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Department of Surgery

Surgery is a branch of medicine concerned with diseases and conditions requiring or amenable to operative or manual procedures. It employs operations in the treatment of disease or injury in which someone's body is cut open so that a doctor can repair, remove, or replace a diseased or damaged part. Surgery can involve cutting, abrading, suturing, or otherwise physically changing body tissues and organs.

The American College of Surgeons recognizes 14 surgical specialties:

  1. General Surgery:
    A general surgeon is a specialist who is trained to manage a broad spectrum of surgical conditions affecting almost any area of the body. The surgeon establishes the diagnosis and provides the preoperative, operative, and post-operative care to patients and is often responsible for the comprehensive management of the trauma victim and the critically ill patient. During at least a five-year educational period after obtaining a medical degree, the surgeon acquires knowledge and technical skills in managing medical conditions that relate to the head and neck, breast, skin, and soft tissues, abdominal wall, extremities, and the gastrointestinal, vascular, and endocrine systems.
  2. Thoracic Surgery:
    Thoracic surgery involves the operative management, perioperative care, and critical care of patients with pathological conditions within the chest. Specifically, it includes surgical care for coronary artery disease; cancers of the lung, esophagus, and chest wall; abnormalities of the great vessels and heart valves; congenital anomalies; tumors of the mediastinum; and diseases of the diaphragm. The management of the airway and injuries to the chest are also areas of surgical practice for the thoracic surgeon. A thoracic surgeon possesses the knowledge, experience, and technical skill to diagnose accurately, to operate upon safely, and to manage effectively patients with intrathoracic abnormalities that are appropriate for surgical treatment. The ability to provide this kind of treatment requires a substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of extracorporeal circulation, cardiac assist devices, management of cardiac dysrhythmias, pleural drainage, respiratory support systems, endoscopy, and other invasive and noninvasive diagnostic techniques.
  3. Colon and Rectal Surgery:
    As a result of their extensive training and experience, colon and rectal surgeons develop the knowledge and skills necessary to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal, and perianal area through medical and surgical means. They are also able to deal surgically with other organs and tissues (such as the liver, urinary, and female reproductive systems) involved with primary intestinal disease. A colon and rectal surgeon has expertise in diagnosing and often managing anorectal conditions in the office, such as hemorrhoids, fissures (painful tears in the anal lining), abscesses, and fistulae (infections located around the anus and rectum). Colon and rectal surgeons also treat problems of the intestine and colon and perform endoscopic procedures to detect and treat conditions of the bowel lining, such as cancer, polyps (precancerous growths), and inflammatory conditions. Colon and rectal surgeons also perform abdominal surgical procedures involving the small bowel, colon, and rectum, including treatment of inflammatory bowel diseases, such as chronic ulcerative colitis, Crohn's disease, diverticulitis, and cancer. Training in colon and rectal surgery also provides the surgical specialist with an in-depth knowledge of intestinal and anorectal physiology, which is required for the evaluation and treatment of problems such as constipation and incontinence (loss of bowel control). Colon and rectal surgeons are committed to the highest standards of care for patients with diseases that affect the lower gastrointestinal tract.
  4. Obstetrics and Gynecology:
    A specialist in obstetrics and gynecology is a physician who has been trained to provide medical and surgical care for the pregnant patient, to deliver babies, and to provide medical and surgical care to treat conditions that affect the female reproductive system. Some obstetricians/gynecologists have a strong professional interest in a specific area such as urogynecology, pelviscopy, adolescent/pediatric gynecology, or infectious diseases, and they focus their practice on one or more of these particular areas of the specialty. All of these physicians are also trained in health maintenance and preventative care for women, and they have a particular knowledge and skills that enable them to serve as consultants to physicians who practice in other areas of medicine. There are also subspecialties in obstetrics and gynecology, which require additional training: maternal-fetal medicine specialists are obstetricians /gynecologists who are prepared to care for, and to consult on, patients with high-risk pregnancies; and reproductive endocrinologists are capable of managing complex problems related to reproductive endocrinology and infertility, including aspects of assisted reproduction, such as in vitro fertilization (IVF).
  5. Gynecologic Oncology:
    A Gynecologic Oncologist is a specialist trained in the comprehensive management of patients with gynecologic cancer–cancers that affect the female reproductive system. Surgeons practicing in this specialty study these conditions, which differ significantly in the cause, prevention, detection, treatment, and survival rates.
  6. Neurological Surgery:
    Neurological surgery is the discipline of medicine and the specialty of surgery that deals with the diagnosis, evaluation, and treatment of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply. Neurological surgery involves the evaluation and treatment of pathological processes that modify the function or activity of the nervous system, including the pituitary gland.
  7. Ophthalmic Surgery:
    An ophthalmologist is concerned with the comprehensive care of the eyes and vision, and is the only medical practitioner who is medically trained to diagnose and treat all eye and visual problems. Ophthalmologists provide vision services (glasses and contact lenses), treat medical disorders of the eye, and perform surgical procedures for treatment.
  8. Oral and Maxillofacial Surgery:
    Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries, and defects in the head, neck, face, jaws, and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, and tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
  9. Orthopaedic Surgery:
    Orthopaedic surgery is a surgical specialty that is specifically devoted to the care of the musculoskeletal system. This system includes bones, joints, muscles, associated nerves, arteries, and the overlying skin. Much of the orthopaedic surgeon's practice involves the performance of surgical procedures, but many conditions are treated medically or physically through the use of braces, casts, splints, or physical therapy. Orthopaedic surgeons take care of a wide variety of problems that may be present at birth, or that may develop at any time during the lifetime of the person. Such problems can include congenital deformities, trauma, infections, tumors, degenerative conditions, and metabolic disturbances that fall into the category of musculoskeletal abnormalities. Orthopaedics may also involve the treatment of secondary muscular problems in patients who suffer from various central or peripheral nervous system lesions such as cerebral palsy, paraplegia, or stroke. The field of orthopaedic surgery has become very broad and now encompasses a number of specialty areas. Following a standard residency experience in orthopaedic surgery, an orthopaedist may continue with an additional one- to two-year fellowship to achieve added qualifications in the following special interest areas.
  10. Otolaryngology:
    An otolaryngologist is a physician who has been trained to provide comprehensive medical and surgical care to patients who have diseases and disorders that affect the ears, the respiratory and upper alimentary systems, and related structures. The otolaryngologist has a command of the core of knowledge, skills, and understanding of: the basic medical sciences relevant to the head and neck; the respiratory and upper alimentary systems; the communication sciences, including knowledge of audiology and speech-language pathology; the chemical senses; and allergy, endocrinology, and neurology as they related to the head and neck. Head and neck oncology and facial plastic and reconstructive surgery are also fundamental areas of expertise for the otolaryngologist.
  11. Pediatric Surgery:
    Pediatric surgeons are primarily concerned with the diagnosis, preoperative, operative, and postoperative management of surgical problems in children, and they operate on children whose development ranges from the newborn stage through the teenage years. Some medical conditions in newborns are not compatible with a good quality of life unless these problems are corrected surgically. These conditions must be recognized immediately by neonatologists, pediatricians, and family physicians. Pediatric surgeons cooperate with all of the specialists involved in a child's medical care to determine whether surgery is the best option for the child. Pediatric surgery focuses on providing surgical care for all problems or conditions affecting children that require surgical intervention. They may also have particular expertise in the following areas of responsibility.
  12. Plastic and Maxillofacial Surgery:
    The specialty of plastic surgery deals with the repair, replacement, and reconstruction of defects of the form and function of the body covering and its underlying musculoskeletal system, with emphasis on the craniofacial structures, the oropharynx, the upper and lower limbs, the breast, and the external genitalia. This surgical specialty also focuses on the aesthetic surgery of structures with undesirable form. Special knowledge and skill in the design and transfer of skin flaps, in the transplantation of tissues, and in the replantation of structures are vital to the performance of plastic surgery. The plastic surgeon must also possess excellent skill in the performance of excisional surgery, in the management of complex wounds, and in the use of allopathic materials. Knowledge of surgical design, surgical diagnosis, surgical and artistic anatomy, surgical pathology, surgical oncology, surgical physiology, pharmacology, bacteriology, biomechanics, embryology, and surgical instrumentation are other fundamental areas of expertise within the specialty. Furthermore, the judgment and technical capacity for achieving satisfactory results are mandatory qualities for the plastic surgeon.
  13. Urology:
    A urologist is a physician who manages benign and malignant medical and surgical disorders of the adrenal gland and of the genitourinary system. Urologists have comprehensive knowledge of, and skills in, endoscopic, percutaneous, and open surgery of congenital and acquired conditions of the reproductive and urinary systems and their contiguous structures.
  14. Vascular Surgery:
    Vascular surgeons care for patients with diseases that affect the arteries and veins throughout the body. Hardening of the arteries, atherosclerosis, is the most common problem that vascular surgeons treat. In addition, vascular surgeons are trained to diagnose and treat strokes, which can be brought on by a blockage or narrowing of the arteries in the neck. Because the damage done by strokes is often irreversible, vascular surgeons must be able to make early diagnoses of potential stroke victims. The surgeon who treats the vascular system must also be able to diagnose and treat aneurysms and blood clots in the arteries and veins, as well as the after effects of conditions of the vascular system.
Word from Head of the Department:

