Surgery Atlas

Replaces the cloudy lens inside the eye with a clear plastic one. A cataract clouds the lens and blurs sight, mostly with age. Surgery is the only way to get rid of it.

How it is done

• Through a tiny hole. The surgeon makes a tiny hole in the front of the eye (the cornea), usually breaks the lens up with ultrasound, sucks it out and places a clear plastic lens inside the lens capsule.

Anaesthetic

Local: eye drops, an injection or both. You are awake.

Time in theatre

20 to 45 minutes

Hospital stay

Home the same day (someone else drives)

Recovery

Most people recover quickly: sight improves over several days, with eye drops for about 4 weeks.

How often

686,343 operations a year in England’s NHS hospitals (2024-25); 99% went home the same day; average age 75. 973 per 100,000 people a year in the middle country of 47 OECD and partner countries.

Since when

• 1750: Jacques Daviel removes a cataract in Cologne: the start of modern cataract surgery
• 1949: Harold Ridley implants the first artificial lens
• 1967: Charles Kelman and Anton Banko introduce ultrasound (phacoemulsification)

Risks

The operation is usually successful and serious complications are rare. Sight can turn cloudy again months or years later. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Cataract surgery · Wikipedia: Cataract surgery

Makes a new drainage channel in the white of the eye, so fluid can leave and the pressure inside the eye falls. For glaucoma when eye drops or laser do not keep the pressure down. It does not improve sight; it helps protect it in the longer term.

How it is done

• A small opening. A small opening is made in the white of the eye near the upper eyelid; fluid drains through it into a little blister (a bleb) under the lid.

Anaesthetic

Local or general.

Time in theatre

Up to an hour

Recovery

Sight is often blurred at first and usually better after a week or two (it can take six); new eye drops stop the opening from scarring.

How often

11,175 operations a year in England’s NHS hospitals (2024-25); 93% went home the same day; average age 69.

Since when

• 1970s: Peter Gordon Watson and John Cairns develop the trabeculectomy

Risks

Bleeding, infection, inflammation, eye pressure too high or too low for a while, and cataract. Serious complications are rare, but very occasionally sight gets worse and does not recover. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Trabeculectomy · Cambridge University Hospitals NHS: Trabeculectomy

Reshapes the cornea with a laser so that people no longer need glasses or contact lenses. To correct vision problems so that glasses or contact lenses are no longer needed; done privately, from the age of 21 (Leeds).

How it is done

• LASIK. One laser makes a thin protective flap in the cornea; it is lifted, a second laser reshapes the tissue beneath, and the flap is smoothed back, sticking without stitches.
• LASEK (surface). The laser removes tissue just beneath the clear skin layer of the cornea, which grows back over about a week.
• SMILE. A laser shapes a lens-shaped piece of tissue inside the cornea, which the surgeon removes through a small cut: no flap.

Hospital stay

Home the same day

Recovery

Back to work within 3 days; no exercise or swimming for 2 weeks and no flying for 3; check-ups the next day and after a week.

Cost (private, UK)

£2,090 per eye at Leeds Teaching Hospitals’ private service

How often

Mostly done privately, so England’s NHS figures do not show it.

Since when

• 1992: Ioannis Pallikaris introduces LASIK to ten US centres, under the direction of the FDA
• 1998: The first laser approved in the US for LASIK

Sources: Wikipedia: LASIK · Leeds Teaching Hospitals NHS: About laser eye surgery

Replaces all or part of a damaged cornea with cornea from a donor who has died. When glasses or contact lenses no longer help, or the eye hurts: for example keratoconus, Fuchs’ dystrophy, a severe infection, an injury or problems after cataract surgery.

How it is done

• A new cornea. The damaged layers (or the whole cornea) are removed and the donor piece is put in with tiny stitches; when only the inner layer is replaced, an air bubble holds it in place.

Anaesthetic

Usually local with numbing drops; sometimes a sedative or general anaesthetic.

Time in theatre

1 to 2 hours

Hospital stay

Most go home the same day; some stay 1 to 2 days

Recovery

About 2 weeks off work; the stitches stay in for several months; sight takes up to 6 months to improve after an inner-layer graft, up to 2 years after a whole one.

How often

England’s NHS figures do not separate cornea transplants clearly.

Since when

• 1905: Eduard Zirm performs the first cornea transplant, at the Olomouc Eye Clinic
• 1931: Vladimir Filatov uses a cornea from a donor who has died
• 1998: Gerrit Melles and colleagues introduce the inner-layer (endothelial) transplant

Risks

Rejection, which can happen at any time but can usually be treated with steroid drops if caught early. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Cornea transplant · Wikipedia: Corneal transplantation

Puts a detached retina back in place, or seals a tear in it. A detached retina is an emergency: surgery usually stops sight getting worse.

How it is done

• Vitrectomy. The jelly inside the eye is removed and replaced; a gas bubble may push the retina back against the wall of the eye.
• Scleral buckle. A small band is fixed around the eye to push its wall and the retina together.
• Laser or freezing. A tear in the retina is sealed with laser or freezing treatment (cryotherapy).

Anaesthetic

Usually local: awake, with the eye numbed.

Hospital stay

Not normally overnight

Recovery

Sometimes lying or sitting in one position for up to 7 days; no flying with a gas bubble in the eye; sight may be blurry for 2 to 6 weeks.

How often

England’s NHS figures do not separate retina repairs clearly.

Sources: NHS: Detached retina

Removes the two tonsils at the back of the throat. The usual reason is repeated attacks of tonsillitis, generally after a year of them; also abscesses next to a tonsil (quinsy).

How it is done

• Through the mouth. Done through the open mouth, so there is no cut on the skin.

Anaesthetic

General: you are asleep.

Time in theatre

About 30 minutes

Hospital stay

At least 6 hours on the ward; often home the same day

Recovery

A couple of weeks off work.

How often

44,895 operations a year in England’s NHS hospitals (2024-25); 82% went home the same day; average age 16. 102 per 100,000 people a year in the middle country of 45 OECD and partner countries.

Since when

• 1st century: Celsus describes cutting out tonsils in Rome (1st century)
• 1930: By the 1930s, very common in the UK and the US

Risks

Bleeding: about 1 in 200 in the first hours, about 5 in 100 after going home (most often near the end of the first week); about 1 in 100 go back to theatre for it. General information, not advice: your surgeon will explain your own risks.

Sources: Dorset County Hospital NHS: Tonsillectomy in adults · Wikipedia: Tonsillectomy

Places a tiny tube in the eardrum, so air reaches the middle ear and trapped fluid can drain. Mainly for children with mild hearing loss from fluid stuck behind the eardrum (glue ear).

How it is done

• Through the ear canal. A tiny cut in the eardrum and the grommet is placed in it, working through the ear canal: no cut on the skin.

Anaesthetic

General (a short one).

Time in theatre

Away from the ward 1 to 2 hours in all

Hospital stay

Home the same day

Recovery

Keep the ears dry for at least the first 2 weeks; ear plugs for swimming. Soapy water especially irritates them.

How often

17,845 operations a year in England’s NHS hospitals (2024-25); 89% went home the same day; average age 20.

Since when

• 1845: First documented use of ear tubes, by Martell Frank and Gustav Lincke in Germany
• 1952: Beverly Armstrong brings them in for glue ear

Sources: Wikipedia: Tympanostomy tube · Sheffield Children's NHS: Myringotomy and grommets

Places an electrode in the inner ear (the cochlea) that stimulates the hearing nerve directly; a sound processor worn behind the ear feeds it. For deafness that hearing aids cannot help enough.

How it is done

• Behind the ear. A cut behind the ear; the surgeon goes through the bone there to the middle ear and slides the electrode into the cochlea, if possible through its natural round window.

Anaesthetic

General.

