Literature review on trividha karma

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Journal name: World Journal of Pharmaceutical Research
Original article title: Literature review on trividha karma
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Author:

Shweta R. Mhatre, Dr. Veerendra Meenkire and Dr. Amit Shedge


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Literature review on trividha karma

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr20229-24773


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Summary of article contents:

Introduction

Ayurveda, regarded as the “science of life,” encompasses various branches that prioritize maintaining health and balance within individuals using natural principles. Among its several branches, Shalyatantra or Ayurvedic surgery is particularly significant. The concept of Trividha Karma, introduced by Acharya Sushruta, plays a crucial role in the Ayurvedic surgical framework. Trividha Karma categorizes surgical procedures into three stages: Purva Karma (pre-operative), Pradhan Karma (operative), and Paschat Karma (post-operative). Each of these stages is vital to achieving successful outcomes in surgical interventions, emphasizing the need for detailed preparation and care before, during, and after surgery.

Purva Karma: The Importance of Pre-operative Procedures

Purva Karma encompasses essential pre-operative actions that establish the groundwork for successful surgical outcomes. This stage includes the ethical considerations for practitioners, comprehensive patient history, and general examinations. Acharya Sushruta highlights the significance of proper diagnostics, including patient assessment in terms of age, medical history, and the specific nature of their illness. Furthermore, prerequisites such as selection of appropriate herbs and surgical tools, as well as sterilization of instruments, are crucial. Pre-operative dietary recommendations and obtaining patient consent are also parts of this phase, ensuring the patient is adequately prepared both physically and psychologically for surgery.

Pradhan Karma: The Surgical Procedures

The Pradhan Karma stage involves the execution of various surgical procedures, collectively referred to as Ashtavidh Shastra Karma. Sushruta delineates eight primary surgical techniques: Chedana (excision), Bhedana (incision), Lekhana (scraping), Vyadhana (puncturing), Eshana (probing), Aharana (extraction), Visravana (drainage), and Seevana (suturing). Each technique is designated for specific medical conditions, demonstrating a nuanced understanding of surgical intervention. Sushruta’s material on how to perform these procedures, the instruments used, and the conditions for their application forms an essential foundation of ancient surgical knowledge, which bears relevance to modern practices.

Paschat Karma: The Focus on Post-operative Care

Paschat Karma addresses the necessary care following surgical procedures, which is critical for recovery and preventing complications. This phase includes wound care management, dietary recommendations, and strategies for patient hygiene. Sushruta emphasizes the creation of a clean environment for recovery and proposes specific diets to enhance healing while avoiding foods that may aggravate conditions. The need for consistent bandaging and careful attention to wound care is also outlined, to protect against infection and ensure optimal recovery. Additionally, methods such as chamber fumigation with medicinal substances are advised to safeguard the health of the patient during recovery.

Conclusion

Acharya Sushruta's contributions to surgery immortalize him as the "Father of Surgery," with his teachings on Trividha Karma providing foundational principles that resonate within modern surgical practices. His detailed exploration of pre-operative, operative, and post-operative procedures demonstrates advanced understanding and systematic methodologies that were relevant in ancient times and remain significant in contemporary contexts. The integration of ethical considerations, patient care, and surgical techniques outlines a holistic approach to surgery, reflecting the depth of Ayurvedic medicine. The lessons from Sushruta emphasize the importance of careful planning, execution, and aftercare in achieving successful surgical outcomes.

FAQ section (important questions/answers):

What are the three types of procedures in Trividha Karma?

Trividha Karma consists of Purva Karma (pre-operative), Pradhan Karma (operative), and Paschat Karma (post-operative). Each stage plays a crucial role in ensuring successful surgical outcomes.

Who was Acharya Sushruta and his significance in surgery?

Acharya Sushruta is known as the 'Father of Surgery', being the first ancient Indian physician to describe various surgical procedures in detail, including the Trividha Karma framework.

What does Purva Karma involve before surgery?

Purva Karma includes pre-operative ethics, detailed patient history, general examination, selection of surgical instruments, sterilization methods, dietary advice, obtaining consent, and anesthesia protocols.

What types of surgical procedures are included in Pradhan Karma?

