A surgical procedure using instruments – or sometimes just the hands; for example, when manipulating a joint or setting a simple fracture. Operations range from simple removal of a small skin lesion under local anaesthetic to a major event such as transplanting a heart, which takes several hours and involves many doctors, nurses and technical staff. Increasingly, operations are done on an outpatient or day-bed basis, thus enabling many more patients to be treated than was previously the case, and permitting them to rapidly resume a normal life – often within 24 hours. (See also SURGERY; MINIMALLY INVASIVE SURGERY (MIS).)