Revolutionary Steps in Surgery

2 Nov 2022

Surgery dates back to, as early as 600 BC.
‘Sushruta Samhita’ is one of the oldest works in the
world dealing with surgery. It indicates that Sushruta
was probably the first surgeon to perform surgical
operations (plastic surgery). Later, some ancient surgeons
performed tooth extraction and bloodletting.
Major surgery could not develop for centuries
because of lack of knowledge and technology. The
doctors had to cut open the part of the body that was
not healthy, remove it or set right that part. This would
involve a lot of pain to the patient. General anaesthetics
like ether or chloroform developed only from mid -
nineteenth century making painless surgical operations
possible and successful.
Modern techniques are used nowadays for anaesthesia.
General anaesthesia benumbs the whole body, and it
is used for surgery of any region of the body. For local
anaesthesia, local anaesthetics are injected into the
surgical spot or an area near nerves.
Over the years now, revolutionary steps have been
taken in different types of complicated surgery and these
have made such operations successful.
Let us start with Cardiac surgery. Today, if you
need to have a heart surgery, you can choose from
many fine doctors. However, before 1893 this type of
surgery was unknown. Doctors did not have modern
medical tools and procedures, essential for heart surgery.
In those days heart patients were treated with sedatives
and they usually did not survive. Then in 1893 Daniel
Hale Williams, a young African American surgeon,
attempted a new medical technique in order to save a
patient’s life.
A patient, James Cornish, was suffering from a
very serious knife wound. The knife had cut an artery
less than an inch from his heart and punctured the
pericardium (the sack around the heart). Dr Williams
with six staff doctors, performed a complicated and
daring operation. Dr Williams became the first surgeon
to save his patient by successfully repairing the human
Now many more advanced techniques are used to
in this speciality, to deal with heart complications. Open
heart surgery, which can help to repair heart defects,
heart valves or even replace them, is also performed
successfully. With proper measures, patients can recover
from cardiac surgery faster than they did before.
Neurosurgery is another recent speciality to have
received recognition since the early 1900s. It is concerned
with the treatment of disorders of the nervous system.
Neurosurgeons operate on the brain, the spine or
nerves. They can treat patients of all ages, from the
new-born to the elderly, who have suffered a stroke.
Harvey Cushing (1869-1939) is considered to be
the father of modern neurological surgery. In the early
part of the 20th Century, he developed basic techniques
and instruments for operating on the brain as a distinct
surgical speciality. Cushing dramatically reduced the
mortality rate for neurosurgery from 90% to less than
10%. By the time of his retirement in 1937, he had
successfully removed more than 2000 tumours.
The main reason that mortality rates had been so
high before, was blood loss. Among Cushing’s significant
achievements are the methods he developed to stem
this blood loss by inventing a clip called ‘silver clip’
or ‘Cushing clip’.
Thus neurosurgery is one the most cutting edges
in the world of surgery and medicine.
What is Robotic Surgery?
Robotic surgery is a type of minimally invasive
surgery. ‘‘Minimally invasive’’ means that instead of
operating on patients through large incisions, use is
made of miniaturized surgical instruments, that fit
through a series of quarter-inch incisions. When
performing surgery with the Da Vinci, - the world’s
most advanced surgical robot - these miniaturized
instruments are mounted on three separate robotic arms,
allowing the surgeon maximum range of motion and
precision. The Da Vinci’s fourth arm contains a
magnified high-definition 3-D camera that guides the
surgeon during the procedure.
The surgeon controls these instruments and the
camera from a console, located in the operating room.
Placing his fingers into the master controls, he is ableto operate all four arms of the Da Vinci. While looking
through a stereoscopic high definition monitor, the robot
literally places the surgeon inside the patient. This gives
him a better, more detailed 3-D view of the operating
site, than the surgeon’s eye can provide. Every movement
he makes with the master controls is replicated
accurately by the robot. When necessary, the surgeon
can even change the scale of the robot’s movement. If
he selects a three-to-one scale, the tip of the robot's
arms will move just one inch for every three inches,
that surgeon’s hand moves.
Utilizing this advanced technology our surgeons are
able to perform a growing number of complex surgical
procedures. Since these procedures can now be performed
through very small incisions, our patients experience a
number of benefits compared to the open surgery of
the past.

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