OR abbreviations and terminologies including prefixes and suffixes
 Terminologies
o Abrasion: A cut or scrape that typically isn’t serious.
o Abscess: A tender, fluid-filled pocket that forms in tissue, usually due to infection.
o Acute: Signifies a condition that begins abruptly and is sometimes severe, but the
duration is short.
o Benign: Not cancerous.
o Biopsy: A small sample of tissue that’s taken for testing.
o Chronic: Signifies a recurring, persistent condition like heart disease.
o Contusion: A bruise.
o Defibrillator: A medical device that uses electric shocks to restore normal heartbeat.
o Edema: Swelling caused by fluid accumulation.
o Embolism: An arterial blockage, often caused by a blood clot.
o Epidermis: The outer layer of the skin.
o Fracture: Broken bone or cartilage.
o Gland: An organ or tissue that produces and secretes fluids that serve a specific
function.
o Hypertension: High blood pressure.
o Inpatient: A patient who requires hospitalization.
o Intravenous: Indicates medication or fluid that’s delivered by vein.
o Malignant: Indicates the presence of cancerous cells.
o Outpatient: A patient who receives care without being admitted to a hospital.
o Prognosis: The predicated outcome of disease progression and treatment.
o Relapse: Return of disease or symptoms after a patient has recovered.
o Sutures: Stitches, which are used to join tissues together as they heal.
o Transplant: The removal of an organ or tissue from one body that is implanted into
another.
o Vaccine: A substance that stimulates antibody production to provide immunity
against disease.
o Zoonotic disease: A disease that is transmissible from animals to humans.
 Prefixes and suffixes
o A-, an-: Lack of or without.
-ation: Indicates a process.
o Dys-: Abnormal, difficult, or painful.
o -ectomy: Surgical removal of something.
o -ismus: Indicates a spasm or contraction.
o -itis: Signifies inflammation.
o -lysis: Decomposition, destruction, or breaking down.
o Macro-: Large in size
o Melan/o-: Black or dark in color.
o Micro-: Small in size.
o -ology: The study of a particular concentration.
o -osis: Indicates something that is abnormal.
o -otomy: To cut into.
o -pathy: Disease or disease process.
o -plasty: Surgical repair.
o Poly-: Many.
o Pseudo-: False or deceptive, usually in regard to appearance.
o Retro-: Behind or backward.
Different types of surgical procedure:
o Immediate
 When life, limb or organ-saving intervention is required and resuscitation is
performed simultaneous with intervention.
 Normally it occurs within minutes of decision to operate.
 Expected location: next available operating theatre, if required “break-in” to existing
lists
 E.g. Repair of ruptured aortic aneurysm; Laparotomy for control of haemorrhage.
o Urgent
 Intervention for acute onset or clinical deterioration of life, limb or organ survival;
for fixation of multiple fractures; and for relief of pain or other distressing
symptoms.
 Normally it occurs within hours of decision to operate and once resuscitation is
completed
 Expected location: day time “emergency” list or Out-of-hours emergency theatre
 E.g. Debridement plus fixation of fracture; Laparotomy for perforation
o Expedited
 When a patient is stable but requires early intervention for a condition that is not an
immediate threat to life, limb or organ survival.
 Normally it occurs within days of decision to operate
 Expected Location: Elective list with “spare” capacity or Day time “emergency” list
(except at night)
 E.g. Retinal detachment; Excision of tumour with potential to bleed or obstruct
o Elective
 Surgical procedure planned or booked in advance of routine admission to hospital.
 It occurs within a planned time that suits patient, hospital and staff.
 Expected Location: Elective theatre list (after being booked and planned prior to
admission)
 E.g. all other conditions not classified as immediate, urgent, or expedited; example,
Cystoscopy
Major classifications of surgical instruments, including classification of sutures and ligatures:
 Classifications of surgical instruments
o Cutting and Dissecting
 These instruments typically have pointed ends or edges that can cut through
suture material, skin, and tissue.
 o Clamping and Occluding
 These surgical instruments are utilized for compressing the hollow organs
and blood vessels to prevent the leakage of the contents, such as blood.
o Retracting and Exposing
 Organs and tissue are held back or retracted using these surgical tools to
access the surgical area. These divide the edges of a surgical incision and
spread open the skin, ribs, and other tissue.
o Grasping and Holding
 Are used during surgical procedure to grasp and hold the tissues or blood
vessels that blocks the operative area.
