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In the United States, over 48 million surgical procedures are carried out each year. Surgeries have become so routine that we often don’t think twice when hearing about someone undergoing an operation. Notably, 28 million of these are outpatient surgeries, where patients leave the hospital the same day. This normalization makes it easy to overlook how groundbreaking, risky, or transformative many now-common procedures were when first introduced. Here are the intriguing stories behind ten such surgeries.
10. First Appendectomy: Removal of an 11-Year-Old Boy’s Appendix in 1735
Appendicitis, a condition characterized by inflammation and pus-filled swelling of the appendix, affects approximately 8% of people during their lifetime. Without treatment, the appendix can rupture, releasing harmful bacteria into the abdominal cavity, which can be fatal if not addressed promptly.
This ailment has been recorded for centuries. Galen, in A.D. 130, was among the first to describe it, and it has been intermittently discussed by medical professionals ever since. Surprisingly, the cause remained a mystery for a long time. The appendix wasn’t identified until the late 1400s, and its connection to the symptoms described since Galen’s time was only established by German surgeon Lorenz Heister in 1711. For centuries, countless individuals suffered and likely died from this condition without understanding its cause.
Understanding the cause was less urgent than finding a remedy. Decades after the appendix was identified, the first appendectomy was conducted in 1735 by Doctor Claudius Amyand on an 11-year-old boy. The boy’s appendix had been pierced by a pin he had swallowed. This surgery was groundbreaking, and the boy also had a rare condition—a type of inguinal hernia, now known as Amyand’s hernia, where part of the intestine protrudes through a weak spot in the abdominal muscles.
In a single procedure, the first appendectomy was performed, and the first Amyand hernia was identified. It took another 24 years before appendectomies were used to treat appendicitis. Today, nearly 300,000 appendectomies are performed annually in the United States alone, saving 8% of the population from severe pain and potential death.
9. First Brain Surgery: Trepanation Performed On Our Distant Ancestors
The brain is protected by a thin layer of tissue called meninges, rich in blood vessels. Head trauma can tear the meninges, causing bleeding. This blood becomes trapped between the brain and skull, increasing pressure and posing a serious risk to the brain. This condition, known as subdural hematoma, can lead to brain damage or death if untreated. A small hole drilled into the skull, called a burr hole, can relieve this pressure. This procedure is known as trepanation.
While this may seem like a modern solution, trepanation has been practiced for 5,000 years. Remarkably, 5-10% of Neolithic skulls (dating from 12,000 to 4,000 years ago) show evidence of burr holes. This ancient method was used to treat subdural hematomas long before the advent of modern painkillers or anesthesia.
However, the procedure wasn’t always used for medical purposes.
Twelve human skulls, all dating back to the copper age, were discovered within a 31-mile radius in southern Russia. Each skull had burr holes in the same location—the obelion, situated at the top back of the skull, near where a ponytail might rest. None of the skulls displayed signs of trauma, indicating the individuals were healthy at the time of the procedure. Elena Batieva, an anthropologist from Southern Federal University, concluded that these individuals underwent trepanation not for medical reasons but as part of a ritual. This is particularly intriguing because the obelion is a risky location for such an operation. Evidence from some skulls suggests the individuals did not survive the procedure.
The specifics of their ritual and its purpose remain a mystery, as no written records exist. We can only speculate about their intentions.
8. First Biopsy: A Hollow Needle in A.D. 1000
Although the term 'biopsy' was coined in 1879 by Ernest Besnier, the practice existed long before. The earliest known biopsy was performed by Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi (Albucasis), a court physician who lived between A.D. 936 and 1013. He used a long needle to extract tissue from the thyroid gland, diagnosing what he referred to as 'Elephant of the throat.' His method closely resembles modern fine needle aspiration (FNA) techniques.
Albucasis’ writings also featured detailed illustrations of his tools, including the first hollow needles ever documented in medical history. These instruments laid the foundation for modern devices used in biopsies, injections, and blood draws.
7. First Successful Cesarean: Mother and Child Saved in 1794
Initially, cesarean deliveries were performed only when the mother was deceased or near death. The procedure was seen as a last resort to save the baby, as it almost always resulted in the mother’s death. Historical records and myths, such as the birth of the demigod Asclepius in Greek mythology, highlight the ancient origins of this practice.
However, achieving a cesarean section where both mother and child survived was the ultimate goal. While medieval attempts were made, their success remains debated. The first confirmed successful cesarean occurred in America in 1794. Elizabeth Bennett, facing a life-threatening childbirth, pleaded with her physicians to perform the procedure to save her baby. When they refused, her husband, Jessie Bennett, a doctor himself, stepped in. Against all odds, he successfully delivered their child and saved Elizabeth’s life, marking a historic milestone.
Today, cesarean sections account for one-third of all births in the United States.
6. First Cataract Surgery: Ancient “Couching” Technique
Cataracts occur when proteins accumulate in the eye’s lens, forming a cloudy layer that obstructs vision. This condition, often linked to aging, has affected humans for millennia. One of the earliest depictions of cataracts is found in an Egyptian statue of a priest named Ka-aper, dating back to 2457-2467 B.C., which shows him with one clouded eye.
Humans have long sought remedies for cataracts. In the tomb of a Pharaoh’s surgeon from 2630 B.C., archaeologists discovered specialized tools, including copper needles or lancets. These instruments were used to push the cataract deeper into the eye, away from the lens, in a procedure known as 'couching.' While the cataract wasn’t removed, this method often improved the patient’s vision by shifting the cloudy mass out of the direct line of sight.