Time in theatre

1.5 to 3 hours per ear

Hospital stay

Home the same day or after one night

Recovery

Sore for 7 to 10 days; the head bandage comes off the next morning; a check-up 1 to 2 weeks later.

How often

1,191 operations a year in England’s NHS hospitals (2024-25); 51% went home the same day; average age 43.

Since when

• 1957: André Djourno and Charles Eyriès make the first cochlear implant
• 1961: William House’s implant
• 1977: The first modern multi-channel implants: the Hochmairs’ (1977) and Graeme Clark’s (1978)

Risks

Small risks of damage to the nerves of the face and of taste (a metallic taste can take 3 to 6 months to settle), dizziness, tinnitus, infection and, very slightly more, meningitis. Natural hearing left in that ear may be lost. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Cochlear implant · Guy's and St Thomas' NHS: Cochlear implant surgery

Removes all of the thyroid gland (total thyroidectomy) or one half of it. For an overactive thyroid (Graves’ disease), a large goitre, lumps that might be cancer (surgery is the only way to be sure) and thyroid cancer.

How it is done

• Neck cut. Through a horizontal cut low on the front of the neck.

Anaesthetic

General.

Time in theatre

2 to 3 hours (total)

Hospital stay

Most go home the day after

Recovery

Most are back at work after two weeks; no driving for a few days. After a total thyroidectomy, a thyroid hormone tablet every day for life.

How often

13,444 operations a year in England’s NHS hospitals (2024-25); 6% went home the same day; average age 51.

Since when

• 952: The earliest confirmed thyroidectomy, recorded by Al-Zahrawi
• 1791: Pierre-Joseph Desault performs the first partial thyroidectomy

Risks

About 5 in 100 notice a temporary change in their voice; permanent nerve damage is under 1 in 100. Low calcium if the small glands beside the thyroid are hurt; rarely, bleeding in the neck. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Thyroidectomy · Leeds Teaching Hospitals NHS: Total thyroidectomy

Takes out a wisdom tooth, a back molar that often has no room to come through. When it lacks space and causes pain, swelling, gum infections or decay.

How it is done

• Inside the mouth. If gum covers the tooth it is cut open; the tooth comes out in one piece or cut into 2 or 3.

Anaesthetic

Usually local (an injection in the gum); general for difficult teeth or anxious patients.

Time in theatre

Often a few minutes, at most 40

Hospital stay

Home the same day

Recovery

Usually back to normal the next day (1 to 3 days off after difficult removals); symptoms can last up to 2 weeks.

How often

84,436 operations a year in England’s NHS hospitals (2024-25); 96% went home the same day; average age 35.

Risks

Dry socket (the blood clot over the socket does not form properly) and numbness of the tongue, lips or chin, which usually gets better. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Wisdom tooth removal

Straightens the septum, the thin wall of cartilage and bone between the two sides of the nose. A bent septum can block the nose.

How it is done

• Inside the nose. A small cut inside the nose; the bent cartilage is removed or straightened and closed with small dissolvable stitches. There is no cut outside.

Anaesthetic

Usually general; sometimes only the nose is numbed.

Time in theatre

About 30 to 45 minutes

Hospital stay

Most likely home the same day

Recovery

At least a week off work; no nose blowing, heavy lifting or hard exercise for two weeks; a blocked nose and bloody discharge for about two weeks.

How often

21,241 operations a year in England’s NHS hospitals (2024-25); 87% went home the same day; average age 41.

Risks

The nose can bleed, in the first hours or up to 5 to 10 days later; rarely infection or a hole in the septum; very rarely a dip in the bridge of the nose. General information, not advice: your surgeon will explain your own risks.

Sources: University Hospitals Sussex NHS: Septoplasty

Opens up blocked sinuses from inside the nose, and removes nasal polyps. For severe or hard-to-treat sinus problems, after nasal drops, sprays or antibiotics have failed.

How it is done

• Through the nose. All done inside the nose with small telescopes and instruments; usually no cuts outside.

Anaesthetic

Usually general; some cases with only the nose numbed.

Time in theatre

About 30 to 60 minutes

Hospital stay

Most likely home the same day

Recovery

At least a week off work; no blowing or sniffing for two weeks.

How often

9,366 operations a year in England’s NHS hospitals (2024-25); 77% went home the same day; average age 52. England’s figure counts operations on the sinuses (codes E13 to E17).

Risks

Bleeding; eye complications in about 1 in 500 operations; a leak of fluid from around the brain in about 1 in 1,000. General information, not advice: your surgeon will explain your own risks.

Sources: University Hospitals Sussex NHS: FESS

Removes the adenoids, a pad of tissue at the back of the nose, mostly in children. Enlarged adenoids can cause noisy breathing, snoring, disturbed sleep and hearing loss.

How it is done

• Through the mouth. Removed through the mouth: no cut outside.

Anaesthetic

General.

Time in theatre

Away from the ward 45 to 60 minutes

Hospital stay

Home after rest

Recovery

Rest for a few days, away from crowds; 2 days to a week off school; no swimming for a while.

How often

6,647 operations a year in England’s NHS hospitals (2024-25); 88% went home the same day; average age 10.

Risks

Bleeding from the nose, a high temperature or pain that painkillers do not ease: call the ward or a GP. General information, not advice: your surgeon will explain your own risks.

Sources: Worcestershire Acute Hospitals NHS: Adenoidectomy

Removes all or part of a brain tumour. Surgery is a common treatment for brain tumours; how much can be removed depends on where the tumour is.

How it is done

• Craniotomy. The neurosurgeon cuts out an area of bone from the skull to make an opening and operate on the brain.
• Awake craniotomy. If the tumour is close to important areas, the patient is kept awake enough to answer questions; the skin is numbed and the brain itself feels no pain.
• Through the nose. Some pituitary tumours are removed through the nose, with a small cut in the wall between the nostrils and often an endoscope.

Anaesthetic

Usually general; local for an awake craniotomy.

Hospital stay

Depends on the operation; some go to intensive or high dependency care first

Recovery

It can take some time; there can be problems straight after and in the longer term.

How often

4,101 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 51.

Since when

• 1884: Rickman Godlee removes a brain tumour in London (25 November), located by Alexander Hughes Bennett from the symptoms alone

Sources: Wikipedia: Rickman Godlee · Cancer Research UK: Brain tumour surgery · Cancer Research UK: Types of surgery

Places two fine leads deep in the brain, wired under the skin to a small pulse generator below the collarbone. Eases some symptoms of Parkinson’s disease, such as tremor, stiffness and slowness, and can allow lower doses of medicine. It is not a cure.

How it is done

• Two small holes. Planned with MRI and CT scans; a frame is fitted to the head and a robot guides the instruments through two small holes in the skull. The stimulator is switched on and set at a later appointment.

Anaesthetic

General at North Bristol (some centres keep the patient awake for part of it).

Time in theatre

About 4 to 5 hours

Hospital stay

1 to 2 nights

Recovery

Parkinson’s medicines restart as soon as appropriate; no driving until the first check, about 4 to 6 weeks later.

How often

468 operations a year in England’s NHS hospitals (2024-25); 6% went home the same day; average age 58.

Since when

• 2002: Deep brain stimulation is approved in the US for Parkinson’s disease

Risks

A serious problem in under 5 in 100: stroke about 1 in 100, infection under 2 in 100, meningitis or a brain abscess about 1 in 100; speech or swallowing problems about 5 in 100. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Deep brain stimulation · North Bristol NHS: Deep brain stimulation for Parkinson’s

Frees nerves squeezed in the lower spine by removing small pieces of bone (laminectomy), and sometimes part of a disc (discectomy). For a narrowed spinal canal (spinal stenosis), a slipped disc or sciatica.

How it is done

• Cut in the back. One large cut in the back, or several small ones.

