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Surgery | Definition, History, Type, & Techniques | Britannica
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sub-toc-drawer"></div></li></ul> <a class="toc-extra-link link-gray-900" href="https://www.britannica.com/science/surgery-medicine/additional-info">References & Edit History</a> <a class="toc-extra-link link-gray-900" href="/facts/surgery-medicine">Related Topics</a> </div> <div class="tlr-media-slider pb-10 mb-30"> <a class="section-header link-gray-900 font-serif font-14 font-weight-bold mb-10 mx-10" href="https://www.britannica.com/science/surgery-medicine/images-videos">Images & Videos</a> <div class="slider js-slider position-relative d-inline-flex align-items-center mw-100 "> <div class="slider-container js-slider-container overflow-hidden d-flex overflow-hidden text-nowrap ml-15"> <a href="https://cdn.britannica.com/86/143586-050-7D848222/team-surgery.jpg" data-href="/media/1/575155/147048" class="media-overlay-link d-inline-block mr-5"> <img loading="lazy" src="https://cdn.britannica.com/86/143586-004-1468A43A/team-surgery.jpg" alt="surgery" height="50" /> </a> <a href="https://cdn.britannica.com/25/131925-050-87501C61/ether-anesthesia-demonstration-William-Thomas-Green-Morton.jpg" data-href="/media/1/575155/160518" class="media-overlay-link d-inline-block mr-5"> <img loading="lazy" src="https://cdn.britannica.com/25/131925-004-58C1F2A3/ether-anesthesia-demonstration-William-Thomas-Green-Morton.jpg" alt="William Thomas Green Morton administering ether anesthesia" height="50" /> </a> <a href="/video/How-Does-Anesthesia-Work/278410" data-href="/media/1/575155/278410" class="media-overlay-link d-inline-block mr-5"> <div class="position-relative --aspect-ratio: 16/9"> <img loading="lazy" src="https://cdn.britannica.com/78/240878-138-E9CB8517/How-Does-Anesthesia-Work.jpg?w=400&h=225&c=crop" alt="anesthesia" class="col-100" /> <div class="btn btn-sm btn-white btn-circle position-absolute shadow" style="top: 50%; left:50%; transform: translate(-50%, -50%)"> <em class="material-icons font-14" data-icon="play_arrow" > </em> </div> </div> </a> <a href="https://cdn.britannica.com/30/10230-004-A30E0562/Joseph-Lister-1857.jpg" data-href="/media/1/575155/12638" class="media-overlay-link d-inline-block mr-5"> <img loading="lazy" src="https://cdn.britannica.com/30/10230-004-A30E0562/Joseph-Lister-1857.jpg" alt="Joseph Lister" height="50" /> </a> <a href="https://cdn.britannica.com/20/130320-050-57EDD079/Wilhelm-Conrad-Rontgen.jpg" data-href="/media/1/575155/161174" class="media-overlay-link d-inline-block mr-5"> <img loading="lazy" src="https://cdn.britannica.com/20/130320-004-82A65353/Wilhelm-Conrad-Rontgen.jpg" alt="Wilhelm Conrad Röntgen" height="50" /> </a> <a href="https://cdn.britannica.com/92/122092-050-1849DEC8/Autoclave-instruments.jpg" data-href="/media/1/575155/118502" class="media-overlay-link d-inline-block mr-5"> <img loading="lazy" src="https://cdn.britannica.com/92/122092-004-1586B4B4/Autoclave-instruments.jpg" alt="autoclave" height="50" /> </a> <a 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topicid="1750387">Ben Carson</a></dd> <dd><a href="/biography/Sanjay-Gupta" topicid="1497486">Sanjay Gupta</a></dd> </dl> <button class="js-more-btn d-none btn btn-unstyled font-12 bg-gray-50" aria-label="Toggle more/less fact data"> <em class="js-content link-blue">(Show more)</em> </button> </div> </div> <div class=""> <div class="js-fact mb-10 line-clamp clamp-3"> <dl> <dt>Related Topics: </dt> <dd><a href="/science/transplant-surgery" topicid="603059">transplant</a></dd> <dd><a href="/science/gender-affirming-surgery" topicid="2228496">gender-affirming surgery</a></dd> <dd><a href="/science/tracheotomy" topicid="674543">tracheotomy</a></dd> <dd><a href="/science/laparotomy" topicid="2111271">laparotomy</a></dd> <dd><a href="/topic/gastric-bypass-surgery" topicid="2146123">gastric bypass surgery</a></dd> </dl> <button class="js-more-btn d-none btn btn-unstyled font-12 bg-gray-50" aria-label="Toggle more/less fact data"> <em class="js-content link-blue">(Show more)</em> </button> </div> <div class="text-center"> <a class="btn btn-sm btn-link p-0" href="/facts/surgery-medicine"> See all related content </a> </div> </div> </div> </div><div class="bg-gray-50 p-15 rounded module-spacing recent-news d-flex flex-column float-false"> <div> <h2 class="font-weight-bold font-14 m-0 d-inline"> News <span class="text-gray-600">•</span> </h2> <div class="recent-news-item first-recent-news-item d-inline"> <a class="font-14 gtm-ap-news-link" href="https://www.cbc.ca/news/canada/manitoba/surgical-backlog-pandemic-recovery-manitoba-1.7370037" rel="nofollow">Surgical volumes hit high point last year, reducing backlog, but doctors say there's still work to do</a> <span class="font-14 text-gray-600"> <span>•</span> Nov. 1, 2024, 3:20 AM ET (CBC) <button class="btn btn-link d-inline p-0 font-12 js-toggle-recent-news"> <span class="text-gray-500">...</span><span>(Show more)</span> </button> </span> </div> </div> <div class="rest-of-recent-news-items"> <div class="recent-news-item mt-5"> <a class="font-14 gtm-ap-news-link" href="https://www.nytimes.com/2024/10/30/health/heart-valve-surgery-aortic-stenosis.html" rel="nofollow">Heart-Valve Patients Should Have Earlier Surgery, Study Suggests</a> <span class="font-14 text-gray-600"> <span>•</span> Oct. 30, 2024, 8:21 AM ET (New York Times) </span> </div> <button class="js-toggle-recent-news d-flex btn btn-unstyled font-14 pr-10 rounded-sm mt-10" aria-label="Toggle additional news items"> Show less <em class="material-icons" data-icon="expand_less"></em> </button> </div> </div><!--[BEFORE-ARTICLE]--><span class="marker before-article"></span><section data-level="1" id="ref1"><!