Pradhan Karma involves eight main surgical procedures called Ashtavidh Shastra Karma, including excision, incision, scrapping, puncturing, probing, extraction, drainage, and suturing.

What is the importance of Paschat Karma after surgery?

Paschat Karma focuses on post-operative care, including wound management, dietary recommendations, bandaging techniques, and maintaining hygiene to promote healing and prevent infection.

How did Sushruta contribute to modern surgical practices?

Sushruta's comprehensive instructions on surgical methods, sterilization, pain management, and wound care laid foundational principles that modern surgical practices continue to utilize today.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Literature review on trividha karma”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Karma (Karman):
'Karmas' refers to the different actions or procedures, particularly in the surgical context. Understanding various Karmas is essential for practitioners to implement appropriate techniques effectively tailored to patient needs, ensuring successful treatment outcomes.

2) Disease:
'Diseases' is the plural form of disease, representing a variety of health conditions affecting individuals. In Ayurvedic practice, diseases are categorized based on their characteristics, etiology, and signs, which aids practitioners in developing targeted treatments and surgical strategies to combat them effectively.

3) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
'Shalya-tantra' is the Ayurvedic branch dedicated to surgery and surgical procedures. It encompasses detailed methodologies for performing surgeries, including the instruments used and post-operative care, indicating a sophisticated understanding of surgical techniques developed in ancient India.

4) Paschat-karma:
'Paschat-karma' refers to post-operative care in Ayurvedic surgical practice. This stage involves managing the patient's recovery, including wound care and rehabilitation, to ensure proper healing and to avoid complications. Effective post-operative procedures are crucial for achieving successful treatment outcomes and patient well-being.

5) Purvakarma (Purva-karman, Purvakarman):
'Purva-karma' describes the pre-operative preparations and procedures in Ayurvedic surgery. This phase includes patient assessment, securing informed consent, and ensuring all necessary materials and methods are in place to facilitate safe and successful operative interventions according to Ayurvedic principles.

6) Shastra (Sastra):
'Sastra' refers to surgical instruments or tools used in procedures. They are categorized for specific functions, emphasizing the meticulous nature of surgery in Ayurveda and the importance of having the appropriate tools to ensure effective and safe surgical outcomes.

7) Pradhan:
'Pradhan' translates to the operative stage in the context of Ayurvedic surgery. It emphasizes the actual surgical actions taken during a procedure. This stage is critical as it translates the plans and preparations of Purva-karma into tangible medical outcomes, showcasing the skilled hands of the surgeon.

8) Purva:
'Purva' means preceding or prior. In medical terminology, it primarily relates to Purva-karma, the preparatory phase before any surgical procedure. In Ayurveda, it denotes the importance of thorough planning, patient assessment, and preparing all necessary tools to ensure a successful surgical outcome.

9) Ayurveda (Ayus-veda):
'Ayurveda' is an ancient Indian system of medicine that emphasizes balance in bodily systems through diet, herbal treatment, and yogic practices. It integrates holistic health principles, aiming for overall wellness, prevention, and treatment of diseases through natural and individualized approaches, embodying a rich traditions.

10) Blood:
'Blood' is a vital fluid in the body that carries essential nutrients, oxygen, and waste products. In Ayurvedic practice, the management of blood is crucial, particularly during surgical procedures, as maintaining blood health is integral to overall wellness and recovery from illness or injury.

11) Maharashtra (Maharastra, Maha-rashtra):
'Maharashtra' is a state in India known for its rich cultural heritage and history in traditional medicine practices, including Ayurveda. It is home to various Ayurvedic colleges and practitioners, contributing significantly to the study and practice of ancient healing arts of India.

12) Swelling:
'Swelling' refers to the increase in size of a body part due to inflammation or accumulation of fluid. In Ayurvedic context, it is often correlated with 'Kapha' dosha imbalances or other pathological conditions which can indicate underlying issues that may require surgical intervention.

13) Lekhana:
'Lekhana' is a specific surgical procedure relating to the scraping of infected tissue or skin lesions. It is indicated for various conditions in Ayurveda, aiming to promote healing by removing necrotic tissue and potentially infected surfaces, facilitating regeneration and recovery.

