History Of Surgery

History of SurgeryHistory of Surgery

An enlightening storyAn enlightening story

History of SurgeryHistory of Surgery

History :History : To know genesis & evolution of life, To know genesis & evolution of life,

society and human behaviorsociety and human behavior History History → progressive path to future→ progressive path to future To appreciate the commanding work To appreciate the commanding work

done by our forefathers and enthuse done by our forefathers and enthuse us to achieve higher goals in us to achieve higher goals in pursuance of excellencepursuance of excellence

Ancient HistoryAncient History

Earliest known – Trepanation Earliest known – Trepanation (trephining) Kiev – Ukraine – 7300 – (trephining) Kiev – Ukraine – 7300 – 6220 B.C6220 B.C

Ancient Egyptian pyramids – Ancient Egyptian pyramids – discovery of brain surgerydiscovery of brain surgery

Edwin Smith Papyrus – 1600 B.CEdwin Smith Papyrus – 1600 B.C

Susrutha – 400 B.C – Father of Susrutha – 400 B.C – Father of surgery Susrutha samhithasurgery Susrutha samhitha

Ancient Greek – Hippocrates & GalenAncient Greek – Hippocrates & Galen

Medieval SurgeryMedieval Surgery

Decline of surgery in the west by 13Decline of surgery in the west by 13thth centurycentury

Physicians higher statusPhysicians higher status

Barbers & monks – self qualified surgeonsBarbers & monks – self qualified surgeons

Medieval SurgeryMedieval Surgery

Rogerius Salernitanus -1180 A.D – Rogerius Salernitanus -1180 A.D – ChirurgiaeChirurgiae

Surgical therapy – amputations , Surgical therapy – amputations , drainage of abscess,scarification, drainage of abscess,scarification, leeching etcleeching etc

Ambroise Pare`Ambroise Pare`

John HunterJohn Hunter

Birth of modern surgeryBirth of modern surgery

Louis Pasteur > Germ theoryLouis Pasteur > Germ theory

Ignaz Semmelweis > Washing hands Ignaz Semmelweis > Washing hands → → ↓Puerperal sepsis↓Puerperal sepsis

Joseph Lister > Sterile surgeryJoseph Lister > Sterile surgery Principles of practice of surgery(March 16, Principles of practice of surgery(March 16,

1867) . “Father of modern antisepsis”1867) . “Father of modern antisepsis”

Birth of modern surgeryBirth of modern surgery

King Edward VII – “ I know that if it King Edward VII – “ I know that if it had not been for you and your work, I had not been for you and your work, I would not have been sitting here would not have been sitting here today”today”

T.G.Morton – Boston dentist -1846 T.G.Morton – Boston dentist -1846 >Anaesthesia>Anaesthesia

Modern SurgeryModern Surgery William Stewart Halsted(1852 – 1922)William Stewart Halsted(1852 – 1922)

1.sterile rubber gloves 1.sterile rubber gloves

2. new surgery, based on anatomic, 2. new surgery, based on anatomic, pathologic, and physiologic principles pathologic, and physiologic principles and employing animal and employing animal experimentation.experimentation.

William Stewart Halsted(1852 – 1922)William Stewart Halsted(1852 – 1922)

3. Modern operating theater.3. Modern operating theater.

4. Residency scheme of training 4. Residency scheme of training surgeonssurgeons

Theodore Billroth (1881)– gastrectomyTheodore Billroth (1881)– gastrectomy

Langenbuch (1882) – cholecystectomyLangenbuch (1882) – cholecystectomy

Synmonds (1883) - AppendicectomySynmonds (1883) - Appendicectomy

Modern SurgeryModern Surgery

4 major advancements in related 4 major advancements in related disciplines helped the advancement of disciplines helped the advancement of surgery are:surgery are:

1. Knowledge of Anatomy1. Knowledge of Anatomy

2. Discovery of Anaesthesia2. Discovery of Anaesthesia

3. Intraoperative haemostasis3. Intraoperative haemostasis

4. Concepts of asepsis 4. Concepts of asepsis

Modern SurgeryModern Surgery

2020thth century surgery land marks century surgery land marks Improved understanding of shockImproved understanding of shock

Knowledge of blood group & blood Knowledge of blood group & blood transfusion techniquestransfusion techniques

Understanding of blood clottingUnderstanding of blood clotting

Development of antibiotics & Development of antibiotics & analgesicsanalgesics

Modern SurgeryModern Surgery

Electrically powered surgical Electrically powered surgical instruments, surgical stapling instruments, surgical stapling instruments, surgical glues, tapes etc.instruments, surgical glues, tapes etc.

Xrays &scansXrays &scans

Cryogenic super cooled probesCryogenic super cooled probes

Ultrasonic devices, Medical LasersUltrasonic devices, Medical Lasers

Heart lung machines, hypothermia, Heart lung machines, hypothermia, transplantation of organstransplantation of organs

Modern SurgeryModern Surgery

Orthopaedics – cementing Orthopaedics – cementing substances, bone & joint replcementssubstances, bone & joint replcements

MicrosurgeryMicrosurgery

Minimally invasive surgeryMinimally invasive surgery

Vascular imaging, AngioplastyVascular imaging, Angioplasty

Surgical disordersSurgical disorders

TraumaTrauma Anatomical abnormalitiesAnatomical abnormalities Disorders of functionDisorders of function InflammationInflammation Ischaemia & infarctionIschaemia & infarction Metabolic disordersMetabolic disorders NeoplasiaNeoplasia Cysts, hyperplasia, hypertrophyCysts, hyperplasia, hypertrophy

According to 1996 data, US – National According to 1996 data, US – National centre for Health Statistics –40.3 centre for Health Statistics –40.3 million I.P surgeries &31.5 million million I.P surgeries &31.5 million O.P.surgeriesO.P.surgeries