--[PREMOD1]--><span class="marker PREMOD1 mod-inline"></span><p class="topic-paragraph"><strong><span id="ref253435"></span>surgery</strong>, branch of <a href="https://www.britannica.com/science/medicine" class="md-crosslink " data-show-preview="true">medicine</a> that is concerned with the treatment of injuries, <a href="https://www.britannica.com/science/human-disease" class="md-crosslink " data-show-preview="true">diseases</a>, and other disorders by manual and instrumental means. <a href="https://www.britannica.com/science/surgery-medicine" class="md-crosslink " data-show-preview="true">Surgery</a> involves the management of <a class="md-dictionary-link md-dictionary-tt-off mw" data-term="acute" href="https://www.merriam-webster.com/dictionary/acute" data-type="MW">acute</a> injuries and illnesses as <a class="md-dictionary-link md-dictionary-tt-off mw" data-term="differentiated" href="https://www.merriam-webster.com/dictionary/differentiated" data-type="MW">differentiated</a> from chronic, slowly progressing diseases, except when patients with the latter type of <a href="https://www.britannica.com/science/disease" class="md-crosslink autoxref " data-show-preview="true">disease</a> must be operated upon.</p><!--[MOD1]--><span class="marker MOD1 mod-inline"></span> <!--[PREMOD2]--><span class="marker PREMOD2 mod-inline"></span><p class="topic-paragraph">A general treatment of surgery follows. For further treatments, <em>see</em> <a href="https://www.britannica.com/science/therapeutics" class="md-crosslink " data-show-preview="true">therapeutics</a>; <a href="https://www.britannica.com/science/history-of-medicine" class="md-crosslink " data-show-preview="true">medicine</a>.</p><!--[MOD2]--><span class="marker MOD2 mod-inline"></span> </section> <!--[H2]--><span class="marker h2"></span><section data-level="1" id="ref6992"> <h2 class="h1">History</h2> <!--[PREMOD3]--><span class="marker PREMOD3 mod-inline"></span><div class="assemblies"><div class="w-100"><figure class="md-assembly m-0 mb-md-0 card card-borderless print-false" data-assembly-id="160518" data-asm-type="image"><div class="md-assembly-wrapper card-media " data-type="image"><a href="https://cdn.britannica.com/25/131925-050-87501C61/ether-anesthesia-demonstration-William-Thomas-Green-Morton.jpg" class="gtm-assembly-link position-relative d-flex align-items-center justify-content-center media-overlay-link card-media" data-href="/media/1/575155/160518"><picture><source media="(min-width: 680px)" srcset="https://cdn.britannica.com/25/131925-050-87501C61/ether-anesthesia-demonstration-William-Thomas-Green-Morton.jpg?w=300"><img src="https://cdn.britannica.com/25/131925-050-87501C61/ether-anesthesia-demonstration-William-Thomas-Green-Morton.jpg?w=300" alt="William Thomas Green Morton administering ether anesthesia" data-width="1600" data-height="1303" loading="eager"></picture><button class="magnifying-glass btn btn-circle position-absolute shadow btn-white top-10 right-10" aria-label="Zoom in"><em class="material-icons link-blue" data-icon="zoom_in"></em></button></a></div><figcaption class="card-body"><div class="md-assembly-caption text-muted font-14 font-serif line-clamp"><span><a class="gtm-assembly-link md-assembly-title font-weight-bold d-inline font-sans-serif mr-5 media-overlay-link" href="https://cdn.britannica.com/25/131925-050-87501C61/ether-anesthesia-demonstration-William-Thomas-Green-Morton.jpg" data-href="/media/1/575155/160518">William Thomas Green Morton administering ether anesthesia</a><span>William Thomas Green Morton administering ether anesthesia during the first successful public demonstration of its use during surgery, undated engraving.</span><button class="js-more-btn d-none btn btn-unstyled font-12 bg-white js-content" aria-label="Toggle more/less fact data"><span class="link-blue">(more)</span></button></span></div></figcaption></figure></div></div><p class="topic-paragraph">Surgery is as old as humanity, for anyone who has ever stanched a wound has acted as a surgeon. In some ancient civilizations surgery reached a rather high level of development, as in <a href="https://www.britannica.com/place/India" class="md-crosslink autoxref " data-show-preview="true">India</a>, China, Egypt, and Hellenistic Greece. In <a href="https://www.britannica.com/place/Europe" class="md-crosslink autoxref " data-show-preview="true">Europe</a> during the <a href="https://www.britannica.com/event/Middle-Ages" class="md-crosslink " data-show-preview="true">Middle Ages</a>, the practice of surgery was not taught in most universities, and ignorant barbers instead wielded the knife, either on their own responsibility or upon being called into cases by physicians. The organization of the <span id="ref253436"></span>United Company of Barber Surgeons of London in 1540 marked the beginning of some control of the qualifications of those who performed operations. This guild was the <a class="md-dictionary-link md-dictionary-tt-off mw" data-term="precursor" href="https://www.merriam-webster.com/dictionary/precursor" data-type="MW">precursor</a> of the Royal College of Surgeons of England.</p><a class="link-module shadow-sm d-block qa-quiz-module" href="/quiz/a-visit-with-the-word-doctor-medical-vocabulary-quiz" data-link-module-iframe-link=""> <img loading="lazy" src="https://cdn.britannica.com/28/254328-131-8CF54640/Yorkshire-terrier-dressed-as-doctor.jpg" alt="A Yorkshire terrier dressed up as a veterinarian or doctor on a white background. (dogs)" class="rounded-sm mr-15" width="70" /> <div class="line-clamp clamp-5"> <div class="module-title bg-green">Britannica Quiz</div> <div class="font-weight-semi-bold mt-5">A Visit with the Word Doctor: Medical Vocabulary Quiz</div> </div> </a><!