 Classifications of sutures and ligatures
o Absorbable sutures
 commonly used for deep tissues and tissues that heal rapidly; as a result,
they may be used in small bowel anastomosis, suturing in the urinary or
biliary tracts, or tying off small vessels near the skin.
o Non-absorbable sutures
 used to provide long-term tissue support, remaining walled-off by the
body’s inflammatory processes (until removed manually if required). Uses
include for tissues that heal slowly, such as fascia or tendons, closure of
abdominal wall, or vascular anastomoses.
o Natural
 made of natural fibres (e.g. silk or catgut). They are less frequently used, as
they tend to provoke a greater tissue reaction. However, suturing silk is still
utilised regularly in the securing of surgical drains.
o Synthetic
 comprised of man-made materials (e.g. PDS or nylon). They tend to be
more predictable than the natural sutures, particularly in their loss of tensile
strength and absorption.
o Monofilament sutures
 a single stranded filament suture. They have a lower infection risk but also
have a poor knot security and ease of handling.
o Multifilament sutures
 made of several filaments that are twisted together. They handle easier and
hold their shape for good knot security yet can harbour infections.
Abdominal surgical sites of operation and indications:
 Midline incision: incision that follows the linea alba (a relatively avascular structure) to
access most of the abdominal viscera; performed on a wide variety of abdominal surgeries,
including emergency procedures, as this incision causes minimal blood loss; the downside is
the susceptibility of significant scars.
 Paramedian incision: incision 2-5cm lateral to the midline; used to access mostly the lateral
viscera (such as kidneys, spleen, and adrenal glands); the anterior rectus sheath is
separated and moved laterally, preventing any division of the rectus muscle; however this
approach takes a long time and is often technically difficult; it also can damage blood and
nerve supply of the muscles, which may result in the atrophy of the muscle; this technique
is rarely perform in the UK.
 Kocher incision: subcostal  incision made parallel to the costal margin, starting below the
xiphoid and extending laterally; used to access the gall bladder; these subcoastal incisions
provide good abdominal viscera exposure and good healing. Other variations of Kocher
incision are:
o Chevron / rooftop incision: the extension of the incision to the other side of the
abdomen; used to access the oesophagus, the stomach, and the liver.
o Mercedes Benz incision: Chevron incision with a vertical incision and break
through the xiphisternum; same indication as Chevron incision, but mostly
performed in liver transplantation.
 Transverse Incision: they vary in size and location; when a full-length transverse incision is
made some muscles (the oblique, the transverse and the rectus abdominis) and linea alba
are cut in a horizontal plane, causing more blood loss than the midline incision and
being more time-consuming; surgeons may also perform smaller transverse incisions and
remain unilateral.
o Supraumbilical transverse incision: offers excellent exposure of the upper
abdomen;
o Pfannenstiel incision: infraumbilical transverse incision in the lower abdomen;
mostly used for gynaecological and obstetric procedures. The skin is incised
transversely, often with a convexity downward to avoid dissection of blood vessels
and nerves.
 Lanz incision and Gridiron incisions: used to access the appendix, mostly to perform
appendicetomy; both are made at McBurney’s point. In comparison to Gridiron
incision, Lanz incision produces better aesthetics results with reduced scarring as it follows
the Langer’s lines.
 Rutherford-Morison incision: similar with the Gridiron incision but the surgeon extends the
incision into an oblique and curvilinear orientation, facilitating access to the ascending colon
and sigmoid; also used for kidney transplantation.
BONDOC VS MANTALA (GR NO. 203080 NOVEMBER 12,2014)
Facts: Respondent was admitted at the Oriental Mindoro Provincial Hospital (OMPH) on April 3,
2009, at around 11:00am, with referral from the Bansud Municipal Health Office. She was due to
deliver her 5th child and was advised for a caesarian section because her baby was big and there was
excessive amniotic fluid in her womb. She started to labor at 7:00am and was initially brought to the
Bongabon Health Center. However, said health center also told her to proceed directly to the hospital.
In her complaint-affidavit, respondent alleged that inside the delivery room of OMPH, she was
attended to by petitioner who instructed the midwife and two younger assistants to press down on
respondent’s abdomen and even demonstrated to them how to insert their fingers into her vagina.