This technique is believed to be referenced in the Code of Hammurabi, established by the ancient king around 1750 B.C. One of his laws stated, 'If a doctor operates on the eye of a nobleman and causes the loss of the eye, the doctor’s hands shall be cut off.'
The couching method remained widely used until 1748, when French doctor Daviel performed the first successful cataract extraction surgery.
5. First Cholecystectomy: Removal of the Gallbladder in 1882
The gallbladder, a small organ beneath the liver, stores and releases bile to aid in fat digestion after meals. Issues like gallstones, infections, or, rarely, cancer can affect it. In the 1880s, Carl Johann August Langenbuch, a 27-year-old German physician in Berlin, treated patients suffering from such conditions. The standard treatment at the time involved surgically opening the abdomen, cutting into the gallbladder, and removing its contents, such as gallstones or infected material. This painful procedure provided only temporary relief, frustrating Langenbuch.
Determined to find a better solution, Langenbuch proposed a radical approach: complete removal of the gallbladder. Though debated among physicians, the consequences were uncertain, with some fearing it could be fatal. After practicing on a cadaver, Langenbuch successfully performed the first gallbladder removal on a living patient in 1882. The patient, who had endured gallstones for 17 years, was cured almost immediately with minimal side effects.
By 1897, over 100 cholecystectomies had been performed. Today, it is the second most common surgical procedure.
4. First Coronary Artery Bypass Graft: Performed in 1960
A Coronary Artery Bypass Graft (CABG) is a surgical procedure that redirects blood flow around a blocked section of the heart’s blood vessels using a healthy vessel from another part of the body. The development of CABG was a gradual process. As early as 1910, Alexis Carrel explored operating on coronary circulation and successfully experimented on dogs. In 1935, Claude Beck worked on inserting materials into the pericardium, the tissue surrounding the heart. Arthur Vineberg introduced the concept of a bypass in 1946 by connecting the left internal thoracic artery to the left ventricle. In 1956, Charles Bailey performed coronary endarterectomies, removing blockages instead of bypassing them. A breakthrough came when Mason Sones accidentally injected contrast dye into a patient’s coronary artery, leading to the development of coronary angiography, which allows doctors to visualize arteries using X-rays.
These incremental advancements culminated in 1960 when Robert Goetz and his team performed the first successful CABG. Although the patient died 13 months later, an autopsy confirmed the graft had held, proving the surgery itself was not the cause of death.
3. First Plastic Surgery: An Ancient Indian Nose Job
The term 'plastic surgery' originates from the Greek word 'plastikos,' meaning 'to mold' or 'to give form,' not from the material plastic. The first cosmetic surgeries predate plastic by over 1,500 years. The Sushruta Samhita, an ancient Indian medical text from the 6th century A.D., details numerous procedures, including one for reconstructing the nose.
The text describes the procedure: Measure the damaged nose with a leaf, then cut a piece of skin from the cheek, leaving it attached by a small pedicle. Attach this skin to the prepared nasal stump, stitch it in place, and use castor-oil plant tubes to shape the nostrils. Apply medicinal powders, cover with cotton, and use sesame oil for healing. If the nose’s length is unsatisfactory, adjust the flap accordingly.
The Sushruta Samhita documents 1,120 diseases, 121 surgical tools, and 300 operations. The nasal reconstruction technique described in the text wasn’t replicated in the West until 1794, when a similar procedure was detailed in Gentleman’s Magazine of London, involving the restoration of a cart-driver’s nose.
2. First Orthopaedic Surgery: A 3,000-Year-Old Knee Pin
For years, an Egyptian mummy from the 11th-16th centuries B.C. resided in California’s Rosicrucian Museum, seemingly unremarkable. However, during a 1995 examination involving X-rays, one mummy stood out. Known as Usermontu, the name was borrowed from a priest whose sarcophagus was reused for this mummy. The true identity of the mummy remains unknown.
The X-ray revealed a 9-inch metal pin in the mummy’s left knee, meticulously placed. Initially, Professor Griggs, the project lead, assumed the pin was modern, stating, 'I thought it might be an interesting footnote to say someone inserted a modern pin into an ancient mummy.'
Upon further investigation, the team drilled a small hole to insert a camera and collect samples. They discovered ancient resin, fat, and textiles, confirming the pin was not modern but the result of a surgical procedure performed 2,600 years ago.
'We are astonished by the ancient ability to craft a pin using biomechanical principles still relevant today, such as rigid bone fixation,' said Dr. Richard Jackson, a Utah-based physician involved in examining the mummy. 'It surpasses anything we expected for that era.'
This surgery, however, wasn’t performed to improve Usermontu’s life but to ensure a functional body in the afterlife. Ancient Egyptians believed the physical body was essential for the afterlife, so they meticulously preserved and repaired it. The knee operation, executed with remarkable skill, was conducted posthumously to restore functionality for the deceased’s journey beyond.
1. First Tonsillectomy: A Procedure Dating Back to 1000 B.C.
A tonsillectomy involves removing the tonsils, two small glands at the back of the throat. Often, this is a child’s first encounter with surgery, typically due to recurrent infections or sore throats.
The procedure’s origins trace back to ancient times. Early records indicate that ancient Hindus performed tonsillectomies as early as 1000 B.C. The Roman Cornelius Celsus provided a detailed account in A.D. 40, describing how doctors would remove the entire tonsil by hand. This method, though crude, was preferred over partial removal and remained in use well into the 20th century.
