As mentioned in the initial Surgical procedures page, the definition of surgical procedure includes intentional non-transient alteration of structures of the body and/or necessarily involves cutting into the body.

Non-surgical actions do not significantly or non-transiently alter anatomy and do not necessarily involve cutting or incision.

• For example,

  • Fine needle biopsy (procedure) or brush biopsy (procedure)

  • Phlebotomy, a synonym for venipuncture for blood test (procedure)

  • Aspiration (procedure)

  • Closed reduction of dislocation (procedure)

Closed procedure naming

• The general pattern <open, closed> is accepted

• When a procedure is specified as closed, the closed procedure should be fully described, e.g. fine needle biopsy, endoscopic, etc.

The definition of surgical repair is restoring, to the extent possible, an anatomical structure, using a surgical action. Repair is an objective or intended accomplishment, not a means (e.g., suturing, transplanting, etc.) nor a need (e.g., normal functioning, cosmetic appearance, pain relief, etc.).

Surgery that restores structure is usually intended to restore function and appearance. Restoring function, however, is not necessary for a procedure to be considered a repair. It is also possible for surgery to restore function without restoring structure (e.g., surgery to attach a prosthetic limb after amputation). This type of surgery would not be strictly categorized as a repair.

The Method (attribute) is used to model both the objective of a procedure and the means used to accomplish it. If a procedure requires both a repair action and another type of action, then two relationship groups should be used.

Fistula

Closure action is a kind of repair action. All fistula closures use the closure action and are classified as kinds of repair procedures.

• For example,

  • 79433000 |Closure of colon fistula (procedure)| has Method (attribute), Closure - action (qualifier value) with a parent, Repair of colon (procedure)

Surgery that accomplishes a repair (a structural restoration) often uses the suffix -plasty. The term plastic repair is also used. In order to avoid redundancy, the following terms are used:

• Prosthetic repair, using external (non-body) materials

• Plastic repair, reshaping the body

A surgical procedure is defined as a procedure that involves intentional non-transient alteration of structures of the body, and/or a procedure that necessarily involves cutting into the body. This definition includes all procedures defined by Method (attribute) with Surgical action (qualifier value).

SNOMED CT classifies concepts as surgical procedures if their methods are surgical actions based on the action hierarchy. The surgical action hierarchy distinguishes surgical from non-surgical actions based on the definition above. Note the Or in the sentence; actions that do not involve cutting or incision, but do involve the intentional non-transient alteration of anatomy, are still surgical.

Surgical procedures are not defined simply as procedures done by a surgeon (despite some dictionary definitions). Surgeons can perform many non-surgical actions and surgical procedures need not necessarily be performed by a surgeon, i.e. if a non-surgeon performs a surgical procedure, it is still a surgical procedure.

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