14) Wounded:
'Wounded' pertains to a condition where there is physical harm or injury to the body, often necessitating surgical intervention in Ayurvedic practice. Proper management of wounds, including the application of appropriate techniques and herbs, is vital for effective healing and prevention of complications.

15) Tantra (Tantrism, Tamtra):
'Tantra' signifies a systematic study or text, particularly in the context of Ayurveda, encompassing methodologies and practices. It relates closely to the various branches of Ayurveda, such as Shalyatantra, which focuses on surgical techniques and approaches, creating a structured understanding of medical procedures.

16) Bandha (Bamdha):
'Bandha' refers to bandaging or dressing of wounds in Ayurveda. It is an important mobilization strategy for protecting wounds, facilitating healing, and preventing infection. Proper bandha techniques are discussed extensively in Ayurvedic texts, marking their importance in post-operative care.

17) Pathya:
'Pathya' pertains to the dietary and lifestyle recommendations in Ayurveda for maintaining health or recovering from diseases. It encapsulates the idea of consuming appropriate foods and avoiding harmful factors to ensure proper healing, especially in post-operative care.

18) Esana (Eshana):
'Esana' refers to exploring or searching, particularly relating to probing methods in surgery to assess conditions. This technique emphasizes careful examination and diagnosis essential for effective surgical interventions.

19) India:
'India' is the birthplace of Ayurveda, a rich cultural heritage of traditional medicine deeply rooted in the country's history. It offers holistic approaches that integrate spirituality and natural healing, making it a significant contributor to global alternative medicine practices.

20) Pain:
'Pain' is a vital symptom indicating injury or pathology in the body. In Ayurveda, understanding and alleviating pain, especially during surgical procedures, is paramount. Various techniques, including herbal treatments and anesthesia as described by Acharya Sushruta, are utilized to manage pain effectively.

21) Post:
'Post' refers to the subsequent phase following surgical interventions. This involves various necessary aftercare practices, including monitoring recovery, managing potential complications, and ensuring proper wound care, underscoring the holistic view of healing embraced by Ayurvedic principles.

22) Bleeding:
'Bleeding' indicates the loss of blood, which can be a serious concern during surgical procedures in Ayurveda. Effective management strategies, including hemostasis methods as prescribed in Ayurvedic texts, are critical for preventing excessive blood loss and ensuring patient safety during operations.

23) Bhedana:
'Bhedana' signifies the surgical practice of making incisions to expose underlying tissues or organs. This procedure is essential in various surgical interventions and requires precision to ensure effectiveness while minimizing trauma to surrounding structures, aligning with Ayurvedic surgical philosophies.

24) Granthi (Gramthi):
'Granthi' refers to a lump or mass, often indicating a pathological condition such as cysts or tumors. Accurate diagnosis and treatment of Granthi are described in Ayurvedic surgery, highlighting the importance of techniques such as excision and drainage in promoting patient recovery.

25) Ashmari (Asmari):
'Ashmari' denotes renal calculi or stones within the body. Recognition and treatment of Ashmari involve surgical interventions in Ayurveda, emphasizing methods like Aharana for removal, showcasing the integration of ancient wisdom in addressing common yet serious health conditions.

26) Hair:
'Hair' is often referenced in Ayurvedic texts concerning bodily health. Issues such as infestations, injuries, or conditions that affect hair growth can be addressed through specific treatments that promote healthy growth and managing scalp health, reflecting the holistic nature of Ayurvedic medicine.

27) Agnikarma (Agni-karma):
'Agnikarma' is a specialized surgical technique in Ayurveda involving the application of heat to address infections or lesions. This method exemplifies ancient Ayurvedic practices related to energy application, showcasing a unique approach to treatment leveraging natural elements for healing purposes.

28) Knowledge:
'Knowledge' pertains to the understanding and expertise required in the practice of Ayurveda. It encompasses learning from classical texts, experiential insights, and clinical wisdom essential for practitioners to implement effective treatment modalities and surgeries in a compassionate, informed manner.

