History of Surgery of the Gastrointestinal Tract

Abstract

Four salient points can be made in any discussion of the history of gastrointestinal surgery. First, major contributions in surgical technique have been made by individual surgeons who were giants in their times. These individuals had the insight to translate scientific observations and knowledge of pathophysiology into advances in patient care. Second and equally important, the evolution of the field has been furthered by advances in allied fields, including anesthesia and critical care, radiology, gastroenterology, and bioengineering. Indeed, complex care in gastrointestinal surgery is being increasingly delivered by teams of experts from all these fields. Third, the field of gastrointestinal surgery has evolved without the benefit of organized, structured training programs The need for specialized training in complex gastrointestinal surgery is becoming increasingly appreciated, and such training is likely to be demanded by better-informed consumers if we fail to provide it. Fourth, advances in pharmacology and microbiology have had a profound effect on both the incidence and safety of surgical procedures. A poignant example is the virtual disappearance of elective surgery for peptic ulcer because of the discovery of powerful acid-suppressing pharmaceutical agents as well as recognition of the etiological significance of Helicobacter pylori eradication. Similarly, antimicrobial therapy has increased the safety of colon resection and other major operations.