{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.ectomy","code":"thing-q15636234","url":"https://ver.cy/models/thing/q15636234/","name":"ectomy","alternateNames":["lymphatic ectomy","gastrointestinal ectomy","genital ectomy","exeresis","esophagectomy","bowel resection","ostectomy","polypectomy","rhinectomy","Surgical extirpation","ileocecal resection","colonic polypectomy"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Activities and processes","entryKind":"thing","plane":"ACT","domain":["ACT.ACT"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Ectomy denotes surgical excision or removal of tissue, an organ, or part of an organ, and occurs chiefly as the suffix \"-ectomy\" in procedure names.","purpose":"Enable an agent to recognise an ectomy as a surgical removal act, distinguish intended from achieved removal, and identify documentation or clinical review needed before further action.","scope":{"in":["Recognition of an ectomy from documented surgical removal rather than the procedure name alone","Anatomical target, laterality, intended extent and achieved extent of removal","Purpose and documented authorization for the specified removal","Removal episode, changes to the plan and links to associated procedures","Removed material, residual anatomy and evidence of completion","Removal-specific consequences and unresolved follow-up needs"],"out":["The linguistic suffix -ectomy as a word-formation object","Complete models of individual operations such as thyroidectomy or hysterectomy","Independent models of the underlying disease, anatomical structure or patient","Detailed surgical technique, anesthesia protocols and instrument operation","Standalone reconstruction, transplantation or stoma-creation procedures","The full pathology laboratory workflow and general postoperative care"],"boundaries":[]},"distinguishingFeatures":["Require evidence that anatomical material is intended to be removed; an incision that only provides access does not establish an ectomy.","Record partial versus total removal explicitly: thyroid gland removal, for example, may remove all or part of the gland. [MedlinePlus: Thyroid gland removal](https://www.medlineplus.gov/ency/article/002933.htm)","Distinguish extraction of tissue from destruction in place; record mixed procedures as separate components instead of inferring removal from treatment intent.","Separate the act of removal from reconstruction or creation of an opening performed during the same operation.","Classify the documented act rather than matching the suffix alone, and distinguish a planned ectomy from one actually performed."],"structure":{"bundles":[{"id":"removal-identity","name":"Removal identity","description":"Establish what qualifies as an ectomy and how the general act relates to named operations.","layers":[{"id":"operative-meaning","name":"Operative meaning","description":"Resolve the intended action meaning and its evidence.","findings":[{"id":"documented-removal-act","name":"Documented removal act","description":"Require an explicit account of material removed or intended for removal, while marking the registry interpretation as provisional.","questions":[{"text":"Does the registry's originating concept denote surgical removal as an act, a procedure family or the suffix -ectomy?","id":"documented-removal-act-q01","kind":"definition"},{"text":"Which operative description establishes removal rather than merely a procedure name ending in -ectomy?","id":"documented-removal-act-q02","kind":"provenance"}]}]},{"id":"neighbouring-act-boundaries","name":"Neighbouring act boundaries","description":"Separate removal from adjacent acts and resolve overlap with established models.","findings":[{"id":"removal-versus-associated-procedures","name":"Removal versus associated procedures","description":"Represent incision, destruction in place and reconstruction as distinct acts; investigate overlaps with excision, resection, biopsy and amputation.","questions":[{"text":"What evidence distinguishes the removal component from access, ablation or reconstruction in this episode?","id":"removal-versus-associated-procedures-q01","kind":"boundary"},{"text":"Does an existing excision, resection or other world model already own this concept, requiring a link instead of another publication?","id":"removal-versus-associated-procedures-q02","kind":"boundary"}]}]}]},{"id":"target-and-removal-boundary","name":"Target and removal boundary","description":"Describe exactly what is to be removed and what is to remain.","layers":[{"id":"target-localisation","name":"Target localisation","description":"Identify anatomical site, side and target multiplicity.","findings":[{"id":"unambiguous-removal-target","name":"Unambiguous removal target","description":"Bind each removal component to a specific anatomical target and distinguish it from nearby preserved structures.","questions":[{"text":"Which organ, tissue, lesion or anatomical part is the target, and is laterality or segment identification necessary?","id":"unambiguous-removal-target-q01","kind":"definition"},{"text":"Are multiple removed structures separate targets or components of one documented composite removal?","id":"unambiguous-removal-target-q02","kind":"boundary"}]}]},{"id":"extent-and-preservation","name":"Extent and preservation","description":"Record planned and achieved anatomical limits independently.","findings":[{"id":"extent-relative-to-target","name":"Extent relative to target","description":"Anchor extent labels to explicit anatomy and record intended preservation; thyroidectomy illustrates that removal can concern all or part of an organ. [MedlinePlus: Thyroid gland removal](https://www.medlineplus.gov/ency/article/002933.htm)","questions":[{"text":"Relative to which anatomical unit is removal described as partial, subtotal or total?","id":"extent-relative-to-target-q01","kind":"definition"},{"text":"What anatomical description or measurement establishes