Published on April 30, 2008
High Technology Surgery: High Technology Surgery Mr McDonald Downloaded from SchoolHistory.co.uk What we will learn today:: What we will learn today: How developments in surgery have progressed What factors have played a part in these developments. X-Rays: X-Rays Originally developed in 1895 by Wilhelm Rontgen, they really came into effect in World War One when finding bullets in the body really showed the usefulness of the X-Ray machine. X-Rays made it possible to see inside the body without having to cut inside. Electrocardiograph: Electrocardiograph Developed in 1903 by Willem Einthoven it allowed a doctor to monitor a patient’s heartbeat in a more effective manner. This was highly useful in surgery to gauge how a patient was doing. Kidney Machine: Kidney Machine Developed in 1943 by Willem Kolff (a Dutch Surgeon). It pioneered the move to get machines to do the jobs the body could not do through illness or injury. Heart and Lung Machine: Heart and Lung Machine This machine allowed the heart and lungs to stop working allowing surgery to be performed whilst the machine took over. The first operation using it was in 1953. Microscopes: Microscopes Not the usual type but ones for surgery. In the 1960s, along with fine sutures and needles it allowed surgery to be performed on blood vessels and nerves – even reattach limbs. This led to the development of MICRO-SURGERY. Fibre Optics: Fibre Optics This is more commonly known as ‘key hole’ surgery. This was surgery that was not invasive and did not need major cutting inside the human body. Case Study: Heart Surgery: Case Study: Heart Surgery Before World War Two operations to do with the heart were rarely considered as a viable idea. This was because if the heart stopped for more than four minutes then the brain would die from a lack of oxygen! World War Two provided some change as surgeons needed to repair wounded soldiers’ hearts. Dwight Harken: Dwight Harken He was an army surgeon in WW2. He used to open the heart and fish out bits of shrapnel and bullets. Of course this was risky but it did sometimes work and was far better than the alternative. However his pioneering work did little about people with defective hearts who needed longer operations! Progression: Progression Canadian Bill Biggelow believed reducing the temperature of the body would lower the heart rat and thus provide more time. He was correct however there was still not enough time to perform complex operations with any degree of success. Pioneers in Heart Surgery: Pioneers in Heart Surgery Norman Shumway – University of Minnesota. He developed heart surgery although up to 50% of patients died. Michael de Blakey – Methodist Hospital Texas. He used new technology to replace diseased arteries. (Dacron) Both men made progress but the problem of transplanting a heart (tissue rejection remained. Christian Barnard: Christian Barnard Surgeon in South Africa. In 1967 he transplanted a heart from a road accident victim to Louis Washkansky (he died after eighteen days) Rejection of the heart was still a problem. The drugs used practically killed off his immune system so he died of pneumonia. Christian Barnard: Christian Barnard Hero or villain? Many saw him as a hero but public expectation of surgery was too high considering the dangers of rejection were still there. Others saw him as a villain who exploited the patients for his ego. In the end, heart transplants stopped until rejection was solved. Developments: Developments To counter the issue of heart transplants, an artificial heart was developed. In 1982 Barney Clarke received one and lived for three weeks. However in 1974, the issue of rejection was solved. A drug called Cyclosporin was developed that reduced the risk of tissue rejection. By 1987, over 90% of transplants ended with the patient living over two years Today: Today Transplants are routine. Careful use of drugs to control rejection means that patients have better chance of survival however this is all linked to a number of factors The skill of the Surgeon The development of drugs The care of the patient in Intensive Care The development of new technologies Conclusion: An Overview: Conclusion: An Overview Prior work by Joseph Lister and others in the 19th century on anaesthetics and antiseptics. Development of aseptic surgery – surgery without germs. Discovery of different blood groups. Specialisation within surgery; heart, brain etc. Developments in science X-Ray, CAT Scan etc. War – speeded up development e.g. plastic surgery.