In the modern world we often think of surgery as a common thing. We have elective surgeries and expect to be safe and healthy after the surgeries. People will have surgeries and go home within hours but this hasn’t always been the case. Surgery during most of human history was a last resort that usually ended in the death of the patient and even now surgery is the most invasive of all medical procedures.
The evidence of the earliest surgeries are 10,000 years old .This process is call trephination and it involves cutting a hole in the skull. It is unknown how many of these surgeries were for medical reasons and how many were for religious reasons but the evidence that they happened all over the world for a period of nearly 5000 years and the evidence shows that many of the people who had trephination lived, sometimes for years after the surgery.
From the bronze age to the renaissance surgeons were considered tradesmen. Most surgeries were what we would now consider minor surgery limited to things close to the surface of the body. This is primarily because there was no anesthetic meaning that the patient was awake.
Barber surgeons were the most common doing surgery as almost a performance art. These surgeries were very quick often less than five minutes and they would do hundreds or thousands of these. A remarkable number when you consider how painful the surgeries must have been and how dangerous they were.
Anesthesia wasn’t the solution that they had hoped though. After long surgeries most patients died of massive infection. The surgery no longer hurt but they would almost certainly die and it continued to kill most patients until Joseph Lister who advocated for cleanliness. He was the one who convinced the Mayo bothers and many others that it was as important to wash your hands before surgery as afterwards and this simple change in surgical technique save thousands of lives as infection was cut dramatically. This allowed for surgery in the gut, the liver, the heart even the brain.
There was still one problem to overcome though. In order to do surgery they would have to cut people open with big incisions. In the 1980’s the idea of laparoscopy took hold. They were able to make small incisions that would allow surgeons to use small holes which people would heal far faster from.
With computers and robots increasingly entering the surgery rooms the future of surgery appears to include far less major incisions as more and more surgeries use laparoscopic techniques. Perhaps we will soon enter an era when the idea of major incisions for surgery will be considered as barbaric as cutting a hole in a person’s head to cure them of mental disorders.