ellis Grey (former Attending General Surgeon at Mayo Clinic and Massachusetts General Hospital)
• Dr. Andrew DeLuca (former Attending General Surgeon at Grey Sloan Memorial Hospital)
• Dr. Sydney Heron (former Attending General Surgeon at Grey Sloan Memorial Hospital)
• Dr. Chalikonda (Attending General Surgeon at Cleveland Clinic)
• Dr. Jake Reilly (Attending General Surgeon, OB/GYN, and REI Specialist at Seaside Health and Wellness)
• Dr. Margaret Goodwin (Attending General Surgeon at Brigham and Women's Hospital)
• Dave (Attending General Surgeon at Seattle Grace Mercy West Hospital)
• Dr. Lee Wong (former Attending General Surgeon at Grey Sloan Memorial Hospital)
• Dr. Paul Stadler (former Attending General Surgeon at Orlando Medical)
• Dr. Marie Cerone (Attending General Surgeon)
• Dr. David Powers (Attending General Surgeon)
• Dr. Kent (Attending General Surgeon at Mercy West Medical Center)

Surgical Procedures

• Appendectomy: Surgical removal of the appendix.
• Cholecystectomy: Surgical removal of the gallbladder.
• Laparoscopic procedures: Procedures taking place using this method are carried out using small incisions in the body, typically 1-2cm, with tools being placed into the body through these holes, including a camera, to perform the procedure. Commonly used for appendectomies and cholecystectomies.
• Laparotomy: Cutting into the abdomen to gain access to the abdominal organs. This may be the first step of the procedure (therapeutic) where the surgeons know the area they need to access, or it may not be (diagnostic, or exploratory) where they are looking for a cause of illness, more commonly carried out in trauma cases.
• Whipple Procedure: Known formally as a Pancreaticoduodenectomy, this operation is used most commonly to treat Pancreatic Cancer. The procedure involves removing the head of the pancreas along with the Gallbladder, duodenum, part of the stomach, bile duct, and sometimes lymph nodes close to the pancreas. Once these have been removed, the remainder of the pancreas, stomach, and bile duct are directly attached to the small bowel. According to Elizabeth Fallon, Whipple Procedures are rare and only seen once about every six months at a hospital Seattle Grace's size. This is due most likely to the fact that in the majority of cases, Pancreatic Cancer is not diagnosed until the disease is advanced and surgery is not an option. A whipple can also be performed when there has been significant abdominal trauma and removal of the aforementioned structures is required to control damage. This is known as a 'trauma whipple'.

Fellowships

While not necessary to become a certified general surgeon (contrary to, for example, pediatric surgery), fellowships exist for general surgery. Said fellowships focus on a specific subject within the field.

• Minimally Invasive Surgery: Jo was offered a minimally invasive surgery fellowship at Mass Gen.
• Surgical Innovation: A unique fellowship was created for Jo Wilson at Grey Sloan, allowing her to dedicate her fellowship year to studying surgical innovative techniques.

Notable Cases

Grey's Anatomy

Season 5

• Domino Transplant of Kidneys (There's No 'I' in Team): Bailey heads up a surgical team to arrange the nephrectomy and transplantation of six kidneys between six pairs of patients.
• Resection of leiomyosarcoma with celiac, splenic, and left gastric arterial involvement (Life During Wartime): Tori Begler has an abdominal tumor that is wrapped around multiple artieries and multiple abdominal organs are affected, deemed removable. The Chief, Bailey and Hahn perform an ex-vivo resection and autotransplantation, that is, removing all her abdominal organs, removing the tumor, and transplanting her organs back into her body.

Season 14

• Abdominal Wall Transplant (Get Off on the Pain): Meredith, Richard, Bailey, Jackson, Teddy, and Jo performed an abdominal wall transplant on Megan Hunt after a temporary abdominal closure due to lack of tissue to close her open abdomen. The transplant was successful.

Notes and Trivia

• General surgery residency is a prerequisite for the following sub-specialties:
  • Cardiothoracic Surgery
  • Neurosurgery
  • Pediatric Surgery
  • Plastic Surgery
  • Surgical Oncology
  • Trauma Surgery
  • Urology

For this reason, most surgeons in Grey's Anatomy and Private Practice, unless otherwise stated by dialogue or promotional material, were general surgeons early in their careers. For example, during the season ten premiere, Arizona and Alex acted as general surgeons due to the staff shortage caused by the storm, and Callie said that Arizona was an excellent general surgeon.

• While in the real-world, neurosurgery is not a sub-specialty of general surgery, and thus, does not require a general surgery residency in order to practice, Grey's Anatomy and Private Practice, as evidenced by Amelia's dialogue and Richard mentoring Derek during his residency, neurosurgery does require a general surgery residency.
• While in the real-world, urology is not a sub-specialty of general surgery, and thus, does not require a general surgery residency in order to practice, Grey's Anatomy, as evidenced by Mara Keaton's fellowship and Catherine Avery offering Stephanie Edwards a spot on the former's program, urology does require a general surgery residency.
• General surgery is often mentioned or simplified as just "surgery" or permutations of "surgery".
• In season one, Cristina likened surgery to the "jocks" along with plastics, and trauma.
• Unlike other surgical departments, there was no official department head for general surgery until Walking Tall when Miranda Bailey appointed Meredith Grey as Head of General Surgery. It was implied that Bailey was the unofficial general surgery head under Richard Webber and Owen Hunt when she was an attending.

See Also

• Resident