Thereafter, petitioner went out of the delivery room and later, his assistants also left. After hours of
being in labor, respondent pleaded for a caesarian section. The midwife and the younger assistants
pressed down on her abdomen causing excruciating pains on her ribs and made her very weak. They
repeatedly did this pressing until the bay and placenta came out. When she regained consciousness, she
was already at the recovery room, she learned that an operation was performed on her by petitioner to
removed her ruptured uterus but what depressed her most was her stillborn baby and the loss of her
reproductive capacity. The respondent noticed that her vulva swollen and there is an open wound
which widened later on and was re-stitched by petitioner. Petitioner was heard uttering words
unbecoming of his profession pertaining to the respondent’s states while in labor. Respondent filed
then a complaint for grave misconduct against the petitioner before the ombudsman. The petitioner
resigned as medical officer of OMPH, alleging that the complaint against him is now moot and
academic.
Issue: Whether or not petitioner’s conduct during the delivery of respondent’s baby constitute grave
misconduct.
Held: Yes. Misconduct is defined as a transgression of some established and definite rule of action,
more particularly unlawful behavior or gross negligence by a public officer, a forbidden act, a
dereliction of duty, willful in character, and implies wrongful intent and not mere error in judgement. It
generally means wrongful, improper or unlawful conduct motivated by a premeditated, obstinate or
intentional purpose. The term, however does not necessarily imply corruption or criminal intent. To
constitute an administrative offense, misconduct should relate to or be connected with the performance
of the official functions and duties of a public officer. On the other hand, when the elements of
corruption, clear intent to violate the law or flagrant disregard of established rule are manifest, the
public officer shall be liable for grave misconduct. In deliberately leaving the respondent to a midwife
and two inexperienced assistants despite knowing that she was under prolonged painful labor and
about to give birth to a macrosomic baby by vaginal delivery, petitioner clearly committed a
dereliction of duty and a breach of his professional obligations. The gravity of respondent’s conditions
is highlighted by the expected complications she suffered – her stillborn baby, a ruptured uterus that
necessitated the immediate surgery and blood transfusion and vulvar hematomas. Article II section 1 of
the code of medical ethics of the medical profession in the Philippines states: A physician, should
attend to his patients faithfully and conscientiously. He should secure fore them all possible benefits
that may depend upon his professional skill and care. As the sole tribunal to adjudge the physician’s
failure to fulfill his obligation to his patient is, in most cases, his own conscience, violation of this rule
on his part is discreditable and inexcusable. A doctor’s duty to his patient is not required to be
extraordinary. The standard contemplated for doctors is simply the reasonable coverage merit among
ordinarily good physicians i.e. reasonable skill and competence. Even by this standard, petitioner fill
short when he routinely delegated an important task that requires his professional skill and competence
to his subordinates who have no requisite training and capability to make crucial decisions in difficult
child births. A physician should be dedicated to provide competent medical care with full professional
skill and accordance with the current standards of care, compassion, independence, and respect for
human dignity.
4×4 (“Four-by-Four”)
What the layperson might think: a vehicle with the ability to send torque power to four
different wheels.
What it means in the OR: a four inch x four inch piece of gauze.
Airplane
What the layperson might think: a flying machine.  procedures.
What it means in the OR: tilting the bed (and patient) in the roll axis to expose a lateral
portion or change the patient’s hemodynamics.
Army Navy
What the layperson might think: the branches of the military that protect the land and
sea, respectively.
What it means in the OR: a retractor with heads on both ends, one wider than the other. I
surmise that the “Army side” is the bigger side since the Army has more personnel, has
produced more U.S. Presidents, and even has more boats than the Navy. There is no clear
consensus on the history of the name.
Bair Hugger
What the layperson might think: someone who hugs bears and spells incorrectly.
What it means in the OR: a plastic sheath/blanket that has a constant supply of warm air
piped in to help the patient maintain body temperature in the normally chilly (66-68F) OR.
Bipolar
What the layperson might think: a psychiatric condition that has manic and depressive
features.
What it means in the OR: a piece of equipment shaped like tweezers… I mean, forceps!
The bipolar is used for cauterization. It provides more precision and decreases the chance of
unwanted tissue damage than the traditional cauterization tool, the “Bovie.”
