Under the Knife: A History of Surgery in 28 Remarkable Operations

by Arnold van de Laar

The distal gastrectomy procedure used today is therefore known in full as the ‘Roux-en-Y Billroth II’ – a strange name for an operation that is still performed regularly.

Because iodine is mainly present in seawater, iodine deficiency is usually prevalent in countries that are far from the sea and in people living in mountainous areas.

Before Billroth settled in Vienna, he had been a professor in Switzerland. He had tried his hand at resecting goitres, but almost 40 per cent of his patients died, so he stopped

Later, Kocher tried it and, by 1895, his precise approach to surgery had reduced the mortality rate to less than 1 per cent.

In the American Wild West, William Halsted was once a cowboy among surgeons. He saved his own sister from blee...

And it was William Halsted who introduced rubber gloves into surgery. He died in 1922 after an operation on his gall bladder performed by his own students.

The only structures that cannot (as yet) be repaired surgically are the spinal cord and the optic nerve. All other tissues in our bodies appear to be able to withstand an assault by a surgeon.

Louis reigned for seventy-two years. His will was law; ‘L’état, c’est moi’ he is reputed to have said – ‘I am the state’. He was an arch-conservative despot who was responsible for the deaths of hundreds of thousands of soldiers and dissidents. Yet he revolutionised music, architecture, literature and fine art, and surrounded himself with the great creative minds of the Baroque

atherosclerosis.

He asked the king for six months to prepare and practised on seventy-five ‘regular’ patients before cutting open Louis’s fistula at seven o’clock in the morning of 18 November 1686. The monarch lay on his stomach in bed, with his legs spread

Louis left his bed after a month and was back on his horse three months later. He was not ashamed of his anal problem. The whole of France knew about it and had shared their monarch’s anxiety in the weeks of waiting. Fortunately, the king survived, proving that the operation had been a success. Wearing bandages in one’s trousers even became the fashion for a short time at the court in Versailles, in imitation of the brave king. The fistulotomy became known as La Grande Opération or La Royale. The story goes that Félix de Tassy was asked by at least thirty courtiers to perform the same operation, but had to disappoint

William Shakespeare wrote a farce, All’s Well that Ends Well, in which the French king’s fistula plays a central role. Songs and jokes appeared making fun of Louis’s fistula. Everyone was talking about it. The success of the fistulotomy exposed the lack of proficiency of doctors with their purgatives, rinses, potions and bloodletting. In the century after the royal operation, the popularity of surgeons reached unprecedented heights.

About a fifth of all the oxygen we need goes to our brains to supply the necessary electrical power.

But the French physicist discovered that the undesirable effects of the alternating current disappears if the frequency is sufficiently increased, to above 10,000 hertz. An electric knife is connected

Heat stems the flow of blood by converting the proteins in the blood and in the surrounding tissues from liquid to solid, just as the white of an egg solidifies when it is boiled. This specific property of protein is known as coagulation. When you do this with electricity,

Bovie’s electrocoagulation device has hardly changed in almost a century. It has been refined and made safer, and the circumstances in which it is used have to comply with much stricter requirements than in the pioneering age of Cushing.