The Historical Timeline of Surgery

Surgery as we know it today wasn’t truly invented until the late 1800s; even then, infection was common, and outcomes were generally poor. Early techniques were primitive—even barbaric by today’s standards. Anesthesia was not used until the mid-1800s.

Even so, what was learned from centuries of trial and error, research, and experimentation led to procedures that are not only commonplace today but highly effective and safe.

These advances continue as robotic surgery, laser surgery, and microsurgery allow surgeons to treat conditions once thought untreatable. These advances have helped ensure that recovery times are shorter, hospitalization stays are fewer, outcomes are improved, and complications are minimized.

This article provides a timeline of notable surgeries and medical advances from the Stone Age through the early 2020s.

Before the 19th Century

The concept of surgery was explored well before recorded history, with early surgeons grasping the basic concepts of human anatomy and organ systems. Among some of the notable findings:

• Stone Age: The oldest known surgery is a leg amputation performed on a child on the island of Borneo around 31,000 years ago.
• 6500 BCE: Skulls found in France show signs of a rudimentary surgery called trepanation (or trephination), which involves drilling a hole in the skull.
• 1750 BCE: The Code of Hammurabi, one of the earliest Babylonian codes of laws, details regulations governing surgeons, medical malpractice, and victim’s compensation.
• 1550 BCE: The Ebers Papyrus, an ancient Egyptian medical treatise, includes information on how to surgically treat crocodile bites and serious burns.
• 600 BCE: Sushruta, regarded as the “founding father of surgery,” is an innovator of plastic surgery, including rhinoplasty.
• 950: The Arab physician Abulcasis draws on the knowledge of earlier Arab, Greek, and Roman physicians and expands the practice of surgery, even inventing new surgical instruments. His writings on surgery remain influential for several centuries.
• 1363: French surgeon and papal physician Guy de Chauliac writes “Chirurgia Magna” (Great Surgery), regarded as the standard text for surgeons until well into the 17th century.
• 1540: English barbers and surgeons unite to form the United Barber-Surgeons Company. These “barber surgeons” perform tooth extractions and bloodletting.
• 1630: Wilhelm Fabry, known as “the Father of German Surgery,” is recognized as the first surgeon to employ amputation as a treatment for gangrene.

19th Century

Based on historical records, many regard the 19th century as the birth of modern surgery. It was a century marked by many “firsts,” the discoveries of which enabled many of the surgical procedures still in use today. Among some of the landmarks of the era:

• 1818: James Blundell performs the first transfusion of human blood.
• 1828: James Blundell performs the first transvaginal hysterectomy.
• 1843: Charles Clay performs the first abdominal hysterectomy.
• 1842: Ether is used for the first time as an anesthetic.
• 1846: The first public use of ether as anesthesia is demonstrated in a surgery performed at the Massachusetts General Hospital in Boston involving the removal of a neck tumor.
• 1855: Mary Edwards Walker graduates from medical school and becomes the first female surgeon in America.
• 1867: British surgeon Joseph Lister publishes “On the Antiseptic Principle in the Practice of Surgery” in the British Medical Journal, extolling the virtues of cleanliness in surgery. In this article, he discusses carbolic acid, one of the first agents used as a microbicide to disinfect surgical incisions and prevent postoperative infections.
• 1885: The first successful appendectomy is performed in Iowa.
• 1893: Daniel Hale Williams, founder of the first Black-owned hospital in America, the Provident Hospital and Training School for Nurses, performs the first successful heart surgery to repair a defect in the pericardium, the membrane that encases the heart. Some do not regard this as “heart surgery” since the heart itself was not treated.
• 1895: Wilhelm Roentgen takes the first X-rays in Germany.
• 1896: The first successful open-heart surgery is performed in Germany to repair a stab wound in the muscle of the right ventricle.

20th Century

During the 20th century, major advances in surgery not only made surgery safer and more effective but enabled the treatment of a wider range of medical conditions, including the transplantation of organs. Among some of the key moments:

