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12 - Enhanced recovery after surgery

Published online by Cambridge University Press:  03 May 2011

John Evans
Affiliation:
St. Mark's Hospital, Middlesex
Robin H. Kennedy
Affiliation:
St. Mark's Hospital, Middlesex
Andrew Kingsnorth
Affiliation:
Derriford Hospital, Plymouth
Douglas Bowley
Affiliation:
Heart of England NHS Foundation Trust
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Summary

Introduction

History of gastrointestinal surgery

Gastrointestinal surgery in one form or another has been described since the writings of Hippocrates in the fourth century BC. By the twelfth century AD, the seminal work Regimen Sanitatis Salerni was published by the School of Salerno and became one of the most influential medical texts ever produced. In it, Roger Frugardi (also known as Roger of Salerno) described suturing wounds of the intestine and laid out rules of hygiene. In the early 1890s, Maunsell described the preoperative preparation of patients by washing out the stomach and rectum, and this principle of mechanical bowel cleansing has been widely followed to this day. However, the art and science of surgery are constantly evolving and many doctrines that were rigorously adhered to in the past have not stood the tests of time and scientific evaluation. Even Hippocrates' teachings have not been immune to subsequent correction; in his ‘Apology and Treatise’, the sixteenth-century French surgeon Ambroise Paré argues against Hippocratic treatment of volvulus.

‘Moreover, I should be sorry to follow the saying of the sayd Hippocrates, in the third booke, De Morbis, who commands in the disease called Volvulus to cause the belly to bee blowne with a pair of Bellowes, putting the nosell of them into the intestinum rectum, and then blow there till the belly be much stretcht, afterwards to give an emollient glister, and to stop the fundament with a sponge. Such practise as this is not made now a dayes therefore wonder not if I have not spoken of it.’

Type
Chapter
Information
Fundamentals of Surgical Practice
A Preparation Guide for the Intercollegiate MRCS Examination
, pp. 181 - 189
Publisher: Cambridge University Press
Print publication year: 2011

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