As early as the mummies unearthed in ancient Egypt, traces of head surgery can be found. And as early as 2000 years ago in China, some practical experience in surgery has been summarized from the practice of war, production and life. Modern surgery was pioneered at the end of the 19th century and was often performed by trained barbers as surrogates - the so-called "medical barbersurgeon" - hence the name "Mr." for surgeons in many of today's Commonwealth countries. Therefore, in many Commonwealth countries today, surgeons are referred to as "Mister" rather than "Doctor". At the beginning of the 20th century, modern surgery was deepened and refined with the development and advancement of techniques for sterilization, anesthesia, hemostasis, and blood transfusion. The foundation of modern surgery was laid in the 1840s, when the problems of surgical pain, wound infection, hemostasis, and blood transfusion were solved.
Surgical pain was one of the important factors hindering the development of surgery. 1846 Morton first adopted ether as a general anesthetic, and assisted Warren to use ether anesthesia to perform a lot of major surgery. Since then, ether anesthesia has been commonly used in surgery. 1892 German Schleich first advocated the use of cocaine for local infiltration anesthesia, but because of its high toxicity, soon to be replaced by procaine, so far procaine is still a safe and effective local anesthetic.
Wound "sepsis" was one of the most difficult problems faced by surgeons more than 100 years ago, when the mortality rate after amputation was as high as 40% to 50%. 1846 Semmelweis of Hungary firstly proposed to wash his hands with bleach before checking the women in labor, which led to a reduction in the mortality rate from 10% to 1% in the mothers he treated. In 1867, British Lister used carbolic acid solution to flush surgical instruments and covered the wounds with gauze soaked in carbolic acid solution to reduce the mortality rate of his amputation surgery from 40% to 15%, thus laying down the basic principles of antimicrobial surgery. 1877, German Bergmann made a study of 15 cases of penetrating knee injury. In 1877, Bergmann of Germany on 15 cases of penetrating knee injuries, only clean and disinfected around the wound that is to be bandaged, there are 12 cases of healing and preservation of the lower limbs, he believes that all wounds can not be regarded as infected, and not let the wounds to be stained again is more important. On this basis, he used steam sterilization, and studied the cloth sheets, dressings, surgical instruments and other sterilization measures, in modern surgery established asepsis. 1889 Germany Furbringer proposed the arm disinfection method, in 1890 the United States Halsted initiative to wear rubber gloves, so that asepsis is perfected. Surgical bleeding was also another important factor hindering the development of surgery. 1872 British Wells introduced hemostatic forceps, 1873 German Esmarch in the amputation of limbs advocating the use of tourniquet, they are the founder of the solution to the surgical bleeding. 1901 United States Landsteiner found that the blood type, from now on, available transfusion to compensate for the blood loss during surgery. Initially, the direct transfusion method, but the operation is complex, the amount of blood transfusion is not easy to control; in 1915, Lewisohn, Germany, put forward the mixing of sodium citrate solution, so that the blood does not coagulate indirect transfusion method, and later there is the establishment of the blood bank, so that the transfusion of simple and easy to implement.
In 1929, Fleming discovered penicillin, and in 1935, Domagk advocated the use of sulfonamides, after which a series of antimicrobial drugs were developed in various countries, which opened up a new era for the development of surgery. In addition to the continuous improvement of anesthesia, blood transfusion and rehydration of more and more attention, which further expanded the scope of surgery, and increased the safety of the operation. 50's, the success of the research of hypothermia anesthesia and extracorporeal circulation for the development of cardiac surgery opened the way to the development of the heart. 60's, due to the microsurgical technology, promote the advancement of the trauma, orthopedic surgery and transplantation. 70's since the various fiberoptic intracorporeal beam surgery, the development of the surgery of the heart, and the development of the surgery of the heart. Since the 1970s, the emergence of various fiber-beam endoscopes, coupled with the rapid development of imaging medicine (from B-mode ultrasound, CT, MRI, DSA to SPECT, PET) has greatly improved the diagnosis and treatment of surgical diseases; in particular, the development of interventional radiology, the application of micro catheters for super-selective vascular cannulation, not only the diagnosis, but also the treatment of the lesion deep into the internal structure. In addition, bioengineering technology is having a newer impact on medicine, and the progress of medical molecular biology, especially the study of oncogenes, has penetrated into the field of surgery. There is no doubt that surgery will eventually undergo dramatic changes on many fronts. With the rapid development of modern surgery in breadth and depth, it is no longer possible for a single surgeon to master all the knowledge and skills of surgery; in order to continue to improve, there must be a division of labor. Therefore, surgery to be further divided into a number of specialties; some by the part of the body, such as abdominal surgery, thoracic and cardiac surgery; some by the body's system, such as orthopedics, urology, cerebral neurosurgery, vascular surgery; some by the characteristics of the patient's age, such as pediatrics, geriatric surgery, some by the way of surgery, such as rehabilitation surgery, microsurgery, transplantation surgery; there are also according to the nature of the disease, such as oncological surgery, acute surgery, etc. Especially due to the increasing development of the scope of surgery, the requirements of anesthesia are increasing, there is a need for anesthesia specialties; the establishment of monitoring wards to achieve the same purpose.
