Surgical instruments are essentially extensions of the surgeon's hands. Using them provides many advantages, they hold tissue more effectively than fingers, and they can also hold other instruments; for example, needle holders hold needles for suturing. Instruments have evolved throughout history from cutting and suturing tissue to transmitting electrical impulses and high-frequency light.
The first instruments used in the Stone Age were knives and awls made of flint or obsidian. Other organic materials such as wood, horn, animal teeth, and some shells were also used. The oldest weapon that has been found is the Leringher spear in Germany, made of yew wood. It is two meters long and its tip is hardened by fire. Chronography indicates that it was made 80,000 years ago.
There are basically three kinds of instruments: cutting instruments such as knives and saws, drills and needles, and percussion instruments such as chisels and hammers. The oldest drilling instruments were awls made of stone, wood, bone or horn. In the age of metals, bronze and other alloys of copper, gold and, finely, iron and steel began to be used. Going a little deeper into the history of the trephine, the first image of the handle similar to the carpenters' berbiquà can be found in the book of Hippocrates illustrated by Guido Guidi (Vidi, Vidus, 1501, a Florentine physician who described the Vidian nerve). The straight trephine handle was also known to be rotated with a bow, intermittently back and forth, but the manubrium has the advantage of continuous rotation. In the Middle Ages, illustrations of the handle are found in books by Berengario de Carpà (1518), Ambrosio Paré (1560,) Andrés Alcázar (1575), Andrés de la Croce (1661) and others. As a carpentry instrument, it can be seen in the workshop of San José in the triptych The Annunciation by the Master of Flemalle (1439). This handle is sold commercially as the Hudson Handle. In reality, this English surgeon attributed it to his master Pott. The same is true of the D'Errico trephine, which has been known since Babylonian times. The Greeks and Romans called it Modiolus which allows the removal of discs or cylinders of bone. Celsus describes it in the first century AD with a central punch.
In medieval times it was modified with two male and female trephines. These drilling instruments have been used by dentists since ancient times, to them, we owe the invention of the pedal machines and finally of the motors (handpiece) that rotate at four or five hundred thousand revolutions per minute, which have been modified for surgical use in different specialties. In ancient Mesopotamia (an area in southern Asia between the Tigris and Euphrates rivers) cultures practiced some degree of surgery. Small copper knives of the Sumerians (present-day southern Iraq) from around 3000 BC are believed to have been surgical instruments. The Babylonian Code of Hammurabi from around 1700 BC mentions bronze lancets (instruments with two-edged cutting points used to make small incisions). Because the Code foresaw severe penalties for poor results of medical treatments, surgery was practiced sparingly. Ancient Chinese and Japanese cultures were opposed to cutting bodies, so surgical instruments were not widely used.