Anaesthetic

General.

Time in theatre

2 to 4 hours

Hospital stay

Around 2 to 5 days

Recovery

Work after about 4 to 6 weeks; up to 12 weeks for all usual activities.

How often

21,213 operations a year in England’s NHS hospitals (2024-25); 7% went home the same day; average age 58.

Risks

Serious complications are uncommon: a leak of spinal fluid, nerve damage or paralysis, back pain that continues, a vertebra slipping out of place. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Lumbar decompression surgery

Straightens a curved spine with metal rods, screws, hooks or wires, and fuses it with bone grafts. When a child’s or teenager’s scoliosis keeps getting worse despite other treatments, or is severe once they stop growing.

How it is done

• Spinal fusion. A major operation: the spine is straightened with metal rods, screws, hooks or wires, and bone grafts (often from the hip) fuse it; the metalwork usually stays for good.
• Growing rods. In younger children, rods beside the spine are lengthened every few months, through a small cut or with a remote control that moves magnets.

Anaesthetic

General.

Hospital stay

About a week

Recovery

Back to school after a few weeks; sport after a few months (contact sports later); sometimes a back brace.

How often

2,811 operations a year in England’s NHS hospitals (2024-25); 4% went home the same day; average age 19. England’s figure counts operations that correct a spinal deformity with instruments.

Since when

• 1953: Paul Harrington develops his steel rod
• 1960s: Up to a million people get Harrington rods between the early 1960s and the late 1990s

Risks

Severe bleeding needing a transfusion, wound infection, metalwork moving or grafts not taking (more surgery); rarely nerve damage, very occasionally paralysis. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Scoliosis treatment in children · Wikipedia: Harrington rod

Builds a detour for blood around a narrowed or blocked artery of the heart. To improve blood flow to the heart muscle when its arteries are narrowed (coronary heart disease).

How it is done

• Open heart surgery. A long cut down the middle of the chest and through the breastbone. A healthy blood vessel is taken from the leg or the chest and sewn around the blockage; most of the time a machine keeps the blood flowing.
• Smaller cuts. Sometimes it can be done through several smaller cuts, with a camera to see the heart. Recovery is usually quicker, but it is not always suitable.

Anaesthetic

General: you are asleep.

Time in theatre

3 to 6 hours

Hospital stay

About a week (1 or 2 days of it in intensive care)

Recovery

Most normal activities after about 6 weeks; no driving for at least 4 weeks; full recovery takes 2 to 3 months.

How often

13,925 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 66. 30.1 per 100,000 people a year in the middle country of 44 OECD and partner countries.

Since when

• 1960: Robert Goetz joins a chest artery to a heart artery
• 1964: Vasilii Kolesov in the Soviet Union does the first successful one
• 1967: René Favaloro standardises it with a vein from the leg

Risks

Wound infection, an irregular heartbeat or weaker kidneys for a few days, memory problems for a few months, and a heart attack or stroke during or soon after the operation. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Coronary artery bypass graft · Wikipedia: Coronary artery bypass surgery · Wikipedia: René Favaloro

Opens a narrowed heart artery from the inside with a tiny balloon, then leaves a mesh tube (a stent) to hold it open. To restore blood flow to the heart when medicines are not enough, and often as emergency treatment during a heart attack.

How it is done

• Through the wrist. A thin tube is passed into an artery at the wrist and steered up to the heart, watched on X-ray video. A balloon at its tip widens the artery and opens the stent, which stays there for good.
• Through the groin. The same tube can go in through an artery in the groin (or the arm) instead.

Anaesthetic

Local: you are awake.

Time in theatre

30 minutes to 2 hours

Hospital stay

Home the same day or the next (several days after a heart attack)

Recovery

No heavy lifting, hard exercise or driving for at least a week.

How often

72,427 operations a year in England’s NHS hospitals (2024-25); 23% went home the same day; average age 66. 195 per 100,000 people a year in the middle country of 45 OECD and partner countries.

Since when

• 1977: Andreas Grüntzig does the first coronary angioplasty in Zurich (16 September)
• 1986: The first coronary stents are implanted (Ulrich Sigwart, Lausanne)

Risks

The risk of serious problems is generally small, but they include heavy bleeding, a heart attack and a stroke. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Coronary angioplasty and stent insertion · Wikipedia: Percutaneous coronary intervention · Wikipedia: Ulrich Sigwart

A small device that treats heart rhythm problems; its wires run along a vein into the heart. For heart rhythm problems such as heart block, and some kinds of heart failure.

How it is done

• Wires through a vein. A small cut on the left side of the chest; the wires are guided along a vein into the heart and the pacemaker sits under the skin near the collarbone.
• Leadless. A tiny leadless pacemaker goes into a vein and is guided straight into the heart: no wires and no chest cut.

Anaesthetic

Local, sometimes with sedation.

Time in theatre

About an hour

Hospital stay

Usually one night (often home the same day after a leadless one)

Recovery

Gentle arm movements within days; no raising the elbow above the shoulder for 4 to 6 weeks; no driving for at least a week. The battery usually lasts 6 to 7 years.

How often

44,680 operations a year in England’s NHS hospitals (2024-25); 41% went home the same day; average age 77.

Since when

• 1958: Arne Larsson gets the first implanted pacemaker in Sweden (8 October), made by Rune Elmqvist and Åke Senning
• 2013: Leadless pacemakers, passed up a leg vein, are announced

Risks

It is a common procedure and unlikely anything will go seriously wrong; sometimes an infection afterwards. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Artificial cardiac pacemaker · NHS: Pacemaker implantation

Replaces a damaged heart valve, most often the aortic valve, with a mechanical valve or one made of tissue. For heart valve disease: a valve that has become too narrow or leaks.

How it is done

• Open heart surgery. A long cut down the centre of the chest, through the breastbone; a machine keeps the blood flowing.
• TAVI (catheter). A new valve is passed on a catheter through a blood vessel in the upper leg (or the arm or chest) up to the heart, under local anaesthetic.
• Smaller cuts. Sometimes the valve can be replaced through smaller cuts in the chest; not always suitable.

Anaesthetic

General for surgery; local for TAVI.

Time in theatre

TAVI usually 1 to 2 hours

Hospital stay

About a week; 2 to 3 days after TAVI

Recovery

No driving for at least 4 weeks; 2 to 3 months to recover fully after surgery, quicker after TAVI.

How often

13,486 operations a year in England’s NHS hospitals (2024-25); 1% went home the same day; average age 75.

Since when

• 2002: Alain Cribier implants the first TAVI valve in Rouen, France (16 April)

Risks

Wound infection, bleeding, an irregular heartbeat (sometimes needing a pacemaker) and, rarely, weaker kidneys. A mechanical valve means blood-thinning medicine for life; most replacement valves last 15 to 20 years, mechanical ones longer. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Transcatheter aortic valve replacement · NHS: How it’s done · NHS: Recovery · NHS: Complications

Replaces a failing heart with a healthy heart from a donor. For severe heart failure that other treatments can no longer help.

How it is done

• Open heart surgery. The chest is opened through the middle of the breastbone and a heart-lung machine takes over; the donor heart is joined to the cuff of the old one and to the blood vessels.

Anaesthetic

General.

Time in theatre

Around 4 to 6 hours

Hospital stay

At least a few weeks (about 2 to 3 for those in good shape); a ward after 2 to 3 days in critical care

Recovery

Sore for a few weeks; immunosuppressant medicines lower the immune system so it does not reject the heart.

How often

172 operations a year in England’s NHS hospitals (2024-25); 1% went home the same day; average age 41.

