History of the development of surgical instruments: from prehistoric times to the present day

Abstract

The purpose of this work is to highlight the historical path of development of surgical instruments from their historical origins to modern high-tech solutions in medicine and veterinary medicine. Surgical instruments have been made since the dawn of prehistoric times. Crude trephines for performing circular craniotomies have been found in Neolithic sites in many places. They are believed to have been used by shamans to exorcise evil spirits and to relieve headaches and head injuries caused by war wounds. A real explosion of new instruments occurred with the hundreds of new surgical procedures developed in the 19th century and the first decades of the 20th century. New materials such as stainless steel, chromium, titanium and vanadium became available for the manufacture of these instruments. Precision instruments for microsurgery in neurosurgery, ophthalmology and otology became possible, and in the second half of the 20th century, energy-based instruments such as electrocautery, ultrasonic and electric scalpels, surgical instruments for endoscopic surgery and, finally, surgical robots were first developed. Innovations in veterinary surgical instruments, from castration and wound care to bloodletting, dentistry, and more, laid the foundation for modern surgery. The basic surgical instruments for treating animals were well developed in Roman times: excavations have revealed scalpels, hooks, wires, probes, forceps, extraction forceps, lithotomes, trephines, and the Diocletian’s spoon of cyantiscus – a V-shaped instrument that could be inserted into a wound and opened to extract arrowheads – invented by Diocletian of Carystus in the fourth century BC. The 20th century saw unprecedented growth in surgical instrument technology due to significant technological breakthroughs. The introduction of minimally invasive instruments revolutionized surgery, allowing procedures to be performed through small incisions rather than large holes. At the turn of the 21st century, robotic surgery emerged, ushering in a new era in surgical instrument technology. Robotic systems, such as the Da Vinci Surgical System, provide surgeons with enhanced dexterity and precision that surpass human capabilities. These systems are designed to perform complex surgeries with minimal invasiveness through precise control of micro-instruments. This innovation has significantly improved patient safety by reducing the likelihood of human error, reducing infection rates, and providing more consistent surgical outcomes. Ongoing innovations in surgical instruments not only empower medical and veterinary professionals, but also underscore our shared goal of prioritizing patient safety and well-being.