1.  starter activity Your teacher will give you a card describing a surgical practice or an individual who helped develop surgery. Place the card in the correct chronological position. Now decide which were the 3 most important advances.

2. Advances in surgery Prehistoric (3000 – 2000 BC) Prehistoric (3000 – 2000 BC) Ancient (2000 BC – 500 AD) Ancient (2000 BC – 500 AD) Medieval (500-1400) Medieval (500-1400) Renaissance (1400-1700) Renaissance (1400-1700) Industrial Age (1700-1900) Industrial Age (1700-1900) Twentieth Century and beyond Twentieth Century and beyond D A J G S F M P L O H B N I K C Q E R The colour code refers to the different periods of surgery we’ve studied

3.  Your task Try to identify factors which helped the advance of medicine: Try to identify factors which helped the advance of medicine: War War Technology Technology Government Government Trade Trade Chance Chance Individual genius Individual genius

4. How has surgery developed in recent years? To revise the earlier advances in surgery To identify the key factors which have led to improvements in twentieth century surgery  Aims

5.  Your task Read p. 173-4 and find out the reasons why surgery has improved in recent years. Complete a spider diagram including the following categories: Read p. 173-4 and find out the reasons why surgery has improved in recent years. Complete a spider diagram including the following categories: Improved anaesthetics Improved anaesthetics Antibiotics Antibiotics Teamwork Teamwork Resources Resources Keyhole surgery Keyhole surgery Microsurgery Microsurgery

6. Improved anaesthetics 1930s Helmuth Wesse discovered a method of injecting anaesthetics into blood stream – allowing dosage to be controlled and operations to last longer 1930s Helmuth Wesse discovered a method of injecting anaesthetics into blood stream – allowing dosage to be controlled and operations to last longer

7. Antibiotics Discovery & mass production of penicillin helped to increase success rate of operations Discovery & mass production of penicillin helped to increase success rate of operations Led to developments in more complex surgical techniques e.g. transplants and replacement surgery Led to developments in more complex surgical techniques e.g. transplants and replacement surgery Penicillin tablets – extremely difficult to obtain initially, but now a very common drug

8. Teamwork Dr Christian Barnard (below) – doctor who pioneered heart transplant surgery required teams of doctors and who were expert in different fields from anaesthetics to cardiography Dr Christian Barnard (below) – doctor who pioneered heart transplant surgery required teams of doctors and who were expert in different fields from anaesthetics to cardiography

9. Resources Complex operations very expensive – teams of surgeons, expensive drugs, aftercare etc. Complex operations very expensive – teams of surgeons, expensive drugs, aftercare etc. Government and media question how much should be spent on healthcare and where resources should be directed Government and media question how much should be spent on healthcare and where resources should be directed Should the NHS pay for controversial operations like cosmetic surgery?

10. Keyhole surgery Reduces size of wound created and reduces chance of infection Reduces size of wound created and reduces chance of infection Fibre-optics and computer-assisted surgery have made this approach possible Fibre-optics and computer-assisted surgery have made this approach possible

11. Microsurgery Ability to attach fine blood vessels and nerve endings, e.g. severed limbs Ability to attach fine blood vessels and nerve endings, e.g. severed limbs This picture shows the limb of a Taiwanese vet which was successfully reattached following an incident at a zoo in Taiwan in 2007

12. Plenary Plenary What were some of the greatest steps forward in surgery that we have studied? What were some of the greatest steps forward in surgery that we have studied? Why has modern surgery improved so much? Why has modern surgery improved so much?