History of Surgery: How is Surgery allied with Medical Sciences? -A General Introduction to the Undergraduate Medical Students explaining the Advent of Surgical Procedures, the Need for Surgery, the Evolution of surgery, the Basic Instincts for a Surgeon and the Future Prospects to be a Surgeon. The Story of : How the barber-surgeons became the Surgeons with Medical Knowledge and How Physicians were attracted to the Surgical Interventions and became the Modern Surgeons.

1. SURGERY :
GENERAL
AND
BASICS
Evolution of Surgery in Historical Perspective and Modern
Revolution in Surgical Specialities
22-09-2022

2. SURGERY!!!!!
WHAT IS THE NECESSITY TO DO SO?
• Dr. Lakshminarayanan Sadhasivan
MBBS (Madras Medical College),
MS (PGIMER, Chandigarh), DNB
• Assistant Professor
• Unit-II (Prof. Muthukumar Sir)
• Department of General Surgery
• SVMCH & RC

3. ANSWER
Wound
Swelling
Tumour

4. Excise Repair Reconstruct
Prevent
further

5. FAMOUS SAYINGS
• John Benjamin (JB) Murphy: Chicago, US
The patient is the Centre of Medical Universe around which all our works revolve
and towards which all our effort tend.

6. MURPHY

7. MURPHY’S EPONYMS
• Murphy’s Sign
• Murphy’s button: Suture-less anastomotic device for gallbladder with duodenum
• Murphy’s Punch: Punch Tenderness at Costo-vertebral angle in PERI-NEPHRIC
ABSCESS
• Murphy’s Drip: Administration of fluids by proctoclysis in peritonitis
• Murphy’s Test: Deep seated tenderness+ rigidity in PERI-NEPHRIC ABSCESS
• Murphy-Lane Bone Skid: Steel instrument for FEMORAL HEAD procedures

8. SIR WILLIAM OSLER
• To study the phenomenon of disease without books is to sail an UNCHARTED SEA,
While to Study books without practice is not to go to sea at all.
• Listen to your patient, he is telling you the diagnosis

9. OSLER EPONYMS
• Osler’s Nodules: Nodules over palms in Infective Endocarditis

10. SIR HARRY PLATT
• Royal College of Surgeons – President
• If You cannot make a diagnosis at-least make a decision.

11. IMPORTANCE OF ANATOMY
• Maldwyn Morgan – Anaesthetist , London, UK
• If the surgeon cuts a vessel knows the name
of that vessel, the situation is serious; if the
anaesthetist knows the name of that vessel,
the situation is irretrievable.

12. CLINICAL MEDICINE/SURGERY
•Two limbs
•Anatomy
•Etiopathology

13. 14TH CENTURY SURGERY
• Minimally Educated
• Procedures
• Lanced Abscesses
• Fixed Simple Fractures
• Dressed Wounds
• Extracted teeth
• Rare- Amputated Digit, Limb, Breast

14. 15TH CENTURY SURGEONS
• Ligated arteries for readily accessible aneurysms
(dilatation in vessel wall)
• Excised large visible tumours
• Performed Trephinations
• Devised indigenous methods to reduce hernias
• Created Colostomies and Ileostomies for Obstruction

15. PROBLEMS FOR ANCIENT SURGEONS
Knowledge
of
Anatomy
Control
Bleeding
Control
Infection
Control
Pain

16. DEALING WITH ANATOMY
• Cadaver dissection
• Learning from mistakes

17. ANDREAS VESALIUS
• Father of Modern Anatomy
• Italy
• De Humani Corporis Fabrica Lebri Septem
• Cadaver Dissection

18. JOHN HUNTER
• Father of Modern Surgery
• Hunter’s Canal
• Hunterian Ligation of Popliteal artery for aneurysm

19. HUNTERS

20. William Hunter- Brother of John Hunter
Obstetrician- Anatomy of Human Gravid Uterus

21. DEALING WITH BLEEDING
• Boiling Oil
• Heat
• Ligatures
• Modern Cautery- Bovie

22. AMBROISE PARE
• Father of Surgery – Western World
• Sushrutha- Ancient India
• Pare
• Army Surgeon
• Method to control bleeding