The problems frequently dealt with in surgery encompass trauma, a variety of thoracic and abdominal emergencies, congenital/acquired malformations, malignant tumors, organ transplantation, etc., and are extremely closely related in their clinical application to the work of other medical specialties, such as anesthesiology, intensive nursing care, pathology, radiology, oncology, and so on. With the development of drugs, early diagnostic techniques and other medical technologies (e.g., interventional radiology), the treatment of many diseases has been transformed into non-surgical treatments. However, surgery is still an indispensable backline support for these treatments that are ineffective or produce complications, and the field of minimally invasive surgical procedures (endoscopic surgery) is also booming. (i) Injury Damage to human tissues caused by violence or other injury-causing factors, such as rupture of internal organs, fractures, burns, etc., most often requires surgery or other surgical treatments to repair tissues and restore function.
(2) infection microorganisms or parasites that cause disease invade the human body, resulting in damage to tissues, organs, destruction, necrosis and abscesses, this kind of confined infected lesions are suitable for surgical treatment, for example, removal of gangrenous appendix, incision and drainage of liver abscesses.
(3) Tumors The vast majority of tumors require surgical treatment. Resection of benign tumors has good efficacy; for malignant tumors, surgery can achieve radical cure, prolong survival time or relieve symptoms.
(4) malformations Congenital malformations, such as cleft lip and palate, congenital heart disease, anorectal atresia, etc., need surgery. Acquired deformities, such as scar contracture after burns, also need surgery to restore function and improve appearance.
(E) other nature of the disease common organ obstruction such as intestinal obstruction, urinary tract obstruction, etc.; blood circulation disorders such as varicose veins of the lower extremities, portal hypertension, etc.; stone formation, such as cholelithiasis, urinary stones, etc.; endocrine dysfunction, such as hyperthyroidism, and so on, also often need surgical treatment to be corrected.
Modern surgery, not only includes the diagnosis of the above diseases, prevention and treatment of knowledge and skills, but also to study the occurrence and development of disease law. For this reason, modern surgery necessarily involves experimental as well as natural science basis.
The scope of surgery is relative to that of internal medicine. As mentioned above, surgery is generally concerned with diseases requiring surgery or manipulation as the main treatment, while internal medicine is generally concerned with diseases to which drugs are applied as the main treatment. However, not all surgical diseases require surgery, but often require surgery at a certain stage of development, for example, septic infections are usually treated with drugs in the early stages, and incision and drainage are required only when an abscess is formed. And part of the internal medicine disease in its development to a certain stage also need surgery, for example, gastroduodenal ulcer caused by perforation or hemorrhage, often need surgery. Not only that, due to the progress of medical science, some of the original thought that should be surgical disease, has been able to change to non-surgical treatment, for example, most of the urinary tract stones can be applied to the extracorporeal shock wave, so that the stone crushed out. Some diseases that could not be operated originally have created effective surgical therapies, for example, most congenital heart diseases can be corrected surgically by applying cryoanesthesia or extracorporeal circulation. Especially due to the rapid development of interventional radiology, surgery has become more intertwined with internal medicine and other specialties. Therefore, with the development of medical science and the improvement of diagnostic and therapeutic methods, the scope of surgery will be constantly updated and changed.
Surgery is one of the subjects of modern medicine, which mainly studies how to use surgical methods to relieve the patient's pathogen, so that the patient can be treated. Surgery, like all clinical medicine, requires an understanding of the definition, etiology, manifestations, diagnosis, staging, treatment, and prognosis of disease, and it emphasizes the indications for surgery, preoperative evaluation and care, surgical techniques and methods, postoperative care, surgical complications, and prognosis, among other surgical-related issues.