--[MOD3]--><span class="marker MOD3 mod-inline"></span> <!--[PREMOD4]--><span class="marker PREMOD4 mod-inline"></span><div class="assemblies"><div class="w-100"><figure class="md-assembly m-0 mb-md-0 card card-borderless print-false" data-assembly-id="278410" data-asm-type="video"><div class="md-assembly-wrapper card-media " data-type="video" video-id="240878"><a data-id="240878" class="gtm-assembly-link d-flex justify-content-center" style="--aspect-ratio: 16/9" href="/video/How-Does-Anesthesia-Work/-278410"><img src="https://cdn.britannica.com/78/240878-138-E9CB8517/How-Does-Anesthesia-Work.jpg?w=800&h=450&c=crop" alt="anesthesia" loading="lazy"><script type="application/json"> { "sources": [ { "file" : "//content.jwplatform.com/manifests/HfxNXuzA.m3u8" } ], "image": "https://cdn.britannica.com/78/240878-138-E9CB8517/How-Does-Anesthesia-Work.jpg" ,"tracks": [ { "file" : "//assets-jpcust.jwpsrv.com/tracks/kLn7FwUg", "label": "English" } ] ,"adfile": "//content.jwplatform.com/manifests/dwfZOvQ7.m3u8" } </script><div class="btn btn-xl btn-white btn-circle position-absolute shadow" style="top: 50%; transform: translateY(-50%)"><em class="material-icons" data-icon="play_arrow"></em></div></a></div><figcaption class="card-body"><div class="md-assembly-caption text-muted font-14 font-serif line-clamp"><span><span class="md-assembly-title font-weight-bold mr-5 d-inline font-sans-serif md-video-caption" video-control="240878">anesthesia</span><span>How anesthesia works.</span><button class="js-more-btn d-none btn btn-unstyled font-12 bg-white js-content" aria-label="Toggle more/less fact data"><span class="link-blue">(more)</span></button></span></div><a class="font-14 mt-10 d-inline-block" href="/science/surgery-medicine/images-videos">See all videos for this article</a></figcaption></figure></div></div><p class="topic-paragraph">In the 18th century, with increasing knowledge of <span id="ref253437"></span><a href="https://www.britannica.com/science/anatomy" class="md-crosslink " data-show-preview="true">anatomy</a>, such operative procedures as <a href="https://www.britannica.com/science/amputation" class="md-crosslink " data-show-preview="true">amputations</a> of the extremities, excision of <a href="https://www.britannica.com/science/tumor" class="md-crosslink " data-show-preview="true">tumours</a> on the surface of the body, and removal of stones from the <a href="https://www.britannica.com/science/urinary-bladder" class="md-crosslink " data-show-preview="true">urinary bladder</a> had helped to firmly establish surgery in the medical curriculum. Accurate anatomical knowledge enabled surgeons to operate more rapidly; patients were sedated with <a href="https://www.britannica.com/science/opium" class="md-crosslink " data-show-preview="true">opium</a> or made drunk with alcohol, tied down, and a leg <a href="https://www.britannica.com/science/amputation" class="md-crosslink autoxref " data-show-preview="true">amputation</a>, for example, could then be done in three to five minutes. The <a href="https://www.britannica.com/science/pain" class="md-crosslink " data-show-preview="true">pain</a> involved in such procedures, however, continued to limit expansion of the field until the introduction of <a href="https://www.britannica.com/science/ether-chemical-compound" class="md-crosslink " data-show-preview="true">ether</a> <span id="ref253438"></span><a href="https://www.britannica.com/science/anesthesia" class="md-crosslink " data-show-preview="true">anesthesia</a> in 1846. The number of operations thereafter increased markedly, but only to <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="accentuate" href="https://www.britannica.com/dictionary/accentuate" data-type="EB">accentuate</a> the frequency and severity of “surgical <span id="ref253439"></span><a href="https://www.britannica.com/science/infection" class="md-crosslink ">infections</a>.”</p><!--[MOD4]--><span class="marker MOD4 mod-inline"></span> <!--[PREMOD5]--><span class="marker PREMOD5 mod-inline"></span><div class="assemblies"><div class="w-100"><figure class="md-assembly m-0 mb-md-0 card card-borderless print-false" data-assembly-id="12638" data-asm-type="image"><div class="md-assembly-wrapper card-media " data-type="image"><a href="https://cdn.britannica.com/30/10230-004-A30E0562/Joseph-Lister-1857.jpg" class="gtm-assembly-link position-relative d-flex align-items-center justify-content-center media-overlay-link card-media" data-href="/media/1/575155/12638"><picture><source media="(min-width: 680px)" srcset="https://cdn.britannica.com/30/10230-004-A30E0562/Joseph-Lister-1857.jpg?w=300"><img src="https://cdn.britannica.com/30/10230-004-A30E0562/Joseph-Lister-1857.jpg?w=300" alt="Joseph Lister" data-width="216" data-height="300" loading="eager"></picture><button class="magnifying-glass btn btn-circle position-absolute shadow btn-white top-10 right-10" aria-label="Zoom in"><em class="material-icons link-blue" data-icon="zoom_in"></em></button></a></div><figcaption class="card-body"><div class="md-assembly-caption text-muted font-14 font-serif line-clamp"><span><a class="gtm-assembly-link md-assembly-title font-weight-bold d-inline font-sans-serif mr-5 media-overlay-link" href="https://cdn.britannica.com/30/10230-004-A30E0562/Joseph-Lister-1857.jpg" data-href="/media/1/575155/12638">Joseph Lister</a><span>Joseph Lister, 1857.