23. METHODS TO CONTROL BLEEDING BY
PARE
• Blend: Egg-Yolk+ Rose Oil+ Turpentine
• Method of Ligature

24. ELECTROCAUTERY
• Harvey Cushing- Father of Neurosurgery
• William Bovie- Engineer
• Alternating Current- generating heat and cauterisation

26. DEALING WITH PAIN
• Horace Wells- Nitrous Oxide
• William T G Morton & Charles Jackson- Sulfuric ether
• William Halsted- Cocaine+ Infiltration Anaesthesia- nerve block
• Spinal and Epidural – 1920s
• IV Sodium thiopental- 1934

28. DEALING WITH INFECTION
• Pasteur’s Germ Theory
• Joseph Lister- Carbolic acid
• Dipped his fingers in Phenol
• 1866
• FATHER OF ANTISEPTIC SURGERY

29. -INFECTION
• NO GLOVES TILL 1870s
• William Halsted: First used Glove- FATHER OF RADICAL SURGERIES
• India Rubber Works, Surrey, England- 1878- 1st manufactured gloves
• Jan Mikuliscz-Radecki : Single layered gauze mask
• His assistant – 2 layered cotton mask

30. REVOLUTIONARY RESEARCH
• X-ray: Wilhelm Roentgen-
• Frozen Section- pathology: Nicholas Senn
• Surgical Shock- definition and management: Alfred Blalock
• Pancreatico-duodenectomy: Allen Oldfather Whipple
• Decompression of Mechanical Bowel Obstruction with Suction apparatus:
Owen H Wangensteen

32. PIONEERS
• MICHEAL . E. DEBAKEY
• FATHER OF MODERN VASCULAR
• Vascular
• Cardio-thoracic
• Invented Dacron Graft

33. NOBEL LAUREATE SURGEONS
1. Theodor Kocher- 1909-Thyroid Gland Pathology
2. Allvar Gullstrand-1911- Opthal- Dioptrics of the eye
3. Alexis Carrel- 1912- Vascular suture- Father of Transplant Surgery
4. Robert Barany- 1914- ENT- Vestibular System
5. Fredrick Banting-1923- Insulin –Diabetes and hormonal association-Youngest
6. Walter Hess- 1949- Neuro- Mid Brain Function
7. Werner Forssmann- 1956- Cardiac Catheterisation
8. Charles Huggins- 1966- Role of Androgen hormone in Prostate Cancer
9. Joseph Murray- 1990- Organ Transplantation- Renal transplant-1954 Identical Twins

34. TRANSPLANT LANDMARKS
• 1st LIVER- 1963-TOM STARZL, US
• 1st PANCREAS+ KIDNEY-1966- RICHARD LILLEHEI & WILLIAM KELLY, US
• 1st HEART- 1967- CHRISTIAN BARNARD- Cape Town , SA
• 1st LUNG- 1968- FRITZ DEROM, Belgium
• 1st Pancreatic Islet Transplant- 1974- David Sutherland & John Nagarian, US
• 1st HEART+LUNG- 1981- BRUCE REITZ & NORMAN SHUMWAY, US
• 1st Lap Liver Donor Nephrectomy- 1995- Lloyd Ratner, US

35. • First Laparoscope- experimental animals- Georg Kelling

36. • 1st Video Lap. Cholecystectomy- 1987- Phillipe Mouret, France
• 1st Robot- Zeus System
• Trans-Atlantic Tele-Robotic Surgery
• US-France

37. ROBOT – MODERN DAY

39. WOMEN IN SURGERY
• 1st Head of Academic Surgery Department- 1987- Ohio State, US
Olga Jonasson
Renal Transplant Surgeon
First lady to perform transplant surgery in US

40. PRESENT SCENARIO

41. FUTURE

42. IMPORTANCE OF LEADERSHIP
•Rosalyn Carter- Ist Lady- US
•A leader takes people where they want
to go; A Great leader takes people where
they don’t necessarily want to go but
ought to be.

43. THANK YOU FOR PATIENCE
• lnss5@yahoo.com
• Provide Your Valuable Feed-Back
•