Since when

• 1967: Christiaan Barnard performs the first human heart transplant in Cape Town (3 December)
• 1968: Norman Shumway at Stanford and Donald Ross in London follow
• 1983: Ciclosporin, an anti-rejection medicine, comes into wide use

Sources: Wikipedia: Heart transplantation · NHS Blood and Transplant: Heart transplant surgery · NHS Blood and Transplant: Recovery

Repairs a ballooned section of the body’s main artery in the belly before it can burst, lining it with a graft. An abdominal aortic aneurysm bigger than 5.5 cm across (5.0 cm in women) is at risk of bursting.

How it is done

• Through the groin (EVAR). Two small wounds in the groin; a stent graft (fabric on metal struts) is passed up inside the artery under X-ray and opened inside the aneurysm.
• Open repair. A larger cut in the belly; a graft is sewn into the aorta.

Recovery

After EVAR the graft is checked with regular scans for life.

How often

6,415 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 70.

Since when

• 1990: Juan Parodi performs the first successful EVAR in Buenos Aires (7 September)

Risks

After EVAR, serious complications including death in about 1 in 70, with a risk of death three times lower than after open repair. Up to 1 in 10 need another procedure later, for a leak around the graft. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Endovascular aneurysm repair · Cambridge University Hospitals NHS: EVAR

Removes fatty deposits (plaque) from inside a carotid artery in the neck. To improve blood flow and help prevent a stroke, usually when the artery is more than half blocked.

How it is done

• Neck cut. A small cut in the side of the neck; the artery is opened, the plaque removed, and a patch is sometimes stitched in. The scar is several centimetres long.

Anaesthetic

General, or local (awake with the neck numb).

Time in theatre

1 to 2 hours

Hospital stay

Usually home the day after

Recovery

A few weeks to recover fully; no driving until you can look over your shoulder; no heavy lifting for at least 6 weeks.

How often

2,990 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 70.

Since when

• 1953: Michael DeBakey performs an endarterectomy in Houston (around 1953)
• 1954: Felix Eastcott’s London operation is the first one recorded, in The Lancet

Risks

Complications are rare: a small risk of stroke after the operation, and nerve damage that can cause numbness or weakness in the face. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Carotid endarterectomy · NHS 111 Wales: Carotid endarterectomy

Seals or removes swollen, twisted veins in the legs. For varicose veins that cause problems.

How it is done

• Heat (ablation). Usually the first choice: a thin tube is threaded up the vein through a small cut at the knee or ankle, guided by ultrasound, and heat from radio waves or a laser seals it.
• Foam injections. A foam is injected into the vein, checked with ultrasound; it blocks the vein.
• Stripping. One cut in the groin and another at the knee or ankle; the vein is tied off and pulled out with a wire.

Anaesthetic

Local for heat or foam; general for stripping.

Hospital stay

Home the same day

Recovery

Most activities straight away after heat or foam, with compression stockings for about a week; 1 to 2 weeks off work after stripping.

How often

32,008 operations a year in England’s NHS hospitals (2024-25); 97% went home the same day; average age 57.

Risks

Some pain and bruising. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Varicose veins treatment

A device that watches the heart and, if a life-threatening rhythm starts, paces the heart or gives it an electric shock. A built-in life-saver for people at risk of dangerous heart rhythm problems.

How it is done

• Lead through a vein. A small cut below the left collarbone makes a pocket under the skin for the device; a lead is passed along a vein to the bottom chamber of the heart.

Anaesthetic

Local.

Time in theatre

1 to 2 hours

Hospital stay

Home once a doctor has checked you

Recovery

No lifting the arm on that side above the shoulder for about a month; no driving for one or six months, depending on why it was fitted. A shock feels like a firm thump in the chest and lasts seconds. The battery lasts about 5 to 10 years.

How often

11,776 operations a year in England’s NHS hospitals (2024-25); 61% went home the same day; average age 66.

Since when

• 1980: Levi Watkins Jr implants the first ICD at Johns Hopkins (February), after Michel Mirowski’s team’s research

Risks

Bleeding or bruising is very common; other risks are extremely small. General information, not advice: your surgeon will explain your own risks.

Sources: Dorset County Hospital NHS: ICD · Wikipedia: Implantable cardioverter-defibrillator

Removes the part of the lung with the cancer: most often one lobe (lobectomy); sometimes a smaller wedge or segment, or the whole lung. A lobectomy is the most common operation for early stage lung cancer.

How it is done

• Keyhole (VATS). 1, 2 or 3 small cuts on the side of the chest; some surgeons use a robotic system.
• Open (thoracotomy). A cut between the ribs that runs around the side of the chest.

Anaesthetic

General.

Hospital stay

About two days

Recovery

A few weeks, with tiredness that can last months; driving can be 6 to 12 weeks after surgery.

How often

13,118 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 66.

Since when

• 1918: Harold Brunn performs the first successful lobectomy
• 1933: Evarts Graham and Singer: the first successful one-stage removal of a whole lung

Risks

Many problems are minor but some can be life threatening; after a whole lung is removed, people can be more breathless. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Pneumonectomy · Cancer Research UK: Types of lung cancer surgery · Cancer Research UK: After surgery

Replaces one or both diseased lungs with healthy lungs from a donor. For severe lung disease that other treatments can no longer help.

How it is done

• Open surgery. The patient’s own lung or lungs are removed and the donor lungs put in; the cut depends on the patient and the surgeon. A machine (ECMO) or a bypass can support the circulation.

Anaesthetic

General.

Time in theatre

6 to 8 hours

Recovery

Most need help with breathing for the first few days.

How often

141 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 54.

Since when

• 1963: James Hardy performs the first human lung transplant in Mississippi (11 June)
• 1983: Joel Cooper in Toronto: the first long-term success

Risks

The tubes used can cause bleeding, infection or damage to vessels or nerves, which is rare. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Lung transplantation · NHS Blood and Transplant: Lung transplant surgery

Removes a breast cancer: either just the lump with a margin of healthy tissue, or the whole breast. To take out the cancer, and to find out whether it has reached the lymph nodes in the armpit.

How it is done

• Lumpectomy. Removes the area of cancer and some of the breast tissue around it, keeping the breast. Lymph nodes in the armpit are checked for cancer cells.
• Mastectomy. Removes all of the breast. A new breast shape can be made with a reconstruction.

Anaesthetic

General: you are asleep.

Hospital stay

Many go home the same day or the next; 2 to 7 days with a reconstruction at the same time

Recovery

Depends on the operation; arm and shoulder exercises afterwards.

How often

64,631 operations a year in England’s NHS hospitals (2024-25); 72% went home the same day; average age 59. 156 per 100,000 women a year in the middle country of 42 OECD and partner countries.

Since when

• 1882: The first radical mastectomy
• 1989: An 8-year randomised trial comparing mastectomy with lumpectomy backs breast-conserving surgery

Risks

Infection, bleeding and shoulder stiffness. General information, not advice: your surgeon will explain your own risks.

Sources: Cancer Research UK: Breast cancer surgery · Cancer Research UK: After surgery · Wikipedia: Mastectomy · Wikipedia: Lumpectomy

Places implants between the breast tissue and the chest muscle, or behind the muscle. Mostly cosmetic; the NHS pays only in some cases, such as very uneven breasts or none at all, depending on the area.

How it is done

• Cut under the breast. A cut next to or below the breast; the implant goes in between the breast tissue and the chest muscle, or behind the muscle.

Anaesthetic

General.

Time in theatre

60 to 90 minutes

Hospital stay

Home the same day or after one night

Recovery

A week or 2 off work; no driving for at least a week; no heavy lifting for a month. Implants do not last a lifetime: some women need more surgery after about 10 years.

Cost (private, UK)

£3,500 to £8,000 in the UK

How often

3,788 operations a year in England’s NHS hospitals (2024-25); 59% went home the same day; average age 53. England’s NHS figure is mostly reconstruction after cancer, not cosmetic surgery.

