Scar less Surgery

The modern technology has come up with a promise for a painless and scar less surgery. It is termed as natural orifice translumenal endoscopic surgery (NOTES). It is performed by passing an endoscope through a natural orifice. This new approach goes beyond laparoscopic surgery which is done after making several small holes in the skin. NOTES is known as scar less surgery as it makes use of natural openings like the mouth, anus, vagina or bladder and eliminates the need for any external incisions. The main benefits of NOTES are minimal postoperative pain and scarring and quick recovery. There are challenging issues, such as the risk of infection and leakage. Additionally, it is more time consuming and technically difficult. A related technique is being perfected in neurosurgery- endoscopic transnasal brain surgery. Surgical access through the nose has proven to be successful in removing pituitary tumours for years. Now, some surgeons are using this route to reach into the brain and remove tumours at the base of the skull. Here also, the main benefit is the absence of any visible scars.

Painless Surgery

There are methods by which a person can be subjected to surgery whilst he/she is awake. It can be achieved by the use of local anaesthetic and this is termed as "freezing". This is very effective in maxillofacial surgery. The main procedures in a maxillofacial surgery are surgical removal of wisdom teeth, dental extractions, surgical treatment for chronic tooth abscess and removal of skin both inside and outside the mouth. All these procedures can be done without pain using the local anaesthetic. Eventhough a freezing of the gum or face provides a painfree state of surgery, it is always recommended that mild painkillers are taken before the numbness wears off.

Herbal derivatives

The first anesthesia (a herbal remedy) was administered in prehistory. Opium poppy capsules were collected in 4200 BC, and opium poppies were farmed in Sumeria and succeeding empires. The use of opium-like preparations in anaesthesia is recorded in the Ebers Papyrus of 1500 BC. By 1100 BC poppies were scored for opium collection in Cyprus by methods similar to those used in the present day, and simple apparatus for smoking of opium were found in a Minoan temple. Opium was not introduced to India and China until 330 BC and 600–1200 AD respectively, but these nations pioneered the use of cannabis incense and aconitum. In the second century, according to the Book of Later Han, the physician Hua Tuo performed abdominal surgery using an anesthetic substance called mafeisan (麻沸散 "cannabis boil powder") dissolved in wine. Throughout Europe, Asia, and the Americas a variety of Solanum species containing potent tropane alkaloids were used, such as mandrake, henbane, Datura metel, and Datura inoxia. Classic Greek and Roman medical texts by Hippocrates, Theophrastus, Aulus Cornelius Celsus, Pedanius Dioscorides, and Pliny the Elder discussed the use of opium and Solanum species. In 13th century Italy Theodoric Borgognoni used similar mixtures along with opiates to induce unconsciousness, and treatment with the combined alkaloids proved a mainstay of anaesthesia until the nineteenth century. In the Americas coca was also an important anaesthetic used in trephining operations. Incan shamans chewed coca leaves and performed operations on the skull while spitting into the wounds they had inflicted to anaesthetize the site.[citation needed] Alcohol was also used, its vasodilatory properties being unknown. Ancient herbal anaesthetics have variously been called soporifics, anodynes, and narcotics, depending on whether the emphasis is on producing unconsciousness or relieving pain.