• 1905: Eduard Zirm performs the first successful cornea transplant.
• 1917: Harold Gillies performs the first documented modern plastic surgery on a burned English sailor.
• 1928: Alexander Fleming discovers penicillin, the first antibiotic, though it will take years to figure out how to purify it. It is first used in a human patient in 1941.
• 1931: Dora Richter undergoes a vaginoplasty (creation of a vagina) at the Institute for Sexual Science in Berlin, the last in a series of gender-affirming surgeries, and becomes the first known person to surgically transition from male to female.
• 1938: Philip Wiles performs the first metal hip replacement surgery.
• 1949: Jose Barraquer pioneers a surgical technique for reshaping the cornea to correct refractive errors such as nearsightedness (myopia) and farsightedness (hyperopia).
• 1950: Richard Lawler performs the first successful organ transplant, giving a kidney to a patient with renal failure. Although the kidney was later removed due to graft rejection, the patient lived several more years.
• 1952: John Lewis and colleagues perform the first successful heart surgery in which the heart is stopped and restarted.
• 1953: John Gibbon performs the first surgery to successfully use a heart-lung bypass machine. Patients hadn’t survived earlier attempts.
• 1954: Joseph Murray at Peter Bent Brigham Hospital in Boston (now part of Brigham and Women’s Hospital) performs the first successful living donor kidney transplant in which the donor is the recipient’s identical twin.
• 1959: John Merrill, also at Peter Bent Brigham Hospital, performs a living donor kidney transplant in which the donor is the recipient’s fraternal (non-identical) twin.
• 1966: Richard Lillehei and William Kelly at the University of Minnesota perform the first successful pancreas transplant.
• 1967: After several attempts in which patients survived at most a few weeks, Thomas Starzl performed the first successful liver transplant at Colorado General Hospital (now part of the University of Colorado Hospital).
• 1967: South African surgeon Christiaan Barnard performs the first heart transplant surgery at the Groote Schuur Hospital in Cape Town.
• 1968: Lars Leksell of the Karolinska Institutet introduces the Gamma Knife, using gamma rays from 201 sources aimed at the same site to treat a pituitary tumor. It goes on to be used to treat many other brain tumors and lesions.
• 1969: Denton Cooley implants the first (temporary) artificial heart, developed by surgeon Domingo Liotta. This allows their patient to survive for 64 hours—long enough to procure a human heart for transplantation.
• 1978: Louise Brown, the first “test-tube” baby, is born in England. This is the first successful use of in vitro fertilization (IVF).
  
• 1980: Kurt Semm performs the first organ surgery—an appendectomy—using minimally-invasive laparoscopic (“keyhole”) surgery.
• 1982: William DeVries at the University of Utah Hospital implants the first permanent artificial heart, the Jarvik-7, named after its creator, former University of Utah doctor Robert Jarvik. The patient, who is already terminally ill, survives for several months.
• 1984: Loma Linda University surgeon Leonard Bailey performs the first cross-species infant heart transplant, transplanting a baboon heart into an infant born with a rare heart defect. The infant, popularly known as “Baby Fae,” only survives 21 days.
• 1985: Doctor Bailey performs the first successful infant-to-infant heart transplant in a baby with the same heart defect as Baby Fae. “Baby Moses,” Eddie Anguiano, has an informal reunion with Bailey at the Loma Linda University Children’s Hospital in 2014.
• 1985: The first documented robot-aided surgery is performed, using software created by Yik San Kwoh of Memorial Medical Center in Long Beach, California, to control an industrial robotic arm to help guide instruments for brain biopsies.
• 1990: Ioannis Pallikaris performs the first LASIK procedure at the University of Crete's Institute of Vision and Optics.
• 1994: John Adler and colleagues at Stanford Health Care first use the CyberKnife, which uses a combination of robotics and imaging for the treatment of intracranial tumors.
• 1999: A team of surgeons at the University of Louisville in Kentucky performs the first truly successful hand transplant.
  

21st Century

The words that arguably best describe surgery in the 21st century are “smaller” and “safer.” Every year, innovations are introduced that allow surgeries that once required lengthy hospital stays to be done on an outpatient basis. Among some of the landmarks of the 21st century thus far:

• 2000: The FDA approves the da Vinci robotic surgical system developed by Intuitive Surgical for use in laparoscopic gallbladder and reflux disease surgery. It is later approved for prostate surgery, coronary artery bypass, and other surgical procedures.
• 2001: A team led by David Levi performs the first abdominal wall transplant at the University of University of Miami.
• 2004: GV Rao and D. Nageshwar Reddy of the Asian Institute of Gastroenterology in Hyderabad, India, perform the first natural orifice transluminal endoscopic surgery (NOTES). They use this technique to perform a transgastric (through the stomach) appendectomy, in which tools are inserted through the mouth and down through the digestive system to remove a patient’s appendix with no external incisions.
• 2005: Isabelle Dinoire in Amiens, France, has the first partial face transplant
• 2008: Connie Culp has the first near-total face transplant performed at the Cleveland Clinic.
• 2010: A team led by Joan Pere Barret performs the world’s first full-face transplant in Barcelona, Spain.
• 2012: Doctors at the University of Gothenburg in Sweden perform the first uterus transplant.
• 2012: A team led by Susan Mackinnon of the Washington University School of Medicine in St. Louis, Missouri, performs the first successful nerve-transfer surgery to restore some hand function to a quadriplegic patient.
• 2014: In Sweden, the first baby is born to a woman with a transplanted uterus.
• 2014: A team led by André van der Merwe at Tygerberg Hospital in Cape Town, South Africa, performs the first successful penis transplant.
• 2022: Bartley Griffith performs the first transplant of a genetically modified pig’s heart into a human at the University of Maryland.
  
• 2023: Eduardo Rodriguez performs the first whole eye and partial face transplant is performed at NYU Langone Health—the first-ever whole eye transplant and the first combined surgery of this kind.

Summary

The first surgeries were performed thousands of years ago, before anesthesia was invented and before infection prevention measures were understood. Since then, extraordinary strides have been made in how surgery is performed and what types of surgeries are now possible (such as heart transplants). Newer surgical techniques have resulted in better outcomes, faster recoveries, less pain, and longer life expectancies for patients.