29) Sarshapa (Sarsapa):
'Sarshapa' refers to mustard seeds often used in Ayurvedic treatments. They hold significance in various therapeutic modalities, including their application in fumigation procedures for wound care or in dietary recommendations, reflecting Ayurveda's integration of food and medicine.

30) Chedana:
'Chedana' is an Ayurvedic surgical procedure focusing on excision or cutting away diseased tissue. This technique is critical in addressing various pathological conditions like tumors or cysts and emphasizes the skill required in performing successful surgical interventions in line with traditional practices.

31) Apathya:
'Apathya' implies foods or practices that are not suitable for an individual’s condition in Ayurveda. Knowledge of Apathya is crucial, especially in post-operative care, to avoid complications and support recovery aligned with individual constitution and medical history.

32) Kshara (Ksara):
'Kshara' refers to alkaline substances utilized in Ayurvedic treatments, particularly in surgeries like the removal of sinuses. These agents have specific applications in medicinal formulations, demonstrating the diverse range of therapeutic measures embedded in traditional Ayurvedic practices.

33) Vaidya:
'Vaidya' is the term for a practitioner or physician in Ayurveda. It signifies someone skilled in herbal medicine and surgical practices, emphasizing the role of Vaidyas in diagnosing and treating patients through established ancient methodologies and comprehensive care approaches.

34) Garbha:
'Garbha' refers to the fetus or embryo in Ayurveda. Understanding the health and wellness of Garbha is crucial in Ayurvedic obstetrics, where preventive measures and treatments are focused on ensuring the well-being of both mother and child, exemplifying an integral aspect of holistic care.

35) Satmya:
'Satmya' embodies the concept of dietary compatibility in Ayurveda, referring to what is suitable or beneficial for an individual based on their constitution and health conditions. Recognizing Satmya is vital in guiding dietary recommendations, particularly in recovery contexts.

36) Arbuda:
'Arbuda' describes tumors or neoplasms in Ayurveda. Diagnosis and treatment protocols for Arbuda involve surgical excision and management, highlighting the importance of early detection and effective intervention in maintaining health and preventing further complications.

37) Vyadhin (Vyadhi):
'Vyadhi' translates to disease or ailment in Ayurveda. Understanding Vyadhi is fundamental to diagnosis, treatment, and guiding surgical practices, as each disease has specific characteristics and requires tailored approaches for effective healing and recovery.

38) Labour (Labor):
'Labour' pertains to the act of childbirth, which involves various physiological processes. Ayurvedic practitioners provide care and support during this critical time, utilizing ancient wisdom to ensure safe deliveries and addressing any complications that may arise during the process.

39) Indian:
'Indian' reflects the origins of Ayurveda and its significance as a traditional system of medicine developed within the context of Indian culture and philosophy. Its practices represent a rich legacy of wellness, holistic healing, and natural therapies that have influenced health paradigms globally.

40) Danta (Damta):
'Danta' refers to teeth within Ayurveda. Dental health is recognized as an essential aspect of overall well-being, and Ayurvedic approaches to oral care include various treatments and preventive measures to maintain dental hygiene and address diseases affecting the oral cavity.

41) Vidha:
'Vidha' translates to a specific procedure or method within Ayurvedic practices. It emphasizes the importance of structured techniques and interventions, ensuring that every treatment is based on a systematic understanding of diseases and tailored to the individual's unique constitution and health conditions.

42) Medas (Meda, Medash):
'Meda' indicates fat or adipose tissue in Ayurvedic context. Its balance is essential for health, with excessive Meda being linked to disease. Ayurvedic principles guide the management of Medas through dietary interventions and lifestyle changes to promote overall health.

43) Patra:
'Patra' signifies a vessel or container used in Ayurvedic practices. It can pertain to the containers for medicines or the anatomical structures in the body, emphasizing the importance of appropriately administering treatments and addressing various health conditions through suitable delivery methods.

44) Karna:
'Karna' refers to the ear in Ayurvedic terminology. Treatment approaches related to Karna include various techniques for ear ailments and conditions, reflecting Ayurveda's holistic outlook on health that embraces the significance of each body part in maintaining overall wellness.

45) Vrana:
'Vrana' means a wound or injury in Ayurveda. The management of Vrana is pivotal, involving specific cleaning, dressing, and care methods to promote healing and avoid complications, illustrating the attention given to wound care in Ayurvedic surgical practices.