</span><button class="js-more-btn d-none btn btn-unstyled font-12 bg-white js-content" aria-label="Toggle more/less fact data"><span class="link-blue">(more)</span></button></span></div></figcaption></figure></div></div><p class="topic-paragraph">In the mid-19th century the French microbiologist <span id="ref253440"></span><a href="https://www.britannica.com/biography/Louis-Pasteur" class="md-crosslink " data-show-preview="true">Louis Pasteur</a> developed an understanding of the relationship of bacteria to infectious diseases, and the application of this theory to wound sepsis by the British surgeon <span id="ref78661"></span><a href="https://www.britannica.com/biography/Joseph-Lister-Baron-Lister-of-Lyme-Regis" class="md-crosslink " data-show-preview="true">Joseph Lister</a> from 1867 resulted in the technique of <span id="ref78662"></span><a href="https://www.britannica.com/science/antiseptic" class="md-crosslink " data-show-preview="true">antisepsis</a>, which brought about a remarkable reduction in the mortality rate from wound infections after operations. The twin emergence of anesthesia and antisepsis marked the beginning of modern surgery.</p><!--[MOD5]--><span class="marker MOD5 mod-inline"></span> <!--[PREMOD6]--><span class="marker PREMOD6 mod-inline"></span><div class="assemblies"><div class="w-100"><figure class="md-assembly m-0 mb-md-0 card card-borderless print-false" data-assembly-id="161174" data-asm-type="image"><div class="md-assembly-wrapper card-media " data-type="image"><a href="https://cdn.britannica.com/20/130320-050-57EDD079/Wilhelm-Conrad-Rontgen.jpg" class="gtm-assembly-link position-relative d-flex align-items-center justify-content-center media-overlay-link card-media" data-href="/media/1/575155/161174"><picture><source media="(min-width: 680px)" srcset="https://cdn.britannica.com/20/130320-050-57EDD079/Wilhelm-Conrad-Rontgen.jpg?w=300"><img src="https://cdn.britannica.com/20/130320-050-57EDD079/Wilhelm-Conrad-Rontgen.jpg?w=300" alt="Wilhelm Conrad Röntgen" data-width="1123" data-height="1600" loading="eager"></picture><button class="magnifying-glass btn btn-circle position-absolute shadow btn-white top-10 right-10" aria-label="Zoom in"><em class="material-icons link-blue" data-icon="zoom_in"></em></button></a></div><figcaption class="card-body"><div class="md-assembly-caption text-muted font-14 font-serif line-clamp"><span><a class="gtm-assembly-link md-assembly-title font-weight-bold d-inline font-sans-serif mr-5 media-overlay-link" href="https://cdn.britannica.com/20/130320-050-57EDD079/Wilhelm-Conrad-Rontgen.jpg" data-href="/media/1/575155/161174">Wilhelm Conrad Röntgen</a><button class="js-more-btn d-none btn btn-unstyled font-12 bg-white js-content" aria-label="Toggle more/less fact data"><span class="link-blue">(more)</span></button></span></div></figcaption></figure></div></div><p class="topic-paragraph"><a href="https://www.britannica.com/biography/Wilhelm-Rontgen" class="md-crosslink " data-show-preview="true">Wilhelm Conrad Röntgen</a>’s discovery of <a href="https://www.britannica.com/science/X-ray" class="md-crosslink " data-show-preview="true">X-rays</a> at the turn of the 20th century added an important diagnostic tool to surgery, and the discovery of <a href="https://www.britannica.com/science/blood-biochemistry" class="md-crosslink autoxref " data-show-preview="true">blood</a> types in 1901 by Austrian biologist <a href="https://www.britannica.com/biography/Karl-Landsteiner" class="md-crosslink " data-show-preview="true">Karl Landsteiner</a> made transfusions safer. New techniques of <span id="ref78663"></span><a href="https://www.britannica.com/science/anesthesiology" class="md-crosslink " data-show-preview="true">anesthesia</a> involving not only new agents for inhalation but also regional anesthesia accomplished by <a href="https://www.britannica.com/science/nerve-anatomy" class="md-crosslink autoxref " data-show-preview="true">nerve</a> blocking (spinal and local anesthesia) were also introduced. The use of positive pressure and controlled <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="respiration" href="https://www.britannica.com/dictionary/respiration" data-type="EB">respiration</a> techniques (to prevent the <a href="https://www.britannica.com/science/lung" class="md-crosslink " data-show-preview="true">lung</a> from collapsing when the pleural cavity was opened) made chest surgery practical and relatively safe for the first time. The intravenous administration (injection into the <a href="https://www.britannica.com/science/vein-blood-vessel" class="md-crosslink " data-show-preview="true">veins</a>) of anesthetic agents was also adopted. In the period from the 1930s to the 1960s, the replenishment of body fluids by intravenous infusion, the introduction of chemicals and <a href="https://www.britannica.com/science/antibiotic" class="md-crosslink " data-show-preview="true">antibiotics</a> to fight infection and to treat the metabolically disturbed body, and the development of <a href="https://www.britannica.com/science/heart-lung-machine" class="md-crosslink " data-show-preview="true">heart-lung machines</a> helped bring surgery to a state in which every body cavity, system, organ, and area could safely be operated on.</p><!--[MOD6]--><span class="marker MOD6 mod-inline"></span> </section> <!--[H3]--><span class="marker h3"></span><section data-level="1" id="ref6993"> <h2 class="h1">Present-day surgery</h2> <!