Welcome to the Department of Surgery at IMTU! In the 18th century, with increasing knowledge of anatomy, such operative procedures as amputations of the extremities, excision of tumours on the surface of the body, and removal of stones from the urinary bladder had helped to firmly establish surgery in the medical curriculum. Accurate anatomical knowledge enabled surgeons to operate more rapidly; patients were sedated with opium or made drunk with alcohol, tied down, and a leg amputation, for example, could then be done in three to five minutes. The pain involved in such procedures, however, continued to limit expansion of the field until the introduction of ether anesthesia in 1846. The number of operations thereafter increased markedly, but only to accentuate the frequency and severity of “surgical infections.”

In the mid-19th century the French microbiologist Louis Pasteur developed an understanding of the relationship of bacteria to infectious diseases, and the application of this theory to wound sepsis by the British surgeon Joseph Lister from 1867 resulted in the technique of antisepsis, which brought about a remarkable reduction in the mortality rate from wound infections after operations. The twin emergence of anesthesia and antisepsis marked the beginning of modern surgery.

Contemporary surgical therapy is greatly helped by monitoring devices that are used during surgery and during the postoperative period. Blood pressure and pulse rate are monitored during an operation because a fall in the former and a rise in the latter give evidence of a critical loss of blood. Other items monitored are the heart contractions as indicated by electrocardiograms; tracings of brain waves recorded by electroencephalograms, which reflect changes in brain function; the oxygen level in arteries and veins; carbon dioxide partial pressure in the circulating blood; and respiratory volume and exchange. Intensive monitoring of the patient usually continues into the critical postoperative stage.

General surgery is being taught for the MBBS programme from the 3yr onwards. Students do both junior and senior clinical rotation. The surgical specialties of Anaesthesia & Critical Care, Otorhinolaryngology, Opthalmology, Orthopedic Surgery & Traumatology, Radiology, Oncology & Palliative Care are taught in the 7th & 8th semester. Each of these courses are also accompanied with either 2 or 4 weeks of clinical rotations.

Vision & Mission:
  • Vision : To become a centre of choice for quality training, innovative research and policy development for the production of surgeons and surgical health care providers in Tanzania.
  • Mission: To train high calibre surgical professionals, carry out creative, innovative and inventive research in current and emerging challenges, set and apply international standards in evidence and science based surgical healthcare provision, and be at the forefront of surgical policy formulation.
Core Values:

Through sustainable, multidisciplinary teams:

  • Espouse and impart the virtues of professional ethics and moral standards in training, research and practice.
  • Provide insight regarding the fundamental nature of patient health and disease.
  • Empower all patients, trainees and colleagues with knowledge.
  • Provide safe and high-quality care based on an advanced understanding of and respect for our patients’ needs, and guided by best practices.
  • Promote evidence based health care provision.
  • Promote research.
  • Promote teamwork.
  • Nurture responsible professionalism through a culture of mentorship.
  • Promote sensitivity and responsiveness to the community and its environmental needs.
  • Promote gender sensitivity in training, research and practice.
  • Promote optimum utilization of resources in surgical training, research and practice.
  • Encourage and champion continuing medical education.