Surgeons

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For other uses of "Surgery", see Surgery (disambiguation).

Surgery (from the Greekcheirourgia meaning "hand work") is the medical specialty that treats diseasesor injuries by operative manual and instrumental treatment. Surgeons are medical practitionerswho 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 of surgery

The earliest known surgical procedure is trepanation, also known as trephinning or trepanning, in which a hole is drilled or scraped into the skull, leaving the membrane around the brain intact. A trepanned cranium found near Kiev, Ukraine, is the oldest yet found, dating back to 7300-6220 BC. Trepanation attempts to address health problems that relate to abnormal intracranial pressure, and has been found in cultures around the world. Modern surgery has largely abandoned this practice, however.

Researchers have also uncovered an Ancient Egyptianmandible, dated to approximately 2750 BC, having 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 pyramidsalso led to the discovery of evidence of brain surgeryon a labourer, who continued living for two years afterwards.

The Edwin Smith papyrusis the oldest known surgical text, dating back to the 1600s BC, although it contains information dating back to 3000 BC. It is an ancient Egyptian textbook on surgery, and describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments.

Susrutha(about 400 BC) - also spelt Susrutaor Sushrutha - 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 North-West 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.

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, the Hippocratic Oathwarns physicians against the practice of surgery, specifiy that cutting persons laboring under the stone, i.e. lithotomy, an operation to relieve kidney stones, which was to be left to such persons as practice [it].

By the thirteenth century, many European towns were demanding that physicians have several years of study or training before they could practice. Surgery had a lower status than pure medicine, beginning as a craft tradition until Rogerius Salernitanuscomposed 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 Warswho were primarily concerned with amputation. Naval surgeons were often barber-surgeons, who combined surgery with their main jobs as barbers.

In London, an operating theatreor operating roomfrom the day before modern anaesthesiaor antisepticsurgery 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.

Before the advent of anaesthesia, 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 amputationsand external growth removals. In addition, the need for strict hygieneduring procedures was little understood, which often resulted in life threatening post-op infectionsin patients.

Beginning in the 1840s, surgery began to change dramatically in character with the discovery of effective and practical anaesthetic chemicals such as etherand 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 relaxantssuch as curareallowed 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 centurywith the rise of microbiologywith scientists like Louis Pasteurand innovative doctors who applied their findings like Joseph Listerdid the idea of strict cleanliness and sterile settings during surgery arise.

Development of modern surgery

In the United Kingdom, surgeons are distinguished from physicians by being referred to as "Mister." This tradition has its origins in the 18th century, when surgeons were barber-surgeonsand did not have a degree (or indeed any formal qualification), 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(RCS) 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 Collegesare entitled to call themselves Mister, Miss, Mrsor Ms.

In contrast, North American physicians and surgeons are always addressed as "Doctor."

Diseases that can be treated by surgery

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• Trauma
• Anatomical Abnormalities
• Disorders of function
• Inflammation
• Ischaemiaand infarction
• Metabolic disorders
• Neoplasia
• Other abnormalities of tissue growth, e.g. cysts, hyperplasiaor hypertrophy

Common surgical procedures

Of the eight most common surgical procedures in the US, four are obstetric:

• dental extraction,
• episiotomy,
• repair of obstetric laceration,
• cesarean section, and
• artificial rupture of the amniotic membrane.

According to 1996data 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.

• C. Walton Lillehei(first successful open heart surgery)
• Christiaan Barnard(cardiac surgery, first heart transplantation)
• Walter Freeman(lobotomy)
• Sir Victor Horsley(neurosurgery)
• Lars Leksell(neurosurgery, inventor of radiosurgery)
• Joseph Lister(discoverer of surgical sepsis, Listerinenamed in his honour)

See also (surgeries)

• List of surgical procedures
• Abdominal surgery
• Dental surgery
• Oral and Maxillofacial Surgery
• Eye surgery
• Orthopedic surgery
• General surgery
• Laparoscopic surgery
• Plastic surgery
• Remote surgery
• Sexual reassignment surgery
• Cardiac surgery

See also

• Biomaterial
• FACS
• Medicine
• Traumatology

External links

• History of Dentistry
• Interview with Dr. Zahi Hawass, Director of the Pyramids
• WikiMed, a wikiwith substantial information about surgery (in German)

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It uses material from the http://en.wikipedia.org/wiki/Surgeons Wikipedia article Surgeons.