Bovie
What the layperson might think: someone butchering Jon Bon Jovi’s name? A slang
term for bovine?
What it means in the OR: named after Dr. Bovie, this is an instrument that has a “cut” and
“cautery” function (you will hear this term a lot in nearly any procedure). Some purists may
call it “cautery” because “Bovie” is an eponym for the tool’s inventor, similar to the “Kleenex”
versus “tissue” conundrum.
Christmas Tree
What the layperson might think: the place where Santa Claus places gifts on Christmas
morning.
What it means in the OR: the thing anesthesiologists use to protect their tubes and cords
from becoming tangled or compressed. You will likely be tempted to rest your hand or some
weight on the “Christmas tree” during a long procedure, and the anesthesiologist will likely
tell you to get off their equipment.
The Count (not of Monte Cristo)
What the layperson might think: a royal person who lives in a castle.
What it means in the OR: the scrub tech/nurse accounts for every surgical instrument,
sharp object, sponges, etc that may possibly be left inside the patient. The count occurs before
the procedure begins, anytime the scrub tech/nurse switches out, many times throughout the
procedure depending on personnel preference and local policy, before closing the fascia, and
at the conclusion of the procedure. If the count is not correct, there will be an extensive search
for the missing item. If the missing item is not found, the patient may need an x-ray to check
for retained items.
Cocaine
What the layperson might think: an alpha-1 agonist traditionally used for illicit
recreational purposes.
What it means in the OR: can be used as a vasoconstrictor and local anesthetic for nasal
Donut
What the layperson might think: a delicious circular pastry.
What it means in the OR: a support for the patient’s head to help keep it in place that
usually replaces the patient’s pillow after anesthetic induction.
Drain
What the layperson might think: where water goes after you take a shower or wash your Valsalva
hands. What the layperson might think: how to equalize ear pressure when ascending or
What it means in the OR: a “Penrose” drain is placed in many operative sites to prevent descending in flight or in water. 
fluid accumulation. Once a drain has less than 30mL of output in 24 hours, it can usually be What it means in the OR: the same maneuver but for a different reason. The Valsalva
removed, a great task for a learning medical student. maneuver decreases preload and builds pressure in the venous system. So, it helps expose
Gator venous bleeding that might not be readily apparent.
What the layperson might think: a hungry carnivore waiting to chomp anything that gets
too close to its swampy home.
What it means in the OR: a surgical tool used to grasp in tight spaces, such as the ears or
nose.
Irrigation
What the layperson might think: the technological advancement that contributed to
humankind’s advancement from a nomadic hunter/gatherer species into an agrarian based
species.
What it means in the OR: a turkey-baster-like piece of equipment filled with normal saline
that is used to irrigate (don’t use the term in the definition… facepalm), er, clean the operative
site of any blood/debris. You will hear this term a lot in nearly any procedure.
Jump Room
What the layperson might think: a trampoline park called Sky Zone.
What it means in the OR: it means that there is another OR waiting for your surgeon
usually staffed with another team (anesthesiologist, scrub tech/nurse, and circulator), so that
the surgical team does not have to wait for OR turnover/cleaning.
Pedals
What the layperson might think: the part that connects you feet to your bicycle (or
tricycle or unicycle)?
What it means in the OR: there are pedals for many pieces of surgical equipment
including the Bovie (cautery), bipolar, coblator, scope cameras, etc. Before starting the
operation, help the OR staff make sure the pedals are plugged into the right machines and
positioned at the correct spot for the operator.
Snow
What the layperson might think: a fluffy form of water that falls from the sky and
provides great skiing.
What it means in the OR: Snow, brand name Surgicel, is a hemostatic agent. When used it
is usually placed at the conclusion of procedures.
Sponge
What the layperson might think: Bob Squarepants’ first name? A fungi? What you use to
wash dishes?
What it means in the OR: Anything used to absorb blood. Laparotomy sponges may also
be called “laps.” They do not look like the other types of aforementioned sponges, but rather
look more like rags.
Suction
What the layperson might think of: the rubber circles that stick to windows or the cups
that Olympic swimmers use.
What it means in the OR: a way to remove blood and or “irrigation” from the operative
site. You will hear this term a lot in nearly any procedure. “Suction” nearly always follows
“irrigation.” So, look for the scrub tech/nurse to pass you the suction handle after the
attending/resident asks for “irrigation.”