Since when

• 1962: The first breast enlargement with a silicone implant, Thomas Cronin and Frank Gerow’s design

Risks

Thick scars, the breast hardening as scar tissue tightens around the implant, rupture, rippling, changes in nipple feeling; very rarely an immune system cancer (BIA-ALCL). General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Breast implant · NHS: Breast enlargement

Removes fat, glandular tissue and skin to make the breasts smaller and lighter, moving the nipple up. The NHS may offer it when very large breasts cause back, shoulder or neck pain and other options have not worked; otherwise it is private.

How it is done

• Anchor-shaped cuts. Cuts around the nipple, down the breast and along the crease below it; the nipple is moved, usually still attached to its blood supply.

Anaesthetic

General.

Time in theatre

2 to 3 hours

Hospital stay

1 or 2 nights

Recovery

2 to 6 weeks to recover fully; 2 to 3 weeks off work; no strenuous exercise for up to 6 weeks; swelling for around 3 months.

Cost (private, UK)

Around £6,500 in the UK

How often

4,207 operations a year in England’s NHS hospitals (2024-25); 56% went home the same day; average age 50.

Risks

Loss of nipple sensation, being unable to breastfeed, scarring, uneven breasts, wound healing problems. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Breast reduction

Takes out the gallbladder, the small pouch under the liver that stores bile. Usually for gallstones causing severe or frequent tummy pain, or an inflamed gallbladder. Gallstones that cause no symptoms may not need surgery.

How it is done

• Keyhole. Most people have keyhole surgery: a cut just below the belly button and a few small cuts on the right side of the tummy, with a camera and long instruments.
• Open. One larger cut in the tummy, used when the gallbladder is very inflamed or keyhole is not possible. It can mean more pain and a longer recovery.

Anaesthetic

General: you are asleep.

Time in theatre

About 1 hour

Hospital stay

Usually home the same day; some people stay a night

Recovery

Back to work after 1 to 2 weeks; it can take several weeks to feel fully recovered.

How often

80,196 operations a year in England’s NHS hospitals (2024-25); 55% went home the same day; average age 51. 198 per 100,000 people a year in the middle country of 45 OECD and partner countries.

Since when

• 1882: Carl Langenbuch removes the first gallbladder in Berlin
• 1985: Erich Mühe does the first keyhole removal in Böblingen, Germany
• 1987: Philippe Mouret in Lyon: keyhole removal with a video camera

Risks

Small risks of infection, blood clots and damage to the bile ducts; rarely, bile leaking into the tummy. Some people have indigestion, pain or diarrhoea afterwards. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Why it is done · NHS: How it is done · NHS: Recovery · NHS: Complications · Wikipedia: Cholecystectomy

Takes out an inflamed appendix, the small finger-shaped pouch on the large bowel. Appendicitis: left alone, the appendix can burst and infect the whole tummy. You do not need your appendix.

How it is done

• Keyhole. A few small cuts in the tummy and a thin tube with a camera to see and remove the appendix.
• Open. Sometimes a larger cut in the lower right side of the tummy is needed.

Anaesthetic

General: you are asleep.

Hospital stay

Often home the day after keyhole surgery; a few days after open surgery

Recovery

Most people recover in 1 to 2 weeks; no driving until you can do an emergency stop.

How often

47,689 operations a year in England’s NHS hospitals (2024-25); 2% went home the same day; average age 35. 120 per 100,000 people a year in the middle country of 45 OECD and partner countries.

Since when

• 1735: Claudius Amyand removes an appendix in London (one of the first recorded)
• 1980: Kurt Semm does the first keyhole appendix removal (13 September)

Risks

Complications are rare: wound infection, bleeding, scar tissue (adhesions) and an abscess. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Appendicitis treatment · Wikipedia: Appendectomy

Pushes back tissue or bowel bulging through a weak spot in the groin and reinforces the wall, usually with a mesh. When the hernia hurts, or to prevent the bowel getting trapped (strangulated). A hernia with no symptoms may not need repair.

How it is done

• Open. One larger cut in the groin; a thin sheet of mesh is put over the weak spot and fixed with small stitches.
• Keyhole. A few small cuts near the belly button and lower tummy; the mesh goes in from the inside.

Anaesthetic

General, or local (you are awake but feel no pain).

Time in theatre

30 to 90 minutes

Hospital stay

Usually home the same day

Recovery

At least 1 to 2 weeks off work (up to 6 with heavy lifting); full recovery in about 4 to 6 weeks.

How often

75,187 operations a year in England’s NHS hospitals (2024-25); 75% went home the same day; average age 57. 182 per 100,000 people a year in the middle country of 45 OECD and partner countries.

Since when

• 1884: Edoardo Bassini describes the first efficient repair (1880s)

Risks

Uncommon: wound infection, bruising, pain or numbness lasting more than 3 months, and the hernia coming back. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Inguinal hernia repair · Wikipedia: Inguinal hernia surgery

Pushes back tissue bulging through a gap in the muscles at the belly button and closes the gap. Adults usually need surgery, as the hernia will not get better by itself; in babies it usually disappears by the age of 5.

How it is done

• Cut by the belly button. Cuts in the skin near the hernia; it is pushed back and the gap is stitched, with a mesh for larger hernias.

Anaesthetic

General.

Time in theatre

30 to 60 minutes

Recovery

Up to 4 to 6 weeks; at least 1 to 2 weeks off work (up to 6 with heavy lifting).

How often

25,732 operations a year in England’s NHS hospitals (2024-25); 74% went home the same day; average age 51.

Risks

A small risk of infection, blood clots, lasting pain and the hernia coming back. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Umbilical hernia

Makes the stomach much smaller: a sleeve removes around 80% of it; a bypass makes a small pouch joined to the lower small intestine. On the NHS for people with a BMI of 40 or more, or 35 to 40 with a condition that losing weight could improve (such as diabetes or high blood pressure), who agree to healthy lifestyle changes.

How it is done

• Sleeve. Keyhole surgery through about 5 small cuts; around 80% of the stomach is removed, leaving a sleeve shape.
• Bypass. Keyhole surgery; staples divide the stomach into a small pouch at the top, and food goes from the pouch into the lower small intestine.

Anaesthetic

General.

Time in theatre

Sleeve 1 to 3 hours; bypass about 2 hours

Hospital stay

1 to 3 days

Recovery

Fluids for 2 weeks, then runny, then soft food; normal activities after 4 to 6 weeks.

How often

5,434 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 44. England’s figure counts sleeve gastrectomies and gastric bypasses (the codes a BJS Open study of NHS bariatric surgery used).

Since when

• 1960s: Weight loss surgery begins, after the gastric bypass is developed
• 1990: The first sleeve gastrectomy, as the first stage of a bigger operation
• 1994: Alan Wittgrove performs the first keyhole gastric bypass

Risks

A small chance of a leak from the stomach, blood clots, gallstones with fast weight loss, and folds of excess skin. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Bariatric surgery · NHS: Why it’s done · NHS: How it’s done · NHS: Recovery · NHS: Complications · BJS Open (2017): bariatric surgery codes

Removes the part of the large bowel (colon) with the cancer; the ends are joined, or one is brought out on the belly as a stoma. To remove a bowel cancer.

How it is done

• Keyhole. Several small cuts in the belly; some surgeons use a robotic system. Recovery is generally quicker.
• Open. One long cut down the belly.

Anaesthetic

General.

Hospital stay

About a week

Recovery

Quicker after keyhole surgery. A stoma, if needed, may be for a while or for good.

How often

35,511 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 64. England’s figure counts every removal of part of the large bowel, for cancer and other diseases.

Sources: Cancer Research UK: Colectomy

Cuts away piles (swollen blood vessels in and around the anus), or staples or stitches them so they shrink. For piles that need more than banding or injections.

