The first operating theatre in history

• Operating theatres are nowadays essential rooms for surgical interventions.
• In the past, surgical interventions were performed anywhere, there used to be no specific place to perform them and no minimum conditions in which to perform them.
• The concept we have of the operating theatre today is very different from the first operating theatres on record.

The appearance of the first operating theatre as we know it today, a specialised room for the performance of surgical interventions, is quite close in time, but there is data indicating that surgical interventions were performed more than 3000 years ago.

Documents have been preserved that show that the Egyptians, around 3,000 BC, were already performing surgery, in fact it is considered that they had a considerable knowledge of medicine compared to other contemporary civilisations.

Surgical instruments, such as knives and scalpels made of stone, iron or bronze, have also been preserved from Egyptian civilisation, proving that they performed certain types of surgery.

In fact, the first surgical operation recorded in history was performed by the Egyptians. It was circumcision, and in the temple of Memphis there is an engraving, the oldest representation of a surgical operation, which depicts this procedure.

The Egyptians performed surgery, but there is no record that they had a specific place with specific characteristics where they performed surgery.

In Ancient Greece, around 400 BC, temples were created in honour of the God of Medicine: Asclepius. Sick people came to these temples to be healed, and on many occasions doctors performed surgery there.

These temples had separate rooms for the sick to do exercises, probably what we know today as rehabilitation, and rooms for them to rest, and on many occasions these rooms had the same function as the resuscitation rooms in hospitals today.

It was at this time that Hippocrates, now considered the father of medicine, rejected everything that was believed about medicine based on legends.

In the Middle Ages, barbers, apart from cutting men's hair and beards, were in charge of performing various surgical operations.

Some barbers provided their services on an itinerant basis or by going to patients' homes, while others performed these operations in their barbershops. Over time, the itinerant barber disappeared and the operations were performed in the barbershops.

Taking this case into account, we could identify barbershops as old improvised operating theatres, although very different from the concept of operating theatres we have today.

From the 15th and 16th centuries onwards, we can say that modern surgery began to be born, although it was not yet studied at the University.

At this time, practices such as the use of boiling oil began to be abandoned and surgical instruments were gradually perfected.

By the beginning of the 18th century, operating theatres as we know them today did not yet exist, as it was very common for operations on patients to be carried out in hospitals or doctors' surgeries or in the patient's or doctor's own home.

One of the first operating theatres known to have been built in Strasbourg in 1782, where an operating theatre is understood to be a specific room for surgical interventions with the necessary equipment.

Also at the end of the 18th century, it is documented that the first operating theatre in the United States was established in Baltimore by the physician Philip Syng Physik.

In London is the "Old Operating Theatre", an operating theatre that belonged to St Thomas' Hospital and is now a museum.

It is one of the oldest operating theatres on record, dating back to 1822.

The Old Operating Theatre is located in the attic of the top floor of St Thomas' Church. This former operating theatre used to be clandestinely located there. Patients used to go there to undergo operations in a clandestine manner as well.

The purpose of this room was to test techniques and remedies for what were hoped to be academic purposes. For this reason, there was an operating table in the centre and it was surrounded by steps at two levels, so that the medical students could watch the operations being performed live.

The operating theatre used a multitude of different herbs and powders, animal skins and even animal foetuses, which are still preserved for the delight of the public.

The medical instruments that were used there, such as forceps, spatulas, forceps and tongs, are also preserved in the museum.

Talking about the origins of the operating theatres we know today, it is important to highlight that anaesthesia was not introduced until 1846, therefore, all the surgical interventions that were carried out until then were done with the patients conscious, or in some cases the patients consumed alcoholic drinks or drugs before undergoing the interventions in order to be able to endure the pain.

An important point on the subject of operating theatres and surgical procedures was made by Ignatius Semmelweis, around 1861, when he promulgated that everyone should wash their hands before entering their "operating theatre" and before and after touching patients. He also introduced sterilisation of surgical equipment. 

These measures were the forerunners of modern antisepsis, as a result of which mortality dropped considerably.

Before antisepsis, it was not only the patients who were harmed by unhygienic surgical procedures, but also some doctors and surgeons who became infected or contracted infections from their patients during surgery.

Nowadays, there are special rooms for surgical interventions, modern operating theatres, which are equipped with all the necessary technical and technological equipment and have optimum hygiene and antisepsis conditions.

Over the years, operating theatres have evolved into what we know today.

Also with the passing of time and the evolution of science, they will probably continue to evolve and it may be that in the future the techniques or procedures used today will be considered erroneous or even barbaric, as we consider some of the procedures of our predecessors today.