The true development of modern surgery originated in the late 19th and early 20th centuries. With the improvement of blood transfusion and anesthesia techniques, surgical procedures underwent a qualitative leap, and surgical instruments were continuously improved. Not only did manufacturing processes advance, such as the evolution of materials from iron to stainless steel, chromium, titanium, and vanadium, but the design also saw a clear separation between the blade and the scalpel body, with the blade being detachable. Furthermore, there were fundamental changes in the comfort, dexterity, and safety of handling. The standardization of the scalpel made it a sophisticated tool for modern surgeons to create miracles.
In 1920, Boviel first introduced electrocautery technology into brain surgery, ushering in the electronic age of surgery.
From the late 20th century onwards, electrocautery, ultrasonic scalpels, and endoscopic surgical instruments were widely used in clinical practice, further promoting the advancement of surgery.
Chinese medicine has a long history. As early as the *Neijing* (Inner Canon of Medicine), ancient Chinese surgical instruments were described. By the Ming Dynasty, medical instruments had become even more sophisticated, and Qing Dynasty medical writings on otolaryngology contained relatively concentrated records of surgical instruments. The legendary story of Hua Tuo scraping the bone to treat poison has been passed down to this day. In 1974, iron willow-leaf shaped surgical knives, flat-bladed scalpels, scissors, copper forceps, bristle medicine brushes, and porcelain washing pots were unearthed from the early Ming Dynasty Xia Dynasty tomb in Jiangyin, Jiangsu. Among them, the willow-leaf shaped surgical knife already resembles a modern scalpel. Various knives were designed with different blade directions, shapes, and lengths according to their different functions, and were often named after their shapes. For example, the most famous willow-leaf knife is named for its narrow, willow-leaf-shaped blade. Its relatively long, single-sided blade is suitable for cutting over a large area. Other knives, such as scalpels, are sharp and pointed, designed for quick incisions without causing severe pain. This demonstrates that the application of surgical knives in ancient my country was relatively comprehensive and mature.
With the advancement of technology, new surgical cutting instruments are increasingly widely used, and their cutting and hemostatic effects are becoming increasingly sophisticated, resulting in smaller surgical trauma and promoting the rapid development of surgery. The popularization and promotion of these new technologies require professional technical training; improper use can easily lead to complications. Therefore, during surgery, we should rationally select and use each type of scalpel based on its different characteristics and advantages.