How it is done

• Cut away. Haemorrhoidectomy: the piles are cut out.
• Stapled or tied. Stapling pushes the piles back inside the anus; artery ligation stitches off their blood supply so they shrink.

Anaesthetic

Usually general.

Hospital stay

Home the same day or the next

How often

10,683 operations a year in England’s NHS hospitals (2024-25); 86% went home the same day; average age 50.

Since when

• 1st century: Celsus describes tying off and cutting out piles

Risks

Treatment does not always stop piles coming back. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Hemorrhoidectomy · NHS: Piles (haemorrhoids)

Replaces a failing liver with a healthy one from a donor; an adult may get part of a liver (a “split liver”), the rest going to a child. For liver failure that other treatments can no longer help.

How it is done

• Open surgery. A cut in the upper half of the belly; the damaged liver is removed and the donor liver put in its place.

Anaesthetic

General.

Time in theatre

5 to 8 hours

How often

823 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 47.

Since when

• 1963: Thomas Starzl attempts the first human liver transplant
• 1967: A child transplanted by Starzl lives more than a year
• 1980s: Ciclosporin makes the liver transplant a standard treatment

Sources: Wikipedia: Liver transplantation · NHS Blood and Transplant: Liver transplant surgery

Removes the inner part of an enlarged prostate, which presses on the tube that carries urine. To help you pee more easily when an enlarged prostate (not cancer) blocks the flow.

How it is done

• Through the penis. A long, thin tube with a camera and tools is passed up the penis to the prostate, and small pieces are cut away from the inside. There is no cut on the skin.

Anaesthetic

General, or spinal (awake, numb from the waist down).

Time in theatre

Around an hour

Hospital stay

1 to 4 days, with a catheter

Recovery

Usual activities after about 2 to 4 weeks; up to 6 weeks to heal fully.

How often

25,542 operations a year in England’s NHS hospitals (2024-25); 22% went home the same day; average age 72. 106 per 100,000 men a year in the middle country of 44 OECD and partner countries.

Risks

No semen when you ejaculate (sex feels the same), erection problems, leaking urine and, if the prostate grows back, a second operation. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: TURP · NHS: TURP risks

Removes the whole prostate gland. To treat prostate cancer.

How it is done

• Robot-assisted keyhole. Most people in the UK have robot-assisted keyhole surgery (also called da Vinci surgery).
• Open. Some have open surgery.

Hospital stay

Usually just one night

Recovery

It takes a few weeks.

How often

10,673 operations a year in England’s NHS hospitals (2024-25); 2% went home the same day; average age 64.

Since when

• 1904: Hugh Hampton Young and William Halsted develop the radical prostatectomy at Johns Hopkins
• 1991: The first keyhole prostatectomy, in Texas

Risks

Difficulty getting an erection, and leaking urine. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Prostatectomy · Cancer Research UK: Prostate cancer surgery

Places a healthy kidney from a donor in the lower belly; the patient’s own kidneys usually stay where they are. For kidney failure.

How it is done

• Cut in the lower belly. A cut in the lower belly on the right or left; the new kidney’s blood vessels are joined to the patient’s, and its ureter to the bladder, usually with a temporary stent.

Anaesthetic

General.

Time in theatre

2 to 4 hours

How often

2,728 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 50.

Since when

• 1954: Joseph Murray’s team transplants a kidney between identical twins in Boston (23 December): the first true success
• 1964: Anti-rejection medicines come into routine use

Sources: Wikipedia: Kidney transplantation · NHS Blood and Transplant: Kidney transplant surgery

Breaks up or removes kidney stones too big to pass by themselves. Most stones pass with medicine and water; larger ones can be very painful and need treatment.

How it is done

• Shock waves. Shock waves from outside the body break the stone into pieces that pass more easily; no anaesthetic is needed.
• Tube (endoscope). A long, thin tube is passed up the urethra, or through a small cut in the back, to reach the stone, under general anaesthetic.

Anaesthetic

None for shock waves; general for the tube procedures.

How often

42,747 operations a year in England’s NHS hospitals (2024-25); 67% went home the same day; average age 55.

Since when

• 1980: Shock wave lithotripsy is first used on a patient (February)

Sources: Wikipedia: Extracorporeal shockwave lithotripsy · NHS: Kidney stones treatment

Seals, blocks or cuts the tubes that carry sperm, so semen no longer contains it. Permanent contraception.

How it is done

• Small cut. A small cut in the scrotum under local anaesthetic; the sperm tubes are sealed, blocked or cut.

Anaesthetic

Local.

Time in theatre

15 to 20 minutes

Hospital stay

Home the same day

Recovery

Back to work within 24 hours; no sport or heavy lifting for 1 to 2 weeks; other contraception until a doctor confirms it worked, usually around 12 weeks.

How often

6,051 operations a year in England’s NHS hospitals (2024-25); 98% went home the same day; average age 39. England’s figure counts vasectomies done in hospital; many are done in community clinics.

Sources: NHS: What happens · NHS: Recovery

Removes the foreskin. On the NHS only for medical reasons, such as a tight foreskin or repeated soreness and swelling, when other treatments have not worked.

How it is done

• Removing the foreskin. The foreskin is removed and the skin closed with dissolvable stitches, which dissolve after 2 to 6 weeks.

Anaesthetic

Usually general; sometimes local or an epidural.

Time in theatre

About 30 minutes

Hospital stay

Usually home the same day

Recovery

4 to 6 weeks to heal; a week off work; no sex for at least 4 weeks.

How often

31,442 operations a year in England’s NHS hospitals (2024-25); 90% went home the same day; average age 40.

Risks

Mostly minor, such as bleeding; less sensitivity; rarely, narrowing of the urethra. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Circumcision in men

Removes the whole kidney with some tissue around it (radical nephrectomy), or only the part with the cancer (partial). Mainly for kidney cancer; which operation depends on the size of the cancer and whether it has spread.

How it is done

• Keyhole. 3 to 5 small cuts of about a centimetre each; people can usually go home sooner.
• Robotic. The surgeon controls four robotic arms holding the camera and instruments from a console, through a few small cuts.
• Open. One large cut.

Anaesthetic

General.

Recovery

A big operation, with several tubes in at first.

How often

10,336 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 61.

Sources: Cancer Research UK: Kidney cancer surgery · Cancer Research UK: Removing part or all of the kidney

Cuts bladder tumours out of the bladder lining from inside, and shows whether the cancer has reached the muscle of the bladder wall. The main treatment for bladder cancer that has not grown into the muscle.

How it is done

• Through the urethra. A thin rigid tube (cystoscope) is passed up the urethra and small instruments cut the tumours out: no cut on the skin.

Anaesthetic

Usually general; sometimes spinal.

Time in theatre

15 to 90 minutes

Hospital stay

Usually a day case; sometimes overnight or a couple of days

Recovery

Lots of fluids to flush the bladder; sometimes a catheter for a short time.

How often

35,058 operations a year in England’s NHS hospitals (2024-25); 49% went home the same day; average age 73.

Risks

Bleeding, sometimes 10 to 14 days later; infection; rarely a small tear in the bladder. General information, not advice: your surgeon will explain your own risks.

Sources: Cancer Research UK: TURBT

Removes or folds away the sac of fluid around a testicle that has made the scrotum swell. To take away the swelling.

How it is done

• Small cut. Through a small cut in the scrotum; the wound is closed with dissolvable stitches.

Hospital stay

Home the same day

Recovery

Take it easy for a few days; most return to work in a week or two; no driving for a week or two; no heavy lifting for at least 4 weeks.

How often

6,384 operations a year in England’s NHS hospitals (2024-25); 85% went home the same day; average age 53.

Risks

Some bleeding, bruising and swelling, which usually settle in a few days. General information, not advice: your surgeon will explain your own risks.