--[PREMOD7]--><span class="marker PREMOD7 mod-inline"></span><p class="topic-paragraph">Contemporary surgical therapy is greatly helped by <span id="ref78664"></span><a href="https://www.britannica.com/technology/control-system" class="md-crosslink " data-show-preview="true">monitoring</a> devices that are used during surgery and during the postoperative period. <a href="https://www.britannica.com/science/blood-pressure" class="md-crosslink " data-show-preview="true">Blood pressure</a> and <a href="https://www.britannica.com/science/pulse-physiology" class="md-crosslink " data-show-preview="true">pulse</a> rate are monitored during an operation because a fall in the former and a rise in the latter give evidence of a critical loss of blood. Other items monitored are the heart <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="contractions" href="https://www.britannica.com/dictionary/contractions" data-type="EB">contractions</a> as indicated by <a href="https://www.britannica.com/science/electrocardiography" class="md-crosslink " data-show-preview="true">electrocardiograms</a>; tracings of <a href="https://www.britannica.com/science/brain" class="md-crosslink " data-show-preview="true">brain</a> waves recorded by <a href="https://www.britannica.com/science/electroencephalography" class="md-crosslink " data-show-preview="true">electroencephalograms</a>, which reflect changes in brain function; the <a href="https://www.britannica.com/science/oxygen" class="md-crosslink " data-show-preview="true">oxygen</a> level in <a href="https://www.britannica.com/science/artery" class="md-crosslink " data-show-preview="true">arteries</a> and veins; <a href="https://www.britannica.com/science/carbon-dioxide" class="md-crosslink " data-show-preview="true">carbon dioxide</a> partial pressure in the circulating blood; and respiratory volume and exchange. Intensive monitoring of the patient usually continues into the critical postoperative stage.</p><div class="module-spacing"> <DIV class="marketing-INLINE_SUBSCRIPTION marketing-content" data-marketing-id="INLINE_SUBSCRIPTION"><style> .student-promo-banner-wrapper { container-type: inline-size; margin-bottom: 15px; } @container (min-width: 475px) { .student-promo-banner { flex-direction: row; } .student-promo-banner-img-wrapper { margin-bottom: 0; margin-right: 10px; justify-content: flex-start; } .student-promo-banner-text-wrapper { text-align: left; margin-bottom: 0px; margin-left: 10px; } .student-promo-banner-button-wrapper { margin-right: 0; } }</style> <div class="student-promo-banner-wrapper"> <div class="student-promo-banner d-flex flex-column align-items-center bg-blue rounded p-20"> <div class="student-promo-banner-img-wrapper mb-20 mr-0 d-flex justify-content-center"> <img class="rounded" style="max-width: 100px; min-width: 80px" src="https://cdn.britannica.com/marketing/BlueThistle.webp" /> </div> <div class="student-promo-banner-text-wrapper ml-0 mb-10 text-center text-white"> <div class="h2 mb-10">Get Unlimited Access</div> <div class="h4 font-weight-semi-bold">Try Britannica Premium for free and discover more.</div> </div> <div class="student-promo-banner-button-wrapper d-flex justify-content-center align-items-center ml-auto mr-auto"> <a class="btn btn-m btn-orange" href="https://premium.britannica.com/premium-membership/?utm_source=premium&utm_medium=inline-cta&utm_campaign=black-friday-2024">Subscribe</a> </div> </div> </div> </DIV></div><!--[MOD7]--><span class="marker MOD7 mod-inline"></span> <!--[PREMOD8]--><span class="marker PREMOD8 mod-inline"></span><div class="assemblies"><div class="w-100"><figure class="md-assembly m-0 mb-md-0 card card-borderless print-false" data-assembly-id="118502" data-asm-type="image"><div class="md-assembly-wrapper card-media " data-type="image"><a href="https://cdn.britannica.com/92/122092-050-1849DEC8/Autoclave-instruments.jpg" class="gtm-assembly-link position-relative d-flex align-items-center justify-content-center media-overlay-link card-media" data-href="/media/1/575155/118502"><picture><source media="(min-width: 680px)" srcset="https://cdn.britannica.com/92/122092-050-1849DEC8/Autoclave-instruments.jpg?w=300"><img src="https://cdn.britannica.com/92/122092-050-1849DEC8/Autoclave-instruments.jpg?w=300" alt="autoclave" data-width="1600" data-height="1179" loading="eager"></picture><button class="magnifying-glass btn btn-circle position-absolute shadow btn-white top-10 right-10" aria-label="Zoom in"><em class="material-icons link-blue" data-icon="zoom_in"></em></button></a></div><figcaption class="card-body"><div class="md-assembly-caption text-muted font-14 font-serif line-clamp"><span><a class="gtm-assembly-link md-assembly-title font-weight-bold d-inline font-sans-serif mr-5 media-overlay-link" href="https://cdn.britannica.com/92/122092-050-1849DEC8/Autoclave-instruments.jpg" data-href="/media/1/575155/118502">autoclave</a><span>Autoclave used to sterilize medical instruments.</span><button class="js-more-btn d-none btn btn-unstyled font-12 bg-white js-content" aria-label="Toggle more/less fact data"><span class="link-blue">(more)</span></button></span></div></figcaption></figure></div></div><p class="topic-paragraph"><span id="ref78665"></span><a href="https://www.britannica.com/science/asepsis" class="md-crosslink ">Asepsis</a>, the freedom from contamination by pathogenic organisms, requires that all instruments and dry goods coming in contact with the surgical field be <span id="ref78666"></span><a href="https://www.britannica.com/science/sterilization-biochemistry" class="md-crosslink ">sterilized</a>. This is accomplished by placing the materials in an <a href="https://www.britannica.com/technology/autoclave" class="md-crosslink " data-show-preview="true">autoclave</a>, which subjects its contents to a period of steam under pressure. Chemical <a href="https://www.britannica.com/science/sterilization-medicine" class="md-crosslink autoxref " data-show-preview="true">sterilization</a> of some instruments is also used. The patient’s skin is sterilized by chemicals, and members of the surgical team scrub their hands and forearms with <a href="https://www.britannica.com/science/antiseptic" class="md-crosslink autoxref " data-show-preview="true">antiseptic</a> or <a href="https://www.britannica.com/technology/disinfectant" class="md-crosslink " data-show-preview="true">disinfectant</a> soaps. Sterilized gowns, caps, and masks that filter the team’s exhaled air and sterilized gloves of disposable plastic complete the picture. Thereafter, attention to avoiding contact with nonsterilized objects is the basis of maintaining asepsis.