General Surgery
A Focused History of Surgery
Built from Maingot's Abdominal Operations
What’s inside
13 sections · 92 slides
Overview
- Scope of this account
- Origin of the word surgery
Beginnings, before 1900
Wound care, the first planned abdominal operation, and the arrival of anaesthesia
- The Edwin Smith Surgical Papyrus
- The Edwin Smith Surgical Papyrus
- The first elective abdominal operation
- Portrait of Ephraim McDowell
- British and American landmarks after 1800
- The permanent opening into the stomach
- Ether anaesthesia, 16 October 1846
- The first public operation under ether
- First gallbladder operation and the appendix
- Billroth and the German schools
- Portrait of Theodor Billroth
- Nineteenth-century landmarks in order
The twentieth century in two halves
Why 1940 is the dividing line, and the order in which the organs are covered
- Two time spans and one route
Oesophagus
Removing the gullet, and learning to stop acid coming back up it
- First resection of the thoracic oesophagus
- Reflux described but not yet repaired
- From hiatal repair to fundoplication
- Fundoplication seen in the upper abdomen
- Development of reflux surgery
Stomach and duodenum
A century of ulcer surgery, undone by two tablets and one bacterium
- Peptic ulcer surgery before 1940
- Ulcer excision and the emptying problem
- Indications for operating on a peptic ulcer
- Operations for obstruction, and neostomal ulcer
- Patch repair and partial gastrectomy
- Dragstedt and the vagotomy era
- Gastric stasis and the drainage procedure
- Selective gastric vagotomy
- Vagotomy and its accompanying procedures
- Acid-suppressing drugs replace the operation
- Helicobacter pylori and peptic ulcer
- Three centuries, three kinds of understanding
- Surgery for extreme obesity
- Gastric bypass
- Roux-en-Y gastric bypass anatomy
Small intestine
The layer that holds a stitch, a new disease, and the rise of the stapler
- The submucosa and anastomotic strength
- Portrait of William Stewart Halsted
- Obstruction and regional ileitis
- From Murphy's button to mechanical staplers
- Moscow instruments and their spread
- How mechanical stapling developed
- Circular end-to-end anastomosis stapler
Colon and rectum
Removing the rectum, saving the anus, and building a new reservoir
- Combined excision of rectal tumours
- Stapling and anal preservation
- The ileal pouch
- Changing definitions of gut tumours
Liver and portal hypertension
Cutting a bleeding organ safely, and rerouting blood that cannot get through it
- Early hepatic resection for tumour
- The modern era of liver resection
- Couinaud's eight hepatic segments
- The eight segments of the liver
- Instruments for bloodless liver surgery
- Shunt surgery for portal hypertension
- Later shunt designs
- Current place of shunts and TIPS
- Choosing between shunt and TIPS
- Biliary atresia
Gallbladder and bile ducts
Taking the gallbladder out, and rebuilding a duct that has been damaged
- The first cholecystectomy
- Draining an obstructed common bile duct
- Tube conduits and their failure
- Mucosa-to-mucosa repair with a Roux limb
Pancreas, spleen and abdominal vessels
Draining and resecting the pancreas, removing the spleen, replacing the aorta
- Operations for chronic pancreatitis
- Neuroendocrine tumours of the pancreas
- Pancreatoduodenectomy
- Splenectomy for trauma
- Splenectomy for haematological disease
- Modern trends in splenic surgery
- Intraabdominal vascular surgery
Transplantation
Kidney, liver, pancreas and finally intestine - organ by organ
- The first kidney transplants
- A transplanted kidney in the pelvis
- Liver transplantation
- Pancreas and islet transplantation
- Intestinal transplantation
- Firsts in abdominal organ transplantation
Minimally invasive and endovascular surgery
Looking inside without opening up, and repairing an aorta from within
- Early inspection of the peritoneal cavity
- Laparoscope and the gas-filled abdomen
- The first laparoscopic cholecystectomy
- Basic and advanced laparoscopic procedures
- Laparoscopic operation in the operating theatre
- Robotics in abdominal surgery
- Endovascular repair of aortic aneurysm
- Abdominal aortic aneurysm on CT
Blood, fluids and feeding
The non-technical advances that made big operations survivable
- Maintaining blood volume
- Operating amphitheatre, 1904
- Storing and preserving blood
- Intraoperative and postoperative fluid therapy
- Salt, potassium and body composition
- Intravenous nutrition
- Growth since the first edition
- Points to carry away
- References
- References (continued)
- Maingot's Abdominal Operations, 12th Edition