Sources: Ashford and St Peter’s NHS: Repair of hydrocele

Removes the womb (uterus), and often the cervix; sometimes the ovaries and fallopian tubes too. For problems such as heavy periods, long-term pelvic pain, fibroids and some cancers, usually after gentler treatments have been tried. It ends periods and pregnancy.

How it is done

• Keyhole. Small cuts in the tummy; the womb comes out through the vagina.
• Through the vagina. The womb is removed through a cut at the top of the vagina, with no cut on the tummy.
• Open. A cut in the lower tummy, along the bikini line or from the belly button down.

Anaesthetic

Usually general; a vaginal hysterectomy can be done under spinal or local anaesthetic.

Time in theatre

About an hour (vaginal or open)

Hospital stay

1 to 4 days; up to 5 for open surgery

Recovery

About 6 to 8 weeks to recover; driving after 2 to 6 weeks.

How often

37,870 operations a year in England’s NHS hospitals (2024-25); 6% went home the same day; average age 53. 171 per 100,000 women a year in the middle country of 44 OECD and partner countries.

Since when

• 1990: Total keyhole hysterectomy is developed in the early 1990s

Risks

A small risk of heavy bleeding, infection, damage to the bladder or bowel, and a reaction to the anaesthetic. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Hysterectomy · NHS: What happens · NHS: Recovery · Wikipedia: Hysterectomy

Delivers a baby through a cut in the tummy and the womb. Planned (usually from the 39th week) when a vaginal birth is not advised, or as an emergency when it becomes too risky.

How it is done

• Bikini-line cut. A cut about 10 to 20 cm long across the lower tummy, just below the bikini line, and through the womb.

Anaesthetic

Usually spinal or epidural: awake, numb from the waist down.

Time in theatre

About 40 to 50 minutes

Hospital stay

1 to 2 days

Recovery

Usually within 6 weeks; longer than after a vaginal birth. No driving for a few weeks.

How often

237,998 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 31. About 31% of births are by caesarean in the middle country of 46 OECD and partner countries.

Since when

• 1881: Ferdinand Kehrer brings in the cut across the womb: the first modern caesarean
• 1912: The low cross cut, the one used today, becomes the norm

Risks

Generally very safe; risks include infection of the wound or the womb, blood clots, heavy bleeding and damage to nearby organs. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Caesarean section · Wikipedia: Caesarean section

Blocks the fallopian tubes, or removes part of them and seals them, so eggs and sperm cannot meet. Permanent contraception.

How it is done

• Keyhole. 2 or 3 small cuts near the belly button and a camera (laparoscope) to reach the tubes.

Anaesthetic

Usually general.

Time in theatre

20 to 30 minutes

Hospital stay

Usually home the same day

Recovery

About 7 days off work and no sex for at least 7 days; keep using contraception for 7 days.

How often

3,817 operations a year in England’s NHS hospitals (2024-25); 87% went home the same day; average age 35.

Since when

• 1880: Samuel Lungren performs the first modern female sterilisation

Sources: Wikipedia: Tubal ligation · NHS: What happens · NHS: Recovery

Replaces a worn hip joint with an artificial ball and socket. Mostly for arthritis, when hip pain and stiffness stop everyday life and other treatments no longer help.

How it is done

• Open. One or more cuts at the side or back of the hip. The top of the thigh bone is removed and a metal (or ceramic) ball is fitted; the socket is drilled out for a plastic (or ceramic) cup. Some surgeons use smaller cuts.

Anaesthetic

Spinal (awake, numb from the waist down) or general.

Time in theatre

About 1 to 2 hours

Hospital stay

Around 1 to 3 days

Recovery

Back to work and driving after about 6 weeks; full recovery takes several months.

How often

103,420 operations a year in England’s NHS hospitals (2024-25); 2% went home the same day; average age 69. 186 per 100,000 people a year in the middle country of 45 OECD and partner countries.

Since when

• 1891: Themistocles Gluck tries an ivory ball in Germany
• 1938: Philip Wiles fits the first total hip replacement in London
• 1962: John Charnley: the low-friction hip, the model for today’s

Risks

Blood clots, wound infection, a small difference in leg length and, uncommonly, dislocation. Modern hips are designed to last at least 15 years. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: How a hip replacement is done · NHS: Complications · NHS: Recovery · Wikipedia: Hip replacement

Replaces the worn surfaces of the knee with metal and plastic parts. Mostly for arthritis that causes severe pain and stiffness despite other treatments.

How it is done

• Open. A cut down the front of the knee. In a total replacement (the most common) the ends of the thigh bone and the shin bone are capped with metal and plastic; a partial replacement fixes one side with a smaller cut.

Anaesthetic

General, or spinal (awake, numb from the waist down).

Time in theatre

About 1 to 2 hours

Hospital stay

1 to 4 days

Recovery

Work after 6 to 12 weeks; driving after at least 6 weeks; full recovery can take several months or longer.

How often

103,847 operations a year in England’s NHS hospitals (2024-25); 2% went home the same day; average age 70. 158 per 100,000 people a year in the middle country of 44 OECD and partner countries.

Since when

• 1890: The first artificial knee, made of ivory
• 1974: The first successful total condylar knee, New York: the model for today’s

Risks

Most people have no complications: blood clots, wound infection, ongoing pain or stiffness. Most knee replacements last about 25 years. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: How a knee replacement is done · NHS: Complications · NHS: Recovery · Wikipedia: Knee replacement

Fixes a broken hip with screws, nails, rods or plates, or replaces part or all of the joint. Surgery usually happens the same day or the day after arriving in hospital.

How it is done

• Fixing the bone. The broken bones are fixed back in place with screws, nails, rods or plates.
• Partial replacement. Part of the damaged hip joint is replaced with an artificial part (hemiarthroplasty).
• Total replacement. The whole damaged joint is replaced.

Hospital stay

Around 1 to 4 weeks

Recovery

Physiotherapy soon after surgery to stand and move again; healing takes weeks or months, and some people never get back the same strength and movement.

How often

31,265 operations a year in England’s NHS hospitals (2024-25); 0% went home the same day; average age 83. England’s figure counts partial hip replacements for broken hips; fixings with screws or nails are coded elsewhere.

Since when

• 1940: Austin Moore fits a metal prosthesis to a hip
• 1952: The Austin Moore prosthesis goes on sale; it is still used for broken hips in older people

Sources: Wikipedia: Hemiarthroplasty · NHS: Hip fracture

Replaces a torn anterior cruciate ligament (ACL) inside the knee with a graft, usually from the hamstring. Not every ACL tear needs surgery; it may if you play a lot of sport, or if the knee still causes problems after physiotherapy.

How it is done

• Keyhole. A small cut at the front of the knee for a camera (arthroscope), then more small cuts to place the graft.

Anaesthetic

General or spinal.

Time in theatre

1 to 3 hours

Hospital stay

Usually home the same day

Recovery

Crutches and a brace at first and physiotherapy for months; work after about 4 to 6 weeks; it can take up to a year to play sport again.

How often

10,918 operations a year in England’s NHS hospitals (2024-25); 62% went home the same day; average age 30.

Sources: NHS: How ACL surgery is done · NHS: Recovery

Looks inside the knee with a small camera and repairs damage. To check for and repair damage to the joint, such as a sports injury. Knee arthroscopy is the most common kind of arthroscopy.

How it is done

• Keyhole. Small cuts about 2 to 3 mm wide near the joint; the camera sends pictures to a screen.

Anaesthetic

General, local or spinal.

Time in theatre

30 minutes to 3 hours

Hospital stay

Most go home within a few hours

Recovery

From about 1 week to several months; driving after at least 2 weeks.

How often

29,135 operations a year in England’s NHS hospitals (2024-25); 89% went home the same day; average age 47.

