The Historical Timeline of Surgery

The surgeries we recognize today often bear little resemblance to the surgical procedures used in centuries past. Even so, what was learned from centuries of trial and error, research and experimentation led to procedures that are not only commonplace today but highly effective and safe.

These advances continue as robotic surgery, laser surgery, and microsurgery allow surgeons to treat conditions once thought untreatable.

Surgery, as we know it today, did not truly begin until the late 1800s; even then, infection was common and outcomes were generally poor. Early techniques were rudimentary, and even barbaric, by today's standards given that anesthesia was not used until the mid-to-late 1800s.

Today, surgery takes a variety of forms and is often performed using minimally invasive techniques such as laparoscopy. These advances have helped ensure that recovery times are shorter, hospitalization stays are fewer, outcomes are improved, and complications are minimized.

To get a sense of how much surgery has changed, take a look at the timeline of major developments in the field.

Before the 19th Century

The concept of surgery was explored well before recorded history with early "surgeons" grasping the basic concepts of the human anatomy and organ systems. Among some of the notable findings:

• 6500 BCE: Skulls found in France show signs of a rudimentary surgery called trepanation, which involves drilling a hole in the skull.
• 1750 BCE: The Code of Hammurabi, one of the earliest Babylonian codes of laws, details regulation governing surgeons, medical malpractice, and victim's compensation.
• 1550 BCE: The Ebers Papyrus, an ancient Egyptian medical treaty, includes information on how to surgically treat crocodile bites and serious burns.
• 600 BCE: Sushruta, regarded as the "founding father of surgery," was an innovator of plastic surgery, including rhinoplasty.
• 950: Abulcasis, an Arab physician considered to among the greatest medieval surgeons, apparently learned many of his skills from Greek surgeons.
• 1363: French surgeon Guy de Chauliac writes Chirurgia Magna (Great Surgery), regarded as the standard text for surgeons until well into the 17th century.
• 1540: English barbers and surgeons unite to form the United Barber-Surgeons Company. These "barber-surgeons" performed tooth extractions and bloodletting.
• 1630: Wilhelm Fabry, known as "the Father of German Surgery," is recognized as the first surgeon to employ amputation as a treatment for gangrene.

19th Century

Based on historical records, many regard the 19th century as the "birth of surgery" as we know it. It was a century marked by many "firsts," the discoveries of which enabled many of the surgical procedures still in use today. Among some of the landmarks of the era:

• 1818: The first transfusion of human blood is performed.
• 1843: The first hysterectomy is performed in England.
• 1843: Ether is used for the first time as an anesthetic.
• 1846: The first public use of ether as anesthesia is demonstrated in a surgery performed at the Massachusetts General Hospital in Boston involving the removal of a neck tumor.
• 1855: Mary Edwards Walker graduates from medical school and becomes the first female surgeon in America.
• 1867: British surgeon Joseph Lister publishes Antiseptic Principle in the Practice of Surgery, extolling the virtues of cleanliness in surgery.
• 1885: The first successful appendectomy is performed in Iowa.
• 1890s: Carbolic acid is one of the first agents used as a microbicide to disinfect surgical incisions and prevent postoperative infections.
• 1893: First successful heart surgery is performed at Provident Hospital in Chicago to repair a defect in the lining of the heart (pericardium). Some do not regard this as "heart surgery" since the heart itself was not treated.
• 1895: The first X-ray is performed in Germany.
• 1896: First successful open-heart surgery is performed in Germany to repair a stab wound in the muscle of the right ventricle.

20th Century

In the 20th century, major advances in surgery not only made surgery safer and more effective but enabled the treatment of a wider range of medical conditions, including the transplantation of organs. Among some of the key moments:

• 1905: The first successful cornea transplant is performed.
• 1917: The first documented plastic surgery performed on a burned English sailor.
• 1928: Antibiotics are discovered.
• 1930: German has the first sex reassignment operation from male to female.
• 1940: The first metal hip replacement surgery is performed.
• 1950: The first LASIK eye procedure is performed in Colombia.
• 1950: The first successful organ transplant involving a kidney is performed, although the recipient dies a few months later of graft rejection.
• 1952: The first successful heart surgery is performed in which the heart is stopped and restarted.
• 1953: The first successful use of a heart-lung bypass machine is performed.
• 1954: The first successful living donor kidney transplant is performed in which the donor was the recipient's twin.
• 1966: The first successful pancreas transplant is performed.
• 1967: The first successful liver transplant is performed.
• 1967: The first heart transplant surgery is performed by South African surgeon Christian Barnard.
• 1975: The first organ surgery is performed using minimally-invasive laparoscopic ("keyhole") surgery.
• 1978: First "test-tube" baby is born using in vitro fertilization (IVF).
• 1982: The Jarvik-7 artificial heart used.
• 1984: A pediatric patient known as Baby Fae survives 21 days after being transplanted with the heart of a baboon.
• 1985: The first documented robotic surgery is performed.
• 1999: The first successful hand transplant is performed.
• 1999: The FDA clears the cyberknife, which uses a combination of robotics and imaging, for the treatment of intracranial tumors.

21st Century

The words that arguably best describe surgery in the 21st century are "smaller" and "safer." Every year, innovations are introduced that allow surgeries that once required lengthy hospital stays to be done on an outpatient basis. Among some of the landmarks of the 21st century thus far:

• 2000: The da Vinci robotic surgical system is approved by the U.S. Food and Drug Administration (FDA), the system of which is used for prostate surgery, coronary artery bypass, and other surgical procedures.
• 2007: The first natural orifice transluminal endoscopic surgery is performed in which tools are inserted through the mouth, nose, and other orifices to perform surgery without external incisions.
• 2008: Connie Culp has the first near-total face transplant performed at the Cleveland Clinic.
• 2010: The world's first full-face transplant is performed in Spain.
• 2011: The first successful transplant of a synthetic tissue-engineered windpipe is performed. The procedure involved a synthetic scaffolding onto which the recipient's own stem cells were implanted to "grow" a new windpipe.
• 2013: The first successful nerve-transfer surgery is performed in St. Louis, Missouri, giving a paraplegic individual the ability to move their hands.
• 2014:The first penis transplant is performed at Tygerberg Hospital in South Africa.
• 2016: The first uterus transplant is performed, again at the Cleveland Clinic

A Word From Verywell

Surgery continues to evolve, with science making great strides on an almost daily basis. As researchers explore newer improved surgical techniques, patients are likely to enjoy better outcomes, faster recoveries, and less pain. 

If faced with a complex surgery, it helps to know what newer procedures are available and if they are right for you. If in doubt about a surgical recommendation, do not hesitate to seek a second opinion from a specialist in the field.

The advent of telehealth has made seeking second options easier than ever, providing you the information and insights needed to make an informed choice.