Encyclopedia
Surgery is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment.
Surgeons may be
physicians,
dentists, or
veterinarians who specialize in surgery.
A
surgery can also refer to the place where surgery is performed, or simply the office of a physician,
dentist, or
veterinarian.
History
Ancient India
In 2001, archaeologists studying the remains of two men from Mehrgarh,
Pakistan, made the discovery that the people of
Indus Valley Civilization, even from the early
Harappan periods , had knowledge of medicine and dentistry. The physical anthropologist that carried out the examinations, Professor Andrea Cucina from the University of Missouri-Columbia, made the discovery when he was cleaning the teeth from one of the men . Later research in the same area found evidence of teeth having been drilled, dating back 9,000 years.
Indian physician Sushruta is an important figure in the history of surgery. He lived, taught and practiced his art of surgery on the banks of the
Ganges in the area that corresponds to the present day city of
Benares in
Northern India. Because of his seminal and numerous contributions to the science and art of surgery he is also known by the title "Father of Surgery". Much of what is known about this inventive surgeon is contained in a series of volumes he authored, which are collectively known as the
Susrutha Samhita. It is the oldest known surgical text and it describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments, as well as procedures on performing various forms of plastic surgery, such as cosmetic surgery and rhinoplasty.
Ancient Egypt
Researchers have uncovered an
Ancient Egyptian mandible, dated to approximately 2750 BC, with two perforations just below the root of the first molar, indicating the draining of an abscessed
tooth. Recent excavations of the construction workers of the
Egyptian pyramids also led to the discovery of evidence of
brain surgery on a labourer, who continued living for two years afterwards.
Ancient Greece
Surgeons are now considered to be specialised
physicians, the profession of surgeon and that of physician have different historical roots and surgeons have now even subspecialised as have physicians. For example, Greek tradition was against opening the body and the Hippocratic Oath warns physicians against the practice of surgery, specifically that
cutting persons laboring under the stone, i.e. lithotomy, an operation to relieve
kidney stones, was to be left to
such persons as practice [it]. Of course, most knowledge of surgery comes from
dissecting bodies, a science which was repulsive to many healers.
Medieval Europe
By the thirteenth century, many European towns were demanding that physicians have several years of study or training before they could practice. Montpellier,
Padua and
Bologna Universities were particularly interested in the academic side to Surgery, and by the fifteenth century at the latest, Surgery was a separate university subject to Physic. Surgery had a lower status than pure medicine, beginning as a craft tradition until Rogerius Salernitanus composed his
Chirurgia, which laid the foundation for the species of the occidental surgical manuals, influencing them up to modern times.
Among the first modern surgeons were battlefield doctors in the
Napoleonic Wars who were primarily concerned with
amputation. Naval surgeons were often barber-surgeons, who combined surgery with their main jobs as barbers.
In
London, an
operating theatre or
operating room from the day before modern
anaesthesia or
antiseptic surgery still exists, and is open to the public. It is found in the roof space of St Thomas Church, Southwark, London and is called the
Old Operating Theatre.
Surgery recently came under the domain of
robots .
Development of modern surgery
Before the advent of
anesthesia, surgery was a traumatically painful procedure and surgeons were encouraged to be as swift as possible to minimize patient suffering. This also meant that operations were largely restricted to
amputations and external growth removals. In addition, the need for strict hygiene during procedures was little understood, which often resulted in life threatening post-operative infections in patients.
Beginning in the 1840s, surgery began to change dramatically in character with the discovery of effective and practical anaesthetic chemicals such as
ether and
chloroform. In addition to relieving patient suffering, anaesthesia allowed more intricate operations in the internal regions of the human body. In addition, the discovery of muscle relaxants such as
curare allowed for safer applications.
However, the move to longer operations increased the danger of dangerous complications since the prolonged exposure of surgical wounds to the open air heightened the chance of infections. It was only in the late
19th century with the rise of
microbiology with scientists like
Louis Pasteur and innovative doctors who applied their findings like
Joseph Lister did the idea of strict cleanliness and sterile settings during surgery arise.
In the United Kingdom, Australia and New Zealand surgeons are distinguished from physicians by being referred to as "Mister." This tradition has its origins in the
18th century, when surgeons were barber-surgeons and did not have a degree , unlike
physicians, who were doctors with a university medical degree.
By the beginning of the
19th century, surgeons had obtained high status, and in 1800, the Royal College of Surgeons in London began to offer surgeons a formal status via RCS membership. The title
Mister became a badge of honour, and today only surgeons who hold the Membership or Fellowship of one of the Royal Surgical Colleges are entitled to call themselves Mister, Miss, Mrs or Ms.
In contrast, North American physicians and surgeons are always addressed as "Doctor."
Diseases that can be treated by surgery
- Trauma
- Anatomical Abnormalities
- Disorders of function
- Inflammation
- Ischaemia and infarction
- Metabolic disorders
- Neoplasia
- Other abnormalities of tissue growth, e.g. cysts, hyperplasia or hypertrophy
Common surgical procedures
- Of the eight most common surgical procedures in the US, four are obstetric:
- The most common non-obstetric surgeries include:
According to 1996 data from the US National Center for Health Statistics, 40.3 million inpatient surgical procedures were performed in the United States in 1996, followed closely by 31.5 million outpatient surgeries.
Noted surgeons
- For a more complete list, see List of surgeons.
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Surgeries
See also
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External links