the achieved extent and the tissue retained?","id":"extent-relative-to-target-q02","kind":"measurement"}]}]}]},{"id":"removal-purpose-and-authority","name":"Removal purpose and authority","description":"Connect the irreversible anatomical change to its documented purpose and authorization.","layers":[{"id":"intended-benefit","name":"Intended benefit","description":"Identify what the removal is intended to accomplish.","findings":[{"id":"purpose-specific-success","name":"Purpose-specific success","description":"Separate removal completion from diagnostic, therapeutic or other intended benefit.","questions":[{"text":"What documented problem or objective motivates removing this target rather than retaining it?","id":"purpose-specific-success-q01","kind":"provenance"},{"text":"What outcome would establish success for this particular purpose, independently of whether tissue was removed?","id":"purpose-specific-success-q02","kind":"measurement"}]}]},{"id":"authorized-removal-scope","name":"Authorized removal scope","description":"Match documented authority to the target and extent under consideration.","findings":[{"id":"scope-discrepancy-review","name":"Scope discrepancy review","description":"Record the applicable consent or other documented authority and route unclear extensions of removal for qualified review.","questions":[{"text":"Which record documents authorization for this anatomical target, laterality and intended extent?","id":"scope-discrepancy-review-q01","kind":"provenance"},{"text":"If the proposed or achieved removal exceeds that scope, who must review the discrepancy and what documented authority applies?","id":"scope-discrepancy-review-q02","kind":"action"}]}]}]},{"id":"removal-execution-and-evidence","name":"Removal execution and evidence","description":"Establish what happened and reconcile evidence of removed material.","layers":[{"id":"execution-history","name":"Execution history","description":"Track whether removal occurred and how it departed from the plan.","findings":[{"id":"actual-removal-event","name":"Actual removal event","description":"Record the removal component's occurrence, achieved target and changes separately from completion of the overall operation.","questions":[{"text":"Was removal performed, partly performed or abandoned before tissue removal, and which record establishes this?","id":"actual-removal-event-q01","kind":"provenance"},{"text":"Did a change in approach also change the target or extent, or only the means of access?","id":"actual-removal-event-q02","kind":"boundary"}]}]},{"id":"specimen-reconciliation","name":"Specimen reconciliation","description":"Connect removed material to operative claims while preserving gaps and conflicting descriptions.","findings":[{"id":"removed-material-traceability","name":"Removed material traceability","description":"Link specimen labels, anatomical origin and available measurements without assuming every ectomy produces an intact or examined specimen.","questions":[{"text":"Which specimen or disposition records correspond to each removed target, and were materials fragmented, pooled or unavailable for examination?","id":"removed-material-traceability-q01","kind":"provenance"},{"text":"Do specimen identity, quantity and laterality agree with the operative account, and what discrepancy needs reconciliation?","id":"removed-material-traceability-q02","kind":"measurement"}]}]}]},{"id":"residual-anatomy-and-consequences","name":"Residual anatomy and consequences","description":"Represent what remains after removal and what further assessment depends on it.","layers":[{"id":"residual-target-assessment","name":"Residual target assessment","description":"Distinguish retained anatomy, residual target tissue and evidence relevant to completeness.","findings":[{"id":"completion-versus-residual-disease","name":"Completion versus residual disease","description":"Keep extent of removal separate from residual disease assessment; capture margin findings when relevant to the indication. [NCI: Surgery for Primary Treatment](https://training.seer.cancer.gov/treatment/surgery/types/primary/)","questions":[{"text":"What tissue was intentionally retained, and what evidence suggests unintended residual target tissue?","id":"completion-versus-residual-disease-q01","kind":"measurement"},{"text":"Are margin findings applicable to this removal, and what can their sampling establish or leave unresolved?","id":"completion-versus-residual-disease-q02","kind":"boundary"}]}]},{"id":"functional-and-follow-up-dependencies","name":"Functional and follow-up dependencies","description":"Connect the resulting anatomy to documented functional changes and further care.","findings":[{"id":"removal-specific-follow-up","name":"Removal-specific follow-up","description":"Record assessed consequences of losing the target and link relevant replacement, reconstruction or monitoring decisions to their responsible clinical models.","questions":[{"text":"Which functional changes are expected or observed from this particular target and extent of removal, and on what evidence?","id":"removal-specific-follow-up-q01","kind":"measurement"},{"text":"Which unresolved removal findings require clinician review for monitoring, replacement support, reconstruction or consideration of further removal?","id":"removal-specific-follow-up-q02","kind":"action"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-confidence-notes","name":"Check these first","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these check these first hold for the sense of ectomy this model covers, and on what evidence?","id":"evidence-confidence-notes-q01","kind":"provenance"}]},{"id":"evidence-kinds","name":"Kinds and varieties","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these kinds and varieties hold for the sense of ectomy this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these real-world use hold for the sense of ectomy this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of ectomy this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these regional variation hold for the sense of ectomy this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of ectomy this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Explain what a procedure name ending in -ectomy means.","Describe the general purpose and risks of a named excision from reliable medical sources."],"mustNot":["Present information as advice for a particular patient's surgery.","Disclose a person's surgery without their consent.","Encourage removal of healthy tissue for non-medical reasons without proper medical consent.","Assist in any surgical procedure outside a qualified setting."],"requiresHuman":["Any decision to remove tissue or an organ."]