46) Aahar:
'Aahar' refers to food or diet in Ayurveda. It constitutes an essential component of health, emphasizing suitable dietary choices based on individual needs to foster balance, prevent diseases, and enhance overall well-being, integrating nourishment into health practices.

47) Death:
'Death' signifies the end of life, a crucial concept in Ayurveda where the aim is to promote longevity and well-being. Ayurvedic practices involve understanding the life cycle and helping individuals live healthily to mitigate risks that lead to premature death.

48) Mala:
'Mala' refers to excreta or waste products in Ayurveda. The management of Mala is vital for maintaining health, as the proper elimination of waste is crucial for balance within the body. Ayurvedic practices emphasize dietary and lifestyle choices to ensure effective bodily functions.

49) Food:
'Food' plays a fundamental role in Ayurveda, constituting the primary source of nourishment that affects health. Ayurvedic approaches advocate for diet diversity and the consumption of suitable foods tailored to individual needs, highlighting the link between diet and overall wellness.

50) Ghi (Ghee):
'Ghee' denotes clarified butter in Ayurveda, recognized for its nutritional and health benefits. It is often incorporated into diets and treatments, showcasing its significance in promoting healing, digestion, and overall wellness.

51) Life:
'Life' in Ayurveda represents the essence of living harmoniously in balance with natural laws. Ayurvedic teachings focus on fostering a meaningful existence by nurturing physical, mental, and spiritual health, which collectively define the quality of life individuals experience.

52) Vajikaranatantra (Vajikarana-tantra, Vajikaranatamtra):
'Vajikarana-tantra' is a branch of Ayurveda focused on aphrodisiacs and sexual health. It emphasizes the importance of vitality and reproductive health in overall well-being, offering various treatments and lifestyle recommendations to enhance amorous vitality and reproductive functions.

53) Sushruta-samhita (Susruta-samhita):
'Sushruta-samhita' is an ancient Ayurvedic text attributed to Acharya Sushruta, focusing on surgical techniques and practices. It constitutes a foundational reference for Ayurvedic surgery, detailing surgical procedures, instruments, and principles that have influenced modern surgical practices.

54) Shalakyatantra (Salakyatantra, Shalakya-tantra, Shalakyatamtra):
'Shalakya-tantra' is a branch of Ayurveda that deals with the treatment of disorders related to the head and neck, including ophthalmology and ENT. It emphasizes specialized treatments and surgical interventions for conditions affecting these critical areas, showcasing the diversity within Ayurvedic practices.

55) Pradhana-karma:
'Pradhana-karma' denotes the main operative phase of surgery in Ayurvedic practice. It focuses on the surgical actions themselves, where precision and skill are paramount to ensure the procedure aligns with the therapeutic goals and utilizes the preparatory stages effectively.

56) Vranashodhana (Vranasodhana, Vrana-shodhana):
'Vrana-shodhana' refers to the cleansing of wounds in Ayurveda. This process is pivotal for preventing infection and facilitating proper healing, underscoring the care and attention afforded to wound management, indicating the depth of Ayurvedic understanding of surgical practices.

57) Utpalapatra (Utpala-patra):
'Utpala-patra' signifies specific tools or substances used in Ayurvedic procedures. Its mention highlights the significance of utilizing specialized instruments to ensure effective treatment during surgical procedures, exemplifying the meticulous nature of surgical practice within the Ayurvedic framework.

58) Mudhagarbha (Mudha-garbha):
'Mudha-garbha' refers to cases of obstructed labor as per Ayurvedic terminology. The understanding and management of Mudha-garbha are essential components of obstetrics in Ayurveda, aligning with holistic principles of care during childbirth.

59) Agadatantra (Agada-tantra, Agadatamtra):
'Agada-tantra' is the branch of Ayurveda focused on toxicology and poison management. It addresses the treatment of diseases caused by toxins, emphasizing methods to detoxify and manage conditions arising from poisonous substances, reflecting the comprehensive nature of Ayurvedic medicine.