Clinical surgery has a clear division of labor according to the different therapeutic goals, and can be divided into general surgery (now exclusively refers to a variety of abdominal, breast, thyroid, and simple skin surgery), cardiac surgery, thoracic surgery (the two can be referred to as cardiothoracic surgery), vascular surgery, neurosurgery (sometimes referred to as neurosurgery), head and neck surgery, urology, plastic surgery, orthopaedic surgery (i.e., orthopaedics), pediatric surgery, transplantation surgery, and so on. Surgery, Transplantation Surgery, etc. Surgery in a broader sense may also include ophthalmology, otorhinolaryngology, obstetrics and gynecology, dentistry (oral and maxillofacial surgery), and so on. Although modern surgery has been introduced to China for hundreds of years, it has been in a backward state in old China. Large hospitals with surgical equipment were located in a few large cities, and slightly larger operations such as major gastric resection, cholecystectomy or nephrectomy could only be performed in a few large hospitals in a few large cities; there were very few surgeons, and various surgical specialties were not yet formed. After the founding of the People's Republic of China, China's surgical science has established a relatively complete surgical system. China's provinces, autonomous regions and municipalities directly under the Central Government have higher medical schools, the surgical team continues to grow; surgical specialties such as anesthesiology, abdominal surgery, thoracic and cardiac surgery, orthopaedics, reconstructive surgery, urology, neurosurgery, and pediatric surgery, etc. have been established successively. Surgical technology has not only been popularized, but also significantly improved on the basis of popularization. In terms of popularization: China's county hospitals have surgical specialties, and their equipment and technical conditions are constantly improving; many grassroots hospitals below the county level are also carrying out surgical work. Improvement: New surgical fields such as cardiovascular surgery, microsurgical techniques, and organ surgery have been developing vigorously and have achieved promising results. In addition, important surgical instruments such as extracorporeal circulation machines, artificial kidneys, pacemakers, fiber-optic endoscopes, artificial blood vessels, artificial heart valves, artificial joints, as well as micro-vascular instruments, shock wave lithotripsy devices, etc. can be designed and produced in-house. As a result of the implementation of the Chinese medicine policy, the combination of Chinese and Western medicine has also made a lot of achievements in the field of surgery. Combination of Chinese and Western medicine has been used in the treatment of some surgical acute abdominal diseases, such as acute pancreatitis, bile duct stones, and adhesive intestinal obstruction, etc., and has gained good results. Combination of Chinese and Western medicine treatment of bone fracture application of static and dynamic principles, the use of small splints local external fixation, not only shorten the healing time of the fracture, but also restore the function of the limb. Others, such as internal hemorrhoids, anal fistula and vascular vasculitis, have achieved better results than Western medicine.
Since the founding of the People's Republic of China, the majority of surgical workers follow the direction of the people's services to the serious health hazards of the people's diseases and traumas, and do everything possible to rescue, and has made excellent results. Since 1985, successfully rescued a case of large-area burns workers, large-area burns rescue treatment level continues to improve, and there are many cases of third-degree burns more than 90% of the area of the cure reported. In 1963, after the first successful resuscitation of a worker's right forearm that had been severed for 6 hours, thousands of cases of severed fingers, palms, and limbs have been resuscitated all over China. Limb severed for as long as 36 hours, replanting of three-segmented upper limbs, and transplantation of allografts have all been successful, which is a leading position in the international arena. Over the years, Chinese surgeons have performed giant splenectomies on tens of thousands of late-stage schistosomiasis patients on both sides of the Yangtze River in simple operating rooms in the countryside in the areas where schistosomiasis is prevalent, left over from the old society, restoring their health and enabling them to return to productive work. The prevention and treatment of tumors has also been carried out rapidly, with hundreds of thousands to millions of people being surveyed for esophageal, stomach and breast cancers, which not only led to the early detection of these cancers, but also resulted in the investigation of the relationship between these cancers and various environmental factors in areas of high incidence, which has led to the introduction of new research topics. It must be recognized that every specialty in the world has undergone many studies and researches in ancient and modern times and at home and abroad, and has accumulated very rich information. Surgery is the same, all the history to relieve the patient's suffering and hard work of the surgical workers, the enrichment and improvement of foreign science have made a useful contribution, are worthy of people to inherit and learn. Surgery of Chinese medicine, Chinese medicine to surgery named the specialty began in the Song Dynasty. See the Song dynasty Wu Qi Yu "new book of surgery", for the deposit of surgical books. Before the Song dynasty, the surgical more to ulcer doctors and other names. Is the study of body surface disease cause, pathology, symptoms, diagnosis, treatment, medical technology and other specialized disciplines. Including carbuncle, gangrene, sores, ulcers, scabies, jock itch, wound folding and other diseases. After the Song Dynasty, the specialized works of such diseases are mostly known as surgery. About the origin of surgery
The surgical instruments used today are identical to those designed by a Muslim surgeon named Zahrawi in the tenth century. Another Arab doctor described the concept of blood circulation in the 13th century, 300 years earlier than William. Harvey 300 years earlier.