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INTRODUCTION The treatment using medicines for the maintaining of health was originated much earlier. In those times, warfare and fighting techniques were taught among commoners, with the intention to save the kingdoms from enemies, and the treatment of injuries formed during these training periods were later termed as surgery. The method of surgery did not exist during the period of physicians such as Pythagoras etc. who promoted kayacikitsa. The contribution in the field of surgery, by our country is very great. Countries such as India, Greece etc. have contributed much to the field of surgery treatment. No manuscript which excelled or equaled Susruta Samhita existed in those times. It was said that Alexander the great had took surgeons from ancient India to Greece during his conquest. In ancient India surgery was practiced in provinces like Kasi. It is believed that the Kasi King Divodasa originated the system of surgery in India. Many references are found in ancient Indian literature about surgery and it is depicted how the severe headache of king 56

Surgeries conducted by Jivaka, the physician of Buddha can be found. Many references of surgeries can be found in epics like Ramayana and Mahabharata. But as there was a rule stipulated in Sanskrit that war scenes and other violent scenario should be excluded from plays, hence, no references of surgeries could be found in Sanskrit dramatic literature. The references of surgery in Sanskrit literature are described in the following chapter. WHAT IS SURGERY The word Surgery derived from the Greek word cheirourgike, via Latin: chirurgiae', meaning "hand work²" is a medical speciality that uses operative manual and instrumental techniques on a patient to investigate and or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, or sometimes for some other reason. An act of performing surgery may be called a surgical procedure, operation, or simply surgery. In this context, the verb 'operating' means performing surgery. The adjective 'surgical' means "pertaining to surgery ³; e.g. surgical instruments or surgical 3, nurse. The patient or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who performs 57

operations on patients. Persons described as surgeons are commonly medical practitioners, but the term is also applied to pediatric physicians, dentists and veterinarians. Surgery can last from a few minutes to several hours, but is typically not an ongoing or periodic type of treatment. The term surgery can also refer to the place where surgery is performed, or simply the clinic of a physician, dentist, or veterinarian. DEFENITION OF SURGERY Surgery is a medical technology consisting of a physical intervention on tissues. As a general rule, a procedure is considered surgical when it involves cutting of a patient's tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy, may be considered surgery if they involve 'common' surgical procedure or settings, such as use of a sterile environment, anesthesia, antiseptic conditions, typical surgical instruments, and suturing or stapling. All forms of surgery are considered invasive procedures; so called 'non invasive surgery' usually refers to an excision that does not penetrate the structure being excised (e.g. laser ablation of the cornea) or to a radio-surgical procedure (e.g. 58

irradiation of a tumor). although some physicians do not support the invasive procedures. TYPES OF SURGERY Surgical procedures are commonly categorized by urgency, type of procedure, body system involved, degree of invasiveness, and special instrumentation. Elective surgery is done to correct a non life threatening condition, and is carried out at the patient's request, subject to the surgeon's and the surgical facility's availability. 6 Emergency surgery is surgery which must be done quickly to save life, limb, or functional capacity. Exploratory surgery is performed to aid or confirm a diagnosis. Therapeutic surgery treats a previously diagnosed condition. 7 Amputation involves cutting off a body part, usually a limb or digit. Re-plantation involves reattaching a severed body part. Reconstructive surgery involves reconstruction of an injured, mutilated, or deformed part of the body. Cosmetic surgery is done to improve the appearance of an otherwise normal structure. Excision is the cutting out of an organ, tissue, or any other body part from the patient. Transplant surgery is the replacement of an organ or body part by insertion of another from different human (or animal) into the 59

patient. Removing an organ or body part from a live human or animal for use in transplant is also a type of surgery³. When surgery is performed on one organ system or structure, it may be classed by the organ, organ system or tissue involved. Examples include cardiac surgery (performed on the heart), gastrointestinal surgery (performed within the digestive tract and its accessory organs), and orthopedic surgery (performed on bones or muscles). Minimally invasive surgery involves smaller outer incision to insert miniaturized instruments within a body cavity or structure, as in laparoscopic surgery or angioplasty 9. By contrast, an open surgical procedure requires a large incision to access the area of interest. Laser surgery involves use of a laser for cutting tissue instead of a scalpel or similar surgical instruments. Microsurgery 10 involves the use of an operating microscope for the surgeon to see small structures. Robotic surgery makes use of a surgical robot, such as the Da Vincil or the Zeus surgical systems, to control the instrumentation under the direction of the surgeon. New development has shifted towards deploying a surgical robot system in mobile settings and extreme 60

environments such as the battlefield or natural disaster areas with surgeons operating wirelessly.11