60) Inflammation:
'Inflammation' is the body's response to injury or infection characterized by redness, swelling, and pain. In Ayurveda, understanding inflammation is crucial for diagnosing conditions and implementing appropriate treatments that restore balance and promote healing.

61) Bhutavidya (Bhuta-vidya):
'Bhuta-vidya' is a branch of Ayurveda focused on spiritual healing and understanding the psychological aspects of health. It integrates concepts of mental well-being, emphasizing that holistic health cannot be achieved without addressing emotional and spiritual dimensions.

62) Ashtavidha (Astavidha, Ashtan-vidha):
'Ashta-vidha' refers to the eight types of surgical procedures delineated in Ayurveda, as discussed by Sushruta. Understanding these procedures is essential for practitioners to employ accurate surgical techniques tailored to specific ailments within the framework of Ayurvedic practice.

63) Accumulation (Accumulating, Accumulate):
'Accumulated' refers to the buildup of substances within the body, such as toxins or waste. In Ayurveda, managing accumulation is crucial for maintaining health, as excesses can lead to diseases, necessitating detoxification strategies and balanced diets.

64) Pratyaksha (Pratyaksa):
'Pratyaksha' means direct perception or observation. In Ayurvedic practice, it refers to the importance of clinical examination and observation in diagnosing diseases and developing treatment plans that align with a patient's individual conditions and needs.

65) Vajikarana:
'Vajikarana' is a specialty in Ayurveda concerning reproductive health and vitality. This branch emphasizes methods to enhance sexual potency and overall health, promoting wellness through various natural treatments aimed at improving quality of life.

66) Discussion:
'Discussion' pertains to the analytical examination of Ayurvedic texts and practices. It involves critical reviews and interactive dialogues among practitioners about methodologies, challenges, and advancements in treatments, contributing to the evolution and relevance of Ayurvedic practices in modern contexts.

67) Kulattha:
'Kulattha' is a variety of pulses recognized in Ayurveda for their nutritional value. They are emphasized in dietary recommendations, reflecting the significance of natural foods in maintaining health and treating various conditions through balanced dietary practices.

68) Shodhana (Sodhana):
'Shodhana' refers to purification processes in Ayurveda. These methods are essential in cleansing the body of toxins and accumulated residues, thereby promoting health and preventing diseases, underlining the importance of detoxification in Ayurvedic healing practices.

69) Pradhana:
'Pradhana' signifies the operative phase in a surgical context, denoting the actual execution of procedures. This stage is pivotal in Ayurvedic surgeries, where surgical skills and knowledge culminate in delivering effective treatments to patients.

70) Rasayana (Rasa-ayana):
'Rasayana' is a branch of Ayurveda focused on rejuvenation and longevity. It encompasses treatments and lifestyle practices aimed at enhancing vitality and health, reflecting the holistic philosophy that prioritizes not only survival but flourishing in life.

71) Upadamsha (Upadamsa):
'Upadamsa' indicates conditions like erysipelas or skin infections in Ayurvedic terminology. Understanding Upadamsa is vital for effective treatment, which may involve surgical and medicinal interventions to address the underlying causes of skin diseases.

72) Shleshma (Slesma):
'Shleshma' refers to the Kapha dosha in Ayurveda, associated with stability and moisture. Imbalances in Shleshma can lead to health issues, necessitating treatments aimed at restoring equilibrium through appropriate dietary and lifestyle modifications.

73) Aushadhi (Ausadhi, Ausadhin, Aushadhin):
'Aushadhi' signifies medicinal herbs or preparations utilized in Ayurveda. These natural substances form the core of Ayurvedic treatments and are essential in formulating remedies that address various ailments, emphasizing the reliance on nature's healing properties.

74) Vitiation (Vitiated):
'Vitiated' refers to an imbalance or disruption in the body’s natural state, particularly related to doshas in Ayurveda. Recognizing and rectifying vitiated conditions are fundamental to restoring health and preventing diseases.

75) Incision:
'Incision' represents the surgical term for cutting into body tissues, crucial in various surgical procedures. Proper techniques of incision are vital for successful surgeries, specifically in accessing tissues or organs to treat underlying conditions effectively.

[Note: The above list is limited to 75. Total glossary definitions available: 149]

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