},"ethics":{"considerations":["Removal of organs is often irreversible, so informed consent is essential.","Some excisions have been forced on people, such as sterilisations; history demands care."],"affectedParties":["Patients","Families","Surgical teams"]},"owners":{"steward":"Nobody owns the term; the treating surgeon answers for each procedure.","roles":[],"masterSystems":[]},"relations":[{"target":"Q15636229","type":"parent","note":"registry parent class"},{"target":"Q23009442","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.ectomy","Wikidata: Q15636234 (https://www.wikidata.org/wiki/Q15636234)"]},"properties":{"applicability":"not-applicable","items":["Anatomical removal target: Link to organ, tissue, lesion or anatomical part, with site and laterality where applicable","Intended removal extent: Partial; subtotal; total; other explicitly described extent; unspecified, each relative to a named anatomical target","Achieved removal extent: Documented anatomical description plus relation to plan: matched; less extensive; more extensive; different target; unknown","Removal purpose: Diagnostic; therapeutic; risk-reducing; palliative; donation-related; other documented purpose; unknown; multiple allowed","Procedure occurrence: Proposed; scheduled; started; completed; stopped after partial removal; abandoned before removal; cancelled; uncertain","Removal quantity: Mass in g, dimensions in mm, volume in mL or count of specified structures when documented; include measurement method","Authorization coverage: Documented for target and extent; documented alternative authority; unclear; missing from available record; discrepancy requiring review","Completion evidence: Links to operative report, specimen record, pathology report or subsequent anatomical assessment, with author and date"]},"recognition":{"applicability":"not-applicable","items":[]},"capabilities":{"applicability":"required","items":["Classify a documented removal act and link it to a narrower procedure model when available.","Compare planned, authorized and achieved removal boundaries and flag discrepancies.","Reconcile operative descriptions with specimen and pathology records.","Represent retained anatomy and associated reconstruction without merging them into the removal act.","Identify missing evidence about completion, residual target tissue or removal-specific consequences.","Prepare a clinician-review summary of uncertainties and follow-up dependencies."]},"hazards":{"applicability":"required","items":["Surgical removal can cause bleeding, infection or injury to adjacent structures.","Removal of tissue or organs can cause lasting functional impairment.","Incorrect identification of the patient, anatomical site or intended extent of removal can cause irreversible harm.","Incomplete removal or inaccurate documentation can compromise subsequent treatment decisions."]},"interfaces":{"applicability":"required","items":["The ICD-10 Procedure Coding System, maintained by the United States Centers for Medicare and Medicaid Services, classifies inpatient surgical removals using categories including Excision and Resection according to the documented procedure."]},"context":{"applicability":"required","items":["Ectomy appears chiefly in names of operations that remove tissue or all or part of an organ.","It is encountered in surgical planning, consent documentation, operative reports and clinical coding, where the named structure and extent of removal determine its meaning."]}},"sources":[{"title":"Wikidata item Q15636234: ectomy","url":"https://www.wikidata.org/wiki/Q15636234","note":"identity and sense of the item"},{"title":"Wikipedia: Ectomy","url":"https://en.wikipedia.org/wiki/Ectomy","note":"general description of the item"}],"openQuestions":["Does the originating registry identifier confirm an action concept for ectomy, rather than a linguistic suffix or list of named procedures?","Does an existing world model already cover ectomy through excision or surgical removal, making this entry an alias?","Where should this registry draw boundaries around excisional biopsy, amputation and named -ectomies that remove non-tissue material?","Which terminology and procedure-coding systems should govern mappings, and how should differences in their definitions of excision and resection be preserved?","Does the intended scope include veterinary surgery and donation-related removal, and which target-specific models must supply functional consequences and follow-up criteria?"],"resources":{"spec":"/models/things/publications/thing-q15636234/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q15636234/spec.json"],"providers":["Codex"],"researchStatus":"unreviewed","generatedAt":"2026-09-12T09:24:52Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"not-applicable","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:26+00:00: completeness 1.00; sense: Wikidata description; 2 live sources; review by codex: pass","interaction.properties":"Plane ACT: no invented physical properties.","interaction.recognition":"Ectomy denotes a category of surgical procedures rather than an entity with a unique visual appearance."},"score":1.0}}