</p><!--[MOD8]--><span class="marker MOD8 mod-inline"></span> <!--[PREMOD9]--><span class="marker PREMOD9 mod-inline"></span><p class="topic-paragraph">During an operation, <span id="ref78667"></span><a href="https://www.britannica.com/science/hemostasis" class="md-crosslink ">hemostasis</a> (the arresting of bleeding) is achieved by use of the <span id="ref78668"></span>hemostat, a clamp with ratchets that grasps <a href="https://www.britannica.com/science/blood-vessel" class="md-crosslink " data-show-preview="true">blood vessels</a> or tissue; after application of hemostats, suture materials are tied around the <a href="https://www.britannica.com/science/bloodletting" class="md-crosslink autoxref " data-show-preview="true">bleeding</a> vessels. Absorbent sterile napkins called sponges, made of a variety of natural and <a class="md-dictionary-link md-dictionary-tt-off mw" data-term="synthetic" href="https://www.merriam-webster.com/dictionary/synthetic" data-type="MW">synthetic</a> materials, are used for drying the field. Bleeding may also be controlled by <span id="ref991793"></span>electrocautery, the use of an instrument heated with an <a href="https://www.britannica.com/science/electric-current" class="md-crosslink autoxref " data-show-preview="true">electric current</a> to cauterize, or burn, vessel tissue. The most commonly used instruments in surgery are still the scalpel (knife), hemostatic forceps, flexible tissue-holding forceps, wound retractors for exposure, crushing and noncrushing clamps for intestinal and vascular surgery, and the curved needle for working in depth.</p><!--[MOD9]--><span class="marker MOD9 mod-inline"></span> <!--[PREMOD10]--><span class="marker PREMOD10 mod-inline"></span><p class="topic-paragraph">The most common method of closing wounds is by <span id="ref78669"></span><a href="https://www.britannica.com/science/suture-surgery" class="md-crosslink ">sutures</a>. There are two basic types of suture materials; absorbable ones such as <span id="ref78670"></span><a href="https://www.britannica.com/technology/catgut" class="md-crosslink " data-show-preview="true">catgut</a> (which comes from sheep intestine) or synthetic substitutes; and nonabsorbable materials, such as nylon sutures, steel <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="staples" href="https://www.britannica.com/dictionary/staples" data-type="EB">staples</a>, or adhesive tissue tape. Catgut is still used extensively to tie off small blood vessels that are bleeding, and since the body absorbs it over time, no foreign materials are left in the wound to become a focus for disease organisms. Nylon stitches and steel staples are removed when sufficient healing has taken place.</p><!--[MOD10]--><span class="marker MOD10 mod-inline"></span> <!--[PREMOD11]--><span class="marker PREMOD11 mod-inline"></span><p class="topic-paragraph">There are three general techniques of wound treatment; <span id="ref78671"></span>primary intention, in which all tissues, including the <a href="https://www.britannica.com/science/human-skin" class="md-crosslink " data-show-preview="true">skin</a>, are closed with suture material after completion of the operation; <span id="ref78672"></span>secondary intention, in which the <a href="https://www.britannica.com/science/wound" class="md-crosslink " data-show-preview="true">wound</a> is left open and closes naturally; and <span id="ref78673"></span>third intention, in which the <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="wound" href="https://www.britannica.com/dictionary/wound" data-type="EB">wound</a> is left open for a number of days and then closed if it is found to be clean. The third technique is used in badly contaminated wounds to allow drainage and thus avoid the entrapment of microorganisms. Military surgeons use this technique on wounds contaminated by shell fragments, pieces of clothing, and dirt.</p><!--[MOD11]--><span class="marker MOD11 mod-inline"></span> <!--[PREMOD12]--><span class="marker PREMOD12 mod-inline"></span><p class="topic-paragraph">The 20th and 21st centuries witnessed several new surgical technologies to supplement the techniques of manual incision. <span id="ref78674"></span><a href="https://www.britannica.com/technology/laser" class="md-crosslink " data-show-preview="true">Lasers</a> became widely used to destroy tumours and other pigmented lesions, some of which are inaccessible by conventional surgery. They are also used to surgically weld detached <a href="https://www.britannica.com/science/retina" class="md-crosslink " data-show-preview="true">retinas</a> back in place and to coagulate blood vessels to stop them from bleeding. <span id="ref78675"></span><a href="https://www.britannica.com/science/stereotaxic-surgery" class="md-crosslink " data-show-preview="true">Stereotaxic surgery</a> uses a three-dimensional system of coordinates obtained by X-ray photography to accurately focus high-intensity radiation, cold, heat, or chemicals on tumours located deep in the brain that could not otherwise be reached. <span id="ref78676"></span><a href="https://www.britannica.com/science/cryosurgery" class="md-crosslink " data-show-preview="true">Cryosurgery</a> uses extreme cold to destroy warts and precancerous and cancerous skin <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="lesions" href="https://www.britannica.com/dictionary/lesions" data-type="EB">lesions</a> and to remove <a href="https://www.britannica.com/science/cataract-eye" class="md-crosslink " data-show-preview="true">cataracts</a>. Some traditional techniques of open surgery were replaced by the use of a thin flexible fibre-optic tube equipped with a light and a video connection; the tube, or <span id="ref78677"></span><a href="https://www.britannica.com/science/endoscopy" class="md-crosslink " data-show-preview="true">endoscope</a>, is inserted into various bodily passages and provides views of the interior of hollow organs or vessels. Accessories added to the endoscope allow small surgical procedures to be executed inside the body without making a major incision.