ReMed 2018 Remed 5 - Histoire de la Médecine | Page 6

Sciences de la Santé
Surgery: Under the Operating Light
Rihab FELLAH
Medicine has known in these last 200 years great leaps and many cutting-edge rev-
olutions that the contrast of these advancement with the ways of the past leaves
us in awe. Of the many medical fields that have changed drastically during this pe-
riod, surgery is in the lead. And so, on surgery the spotlight must fall today!
I
t is general knowledge that the history and future of
surgery faced a turning point in 1846 when ether anes-
thesia was introduced 1 . Indeed pain has always been a
great obstacle in the face of surgical advancement 1, 2 . Not
only does it worsen patient’s comfort, it is also deeply
related to the outcome of the intervention. Pathophys-
iologically speaking, pain increases heart rate, systemic
vascular resistances and circulating catecholamines re-
sulting thus in an elevated risk of myocardial infarction,
stroke and bleeding among other complications. It may
alter neural sensitization in both the peripheral and cen-
tral nervous system which could lead to chronic pain
syndromes 2, 11 .

Surgeons thus were given a tool that could
help them in the operating theatre by extending their
operating time. It also lessened for the patient the
horror of being operated on in giving him the gift of
unconsciousness. It was the birth of anesthesia and
anesthesiology.
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Printemps 2018

In 1867, sepsis was also being dealt with. A
series of publications in the Lancet by Joseph Lister
(after whom Listeria monocytogenes was named by the
way) demonstrated the efficiency of using carbolic
acid as an antiseptic to prevent post-operative infec-
tion 1 . A few decades later, the wear of latex gloves was
introduced by Halstead 1 .
After these two major discoveries, diseases that have
always been an issue and to which medical treatment
gave mediocre results have found in surgery the salva-
tion of patient’s endeavors. Among those, there is the
common case of Gallbladder disease: cholelithiasis or
gallstones (stone in the gallbladder) and cholecystitis
(inflammation of the gallbladder).

It is a disease that predominates in the femi-
nine population and increases with age. It concerns a
small pouch annexed to the liver called the Gallblad-
der which stores bile and excretes it in the Duodenum.
This disease manifests often in a typical abdominal