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Interesting Facts about Surgery

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Facts about Surgery

Surgery is any medical procedure that involves cutting a patient's body or closing a wound.

Elective Surgery is surgery that a patient elects (chooses) to have to help with non-life threatening conditions. Common kinds of elective surgery are hip replacement operations and knee replacements. All cosmetic surgery is elective.
Emergency surgery is any surgery that is urgently performed to save life- such as after a serious accident or following a heart attack.

History

Surgery has been performed since pre-historic times. Trepanation was a commonly performed surgery. It involved drilling or scraping a hole in the skull to relieve pressure on the brain.

Later, surgery developed to an advanced degree in Egypt, India, the Arab World and China.

The ancient Egyptians had very specialized surgeons. Each performed only one kind of surgery- whether it was eye surgery, dental surgery or intestinal surgery. A lot of writings survive describing the surgeries performed. There are even case histories of individual patients.

In Europe, barber surgeons were common but not always very successful. The most common operations that they performed were wound dressings and amputations (cutting off parts of the arms or legs) especially for soldiers or sailors hurt in battle. They practiced speed to minimize pain and could remove a leg in a few minutes. The image below is of a chart used by barber surgeons in the UK and indicates the kinds of wounds they would deal with.

Barber surgeon wound chart from the British Library.

Key Modern Advances in the History of Surgery

The biggest problems in early surgery were:
• pain caused to the patient (the shock alone could kill some people),
• bleeding (patients could bleed to death very quickly)
• Infection- blood poisoning and gangrene were common outcomes of surgery.

These problems were gradually solved in the nineteenth and twentieth centuries

Two American dental surgeons Horace Wells (1815-1848) and William Morton pioneered the use of nitrous oxide (laughing gas) and ether respectively as anesthetics (chemicals that stop someone feeling pain during an operation). There now many kinds of gases vapours and drugs used to ensure a patient is comfortable during surgery.

Joseph Lister in the UK developed ways to cut infection by sterilizing surgical instruments, hand washing and using a carbolic acid spray (see machine left) to kill germs in the air. Nowadays, air in operating theatres is carefully filtered to remove bacteria and a germ free area around the site of the operation (a sterile field) is maintained at all times. Modern antiseptics include betadine- the orange solution painted around operation sites prior to surgery.
Antibiotics such as Penicillin, developed in the 1930's, mean few people nowadays die from blood poisoning and other infections.
Research into the nature of blood- including the importance of blood groups- led to successful blood transfusions in the early twentieth century, These have reduced deaths from blood loss hugely.

Transplant operations.

Nowadays, many organs can be transplanted from a donor to a patient; these include hearts, livers, pancreas and kidneys as well as skin and body parts like hands and faces.

The main problem is that the patient's body will attack the new organ as a foreign body, if it is genetically different. Drugs are used to suppress this reaction. Sometimes organs are taken from close relatives. It is hoped in future to grow all organs in the laboratory from the patients own cells so rejection of this kind is no longer a problem. A successful windpipe transplant using a lab grown windpipe was carried out in 2008.

Timeline of Successful Transplant Operations

1905: cornea
1954 kidney
1966: pancreas
1967: liver
1967: heart
1981: heart/lung
1986 double-lung
1998: hand transplant
2005: partial face transplant
2008: full double arm transplant
2008: First baby was born from a transplanted ovary.[16]
2008: First transplant of a human windpipe grown from a patient's own stem cells

Minimally Invasive Surgery

All surgery is invasive. Any incision is traumatic for a patient. Minimally invasive surgery means doing as little damage as possible to the patient's body when operating. Incisions are kept as small. Special very small instruments- often with video cameras attached- are used to remove tumors etc or place devices like stents in place.

The surgeon controls the operation with a computer and may operate remotely. There is less chance of complications arising and people get recover more quickly. This approach is sometimes called keyhole surgery because of the size of the incision.

Laparoscopic and Thorascopic Surgery

Laparoscopic surgery is minimally invasive surgery in the stomach and pelvis. Thorascopic surgery is minimally invasive surgery in the chest.

A surgery robot.

Robotic Surgery

A robot is guided by a surgeon to perform an operation; the surgeon can be thousands of miles from the patient.

Virtual Surgery

Surgeons are increasingly been trained using interactive virtual surgery. Students can practice what is involved without endangering patients.

Practicing surgeons sometimes perform a 'dry run' of a complex operation using a 3d virtual model of the patient they will be working on. A graphic representation is built up from X-ray and CAT scan images of the area to be treated. The surgeon can then work out which approach will work best.

Surgery Games

Many online games offer insights into surgical techniques. Some of the best come with notes to help teachers prepare a lesson around a game. This site offers offers over twenty games: Operation Games Online, some educational, some just for fun.