</p><!--[MOD12]--><span class="marker MOD12 mod-inline"></span> <!--[PREMOD13]--><span class="marker PREMOD13 mod-inline"></span><p class="topic-paragraph">Preoperative and <span id="ref78678"></span>postoperative care both have the same object: to restore patients to as near their normal physiologic state as possible. <a href="https://www.britannica.com/science/blood-transfusion" class="md-crosslink " data-show-preview="true">Blood transfusions</a>, intravenous administration of fluids, and the use of measures to prevent common complications such as lung infection and <a href="https://www.britannica.com/science/coagulation-of-blood" class="md-crosslink autoxref " data-show-preview="true">blood clotting</a> in the legs are the principal features of postoperative care.</p><!--[MOD13]--><span class="marker MOD13 mod-inline"></span> <!--[PREMOD14]--><span class="marker PREMOD14 mod-inline"></span><p class="topic-paragraph">There are four major categories of surgery: (1) <span id="ref78679"></span><a href="https://www.britannica.com/science/wound" class="md-crosslink " data-show-preview="true">wound</a> <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="treatment" href="https://www.britannica.com/dictionary/treatment" data-type="EB">treatment</a>, (2) extirpative surgery, (3) reconstructive surgery, and (4) <a href="https://www.britannica.com/science/transplant-surgery" class="md-crosslink " data-show-preview="true">transplantation</a> surgery. The technical aspects of wound surgery, already partly discussed, centre on procuring good healing and the avoidance of infection. <span id="ref78680"></span><a href="https://www.britannica.com/science/extirpative-surgery" class="md-crosslink ">Extirpative surgery</a> involves the removal of diseased tissue or organs. <span id="ref78681"></span><a href="https://www.britannica.com/science/cancer-disease" class="md-crosslink " data-show-preview="true">Cancer</a> surgery usually falls into this category, with <a href="https://www.britannica.com/science/mastectomy" class="md-crosslink " data-show-preview="true">mastectomy</a> (removal of the breast), cholecystectomy (removal of the <a href="https://www.britannica.com/science/gallbladder" class="md-crosslink " data-show-preview="true">gallbladder</a>), and <a href="https://www.britannica.com/science/hysterectomy" class="md-crosslink " data-show-preview="true">hysterectomy</a> (removal of the <a href="https://www.britannica.com/science/uterus" class="md-crosslink " data-show-preview="true">uterus</a>) among the most frequent procedures. <span id="ref78682"></span><a href="https://www.britannica.com/science/reconstructive-surgery" class="md-crosslink ">Reconstructive surgery</a> deals with the replacement of lost tissues, whether from fractures, burns, or degenerative-disease processes, and is especially prominent in the practice of <a href="https://www.britannica.com/science/plastic-surgery" class="md-crosslink " data-show-preview="true">plastic surgery</a> and orthopedic surgery. <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="Grafts" href="https://www.britannica.com/dictionary/Grafts" data-type="EB">Grafts</a> from the patient or from others are frequently used to replace lost tissues. Reconstructive surgery also uses artificial devices (<span id="ref78683"></span><a href="https://www.britannica.com/science/prosthesis" class="md-crosslink " data-show-preview="true">prostheses</a>) to replace damaged or diseased organs or tissues. Common examples are the use of metal in reconstructing hip joints and the use of plastic valves to replace heart valves. <span id="ref78684"></span><a href="https://www.britannica.com/science/transplant-surgery" class="md-crosslink " data-show-preview="true">Transplantation</a> surgery involves the use of organs transplanted from other bodies to replace diseased organs in patients. <a href="https://www.britannica.com/science/kidney" class="md-crosslink " data-show-preview="true">Kidneys</a> are the most commonly transplanted organs.</p><div class="one-good-fact-module"> </div><!--[MOD14]--><span class="marker MOD14 mod-inline"></span> <!--[PREMOD15]--><span class="marker PREMOD15 mod-inline"></span><p class="topic-paragraph">The major medical specialties involving surgery are <span id="ref78685"></span>general surgery, plastic surgery, orthopedic surgery, <a href="https://www.britannica.com/science/obstetrics" class="md-crosslink " data-show-preview="true">obstetrics and gynecology</a>, neurosurgery, thoracic surgery, colon and rectal surgery, <a href="https://www.britannica.com/science/otolaryngology" class="md-crosslink " data-show-preview="true">otolaryngology</a>, <a href="https://www.britannica.com/science/ophthalmology" class="md-crosslink " data-show-preview="true">ophthalmology</a>, and <a href="https://www.britannica.com/science/urology" class="md-crosslink " data-show-preview="true">urology</a>. General surgery is the parent specialty and now centres on operations involving the <a href="https://www.britannica.com/science/stomach" class="md-crosslink autoxref " data-show-preview="true">stomach</a>, intestines, breast, blood <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="vessels" href="https://www.britannica.com/dictionary/vessels" data-type="EB">vessels</a> in the extremities, endocrine glands, tumours of soft tissues, and amputations. <span id="ref78686"></span><a href="https://www.britannica.com/science/plastic-surgery" class="md-crosslink " data-show-preview="true">Plastic surgery</a> is concerned with the bodily surface and with reconstructive work of the face and exposed parts. <span id="ref78687"></span><a href="https://www.britannica.com/science/orthopedics" class="md-crosslink " data-show-preview="true">Orthopedic surgery</a> deals with the bones, tendons, ligaments, and muscles; fractures of the extremities and congenital skeletal defects are common targets of treatment. Obstetricians perform <a href="https://www.britannica.com/science/cesarean-section" class="md-crosslink " data-show-preview="true">cesarean sections</a>, while gynecologists operate to remove tumours from the uterus and <a href="https://www.britannica.com/science/ovary-animal-and-human" class="md-crosslink " data-show-preview="true">ovaries</a>. Neurosurgeons operate to remove brain tumours, treat injuries to the brain resulting from skull fractures, and treat ruptured intravertebral disks that affect the <a href="https://www.britannica.com/science/spinal-cord" class="md-crosslink " data-show-preview="true">spinal cord</a>. Thoracic surgeons treat disorders of the lungs; the subspecialty of cardiovascular surgery is concerned with the <a href="https://www.britannica.com/science/heart" class="md-crosslink " data-show-preview="true">heart</a> and its major blood vessels and has become a major field of surgical endeavour. Colon and rectal surgery deals with disorders of the <a href="https://www.britannica.com/science/large-intestine" class="md-crosslink autoxref " data-show-preview="true">large intestine</a>. Otolaryngologic surgery is performed in the area of the <a href="https://www.britannica.com/science/ear" class="md-crosslink " data-show-preview="true">ear</a>, <a href="https://www.britannica.com/science/nose" class="md-crosslink " data-show-preview="true">nose</a>, and <a href="https://www.britannica.com/science/pharynx" class="md-crosslink autoxref " data-show-preview="true">throat</a> (e.g., tonsillectomy), while ophthalmologic surgery deals with disorders of the <a href="https://www.britannica.com/science/human-eye" class="md-crosslink " data-show-preview="true">eyes</a>. Urologic surgery treats diseases of the urinary tract and, in males, of the genital <a class="md-dictionary-link md-dictionary-tt-off eb" data-term="apparatus" href="https://www.britannica.com/dictionary/apparatus" data-type="EB">apparatus</a>.</p><!--[MOD15]--><span class="marker MOD15 mod-inline"></span> </section> <span class="md-signature"><a href="/editor/The-Editors-of-Encyclopaedia-Britannica/4419">The Editors of Encyclopaedia Britannica</a></span><span class="md-signature">This article was most recently revised and updated by <a href="/editor/Adam-Augustyn/6394">Adam Augustyn</a>.</span><!--[END-OF-CONTENT]--><span class="marker end-of-content"></span><!--[AFTER-ARTICLE]--><span class="marker after-article"></span></div> <div id="chatbot-root"></div> </div> </div> </div> <div class="ai-dialog-placeholder"></div> </div> </div> <aside class="col-md-da-320"></aside> </div> </div> </div> </div> </article></div> </div></div> </div> </main> <div id="md-footer"></div> <noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-5W6NC8" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript> <script type="text/javascript" id="_informizely_script_tag"> var IzWidget = IzWidget || {}; (function (d) { var scriptElement = d.createElement('script'); scriptElement.type = 'text/javascript'; scriptElement.async = true; scriptElement.src = "https://insitez.blob.core.windows.net/site/f780f33e-a610-4ac2-af81-3eb184037547.js"; var node = d.getElementById('_informizely_script_tag'); node.parentNode.insertBefore(scriptElement, node); } )(document); </script> <!-- Ortto ebmwprod capture code --> <script> window.ap3c = window.ap3c || {}; var ap3c = window.ap3c; ap3c.cmd = ap3c.cmd || []; ap3c.cmd.push(function() { ap3c.init('ZO4siT4cLwnykPnzZWJtd3Byb2Q', 'https://engage.email.britannica.com/'); ap3c.track({v: 0}); }); ap3c.activity = function(act) { ap3c.act = (ap3c.act || []); ap3c.act.push(act); }; var s, t; s = document.createElement('script'); s.type = 'text/javascript'; s.src = "https://engage.email.britannica.com/app.js"; t = document.getElementsByTagName('script')[0]; t.parentNode.insertBefore(s, t); </script> <script class="marketing-page-info" type="application/json"> {"pageType":"Topic","templateName":"DESKTOP","pageNumber":1,"pagesTotal":1,"pageId":575155,"pageLength":1687,"initialLoad":true,"lastPageOfScroll":false} </script> <script class="marketing-content-info" type="application/json"> [] </script> <script src="https://cdn.britannica.com/mendel-resources/3-130/js/libs/jquery-3.5.0.min.js?v=3.130.14"></script> <script type="text/javascript" data-type="Init Mendel Code Splitting"> (function() { $.ajax({ dataType: 'script', cache: true, url: 'https://cdn.britannica.com/mendel-resources/3-130/dist/topic-page.js?v=3.130.14' }); })(); </script> <script class="analytics-metadata" type="application/json"> {"leg":"A","adLeg":"A","userType":"ANONYMOUS","pageType":"Topic","pageSubtype":null,"articleTemplateType":"LARGE","gisted":false,"pageNumber":1,"hasSummarizeButton":false,"hasAskButton":false} </script> <script type="text/javascript"> EBStat={accountId:-1,hostnameOverride:'webstats.eb.com',domain:'www.britannica.com', json:''}; </script> <script type="text/javascript"> ( function() { $.ajax( { dataType: 'script', cache: true, url: '//www.britannica.com/webstats/mendelstats.js?v=1' } ) .done( function() { try {writeStat(null,EBStat);} catch(err){} } ); })(); </script> <div id="bc-fixed-dialogue"></div> </body> </html>