Since when

• 1912: Severin Nordentoft reports arthroscopies of the knee
• 1919: Kenji Takagi in Tokyo, traditionally credited with the first knee arthroscopy

Risks

Rare: a reaction to the anaesthetic, joint pain, numbness, blood clots or infection. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Arthroscopy · NHS: Arthroscopy

Cuts the carpal tunnel open, so it stops pressing on the nerve to the hand. For carpal tunnel syndrome (tingling, numbness and pain in the hand); surgery usually cures it.

How it is done

• Small cut. An injection numbs the wrist, a small cut is made in the hand and the carpal tunnel is cut so it no longer presses on the nerve.

Anaesthetic

Local.

Time in theatre

Around 20 minutes

Hospital stay

No overnight stay

Recovery

About a month to get back to normal activities.

How often

45,996 operations a year in England’s NHS hospitals (2024-25); 98% went home the same day; average age 62.

Sources: NHS: Carpal tunnel syndrome treatment

Removes the bunion and straightens the big toe bone, fixing it with screws or staples. For painful bunions.

How it is done

• Cut over the big toe. A small cut over the big toe; the bunion is cut or scraped away and the toe bone straightened, held with metal screws or staples that often stay in for good.

Anaesthetic

Usually general; sometimes local.

Hospital stay

Most go home the same day

Recovery

Feet up for at least 2 weeks; 2 to 12 weeks off work; no driving for 6 to 8 weeks; no sport for 3 to 6 months.

How often

8,719 operations a year in England’s NHS hospitals (2024-25); 82% went home the same day; average age 54.

Risks

Bunions sometimes come back; the toe may be weaker, stiffer or not perfectly straight. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Bunions

Repairs torn tendons of the rotator cuff, the group of muscles and tendons that holds the shoulder joint. To repair a torn rotator cuff.

How it is done

• Keyhole or mini open. Two or three small keyhole cuts, or one small open cut; often with a nerve block, an injection of local anaesthetic around the nerves in the neck.

Anaesthetic

General, often with a nerve block.

Recovery

A sling for up to six weeks; no driving until after six weeks; desk jobs after 6 to 8 weeks, manual jobs 3 to 4 months; non-contact sport after about six months.

How often

9,247 operations a year in England’s NHS hospitals (2024-25); 71% went home the same day; average age 57.

Sources: University Hospital Southampton NHS: Rotator cuff repair

Releases fingers bent into the palm by thickened tissue (Dupuytren’s contracture). When the fingers can no longer straighten.

How it is done

• Fasciectomy. A cut along the palm and finger; the tissue is removed and the finger straightened. It has the lowest risk of the contracture coming back.
• Needle fasciotomy. A needle is passed in at several places along the palm and finger to loosen and straighten it, under local anaesthetic; more likely to come back.

Anaesthetic

General or local.

Hospital stay

Home the same day

Recovery

Up to 2 weeks after the needle; 4 to 12 weeks after a fasciectomy.

How often

19,986 operations a year in England’s NHS hospitals (2024-25); 96% went home the same day; average age 67. England’s figure counts operations to remove or divide fascia, mostly for Dupuytren’s (codes T52 and T54).

Risks

The contracture can come back after a few years; the finger may not be fully straight, and may be weaker and less flexible. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Dupuytren’s contracture

Frees a finger or thumb that catches or locks when it bends, by releasing a tight band over its tendon. When other treatments, such as a steroid injection, have not worked.

How it is done

• Small cut. A small cut in the palm releases the tight band (the A1 pulley) that catches the tendon.

Anaesthetic

Local, as a day case.

Time in theatre

Usually under 30 minutes

Hospital stay

Home the same day

Recovery

Fingers move straight away; no driving until the wound has healed; 4 to 6 weeks off for manual jobs.

How often

12,077 operations a year in England’s NHS hospitals (2024-25); 87% went home the same day; average age 56. England’s figure counts operations on tendon sheaths (code T72), which include trigger finger releases.

Risks

Wound infection (under 1 in 100), scar tenderness or lasting pain and swelling (under 5 in 100), nerve or blood vessel injury (under 1 in 100). General information, not advice: your surgeon will explain your own risks.

Sources: Gateshead Health NHS: Trigger finger release

Changes the shape of the nose by reshaping its bone and cartilage. Mostly cosmetic; the NHS provides it only when it is needed to help breathing.

How it is done

• Closed. Tiny cuts inside the nostrils: no visible scars, but not always possible.
• Open. A cut across the skin between the nostrils.

Anaesthetic

Usually general.

Time in theatre

1.5 to 3 hours

Hospital stay

1 or 2 nights

Recovery

A splint taped over the nose for 7 days; up to 2 weeks off work; bruising around the eyes for 3 weeks; swelling can take up to 6 months to go.

Cost (private, UK)

£4,000 to £7,000 in the UK

How often

3,380 operations a year in England’s NHS hospitals (2024-25); 67% went home the same day; average age 41.

Since when

• Ancient: The Sushruta Samhita describes rebuilding a nose with a flap of skin from the cheek
• 1887: John Orlando Roe performs the first modern rhinoplasty from inside the nose

Risks

Occasionally permanent breathing difficulty or a changed sense of smell; infection and bleeding. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Rhinoplasty · NHS: Nose reshaping (rhinoplasty)

Removes excess skin or fat from the upper or lower eyelids. For hooded or drooping upper lids and bags under the eyes.

How it is done

• Upper lids. A cut along the natural crease of the eyelid; excess skin, fat or muscle is removed and the scar sits in the fold.
• Lower lids. A cut just below the lower lashes, or on the inside of the lid; fat may be moved or removed.

Anaesthetic

Local or general.

Time in theatre

45 minutes to 2.5 hours

Hospital stay

Most go home the same day

Recovery

About 2 weeks off work; no driving for several days; bruising and redness can take weeks to fade.

Cost (private, UK)

£2,000 to £6,000 in the UK

How often

4,976 operations a year in England’s NHS hospitals (2024-25); 98% went home the same day; average age 67.

Risks

Occasionally blurred or double vision and uneven eyes; rarely the lower lid turns outwards (ectropion) or sight is affected. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Eyelid surgery

Lifts and pulls back the skin of the face, mainly to reduce loose skin around the jowls and neck. Cosmetic.

How it is done

• Cuts around the ear. Cuts above the hairline at the temple, running down in front of the ear, under the earlobe and behind it.

Anaesthetic

Usually general; sometimes local with sedation.

Time in theatre

2 to 3 hours

Hospital stay

Most stay one night

Recovery

About 2 to 4 weeks; the full effect can take 6 to 9 months to show.

Cost (private, UK)

From a few thousand pounds to £10,000 in the UK

How often

644 operations a year in England’s NHS hospitals (2024-25); 79% went home the same day; average age 65.

Since when

• 1901: Eugen Holländer performs the first facelift in Berlin, cutting away skin around the ears

Risks

Occasionally nerve injury, uneven results, hair loss, thick scars or slow healing. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Rhytidectomy · NHS: Facelift

Removes unwanted body fat from chosen areas with a suction tube. Cosmetic; it is not a treatment for obesity.

How it is done

• Suction tube. A small cut and a suction tube attached to a vacuum machine.

Anaesthetic

Usually general (an epidural for the lower body).

Time in theatre

1 to 3 hours

Hospital stay

Most stay one night

Recovery

A support corset or bandages worn constantly for several weeks; the results take up to 6 months to settle.

Cost (private, UK)

£3,000 to £8,500 in the UK

How often

Mostly done privately, so England’s NHS figures do not show it.

Since when

• 1970s: Arpad and Giorgio Fischer in Rome use a blunt tube with suction

Risks

Lumpy or uneven results and, rarely, a blood clot in the lungs. General information, not advice: your surgeon will explain your own risks.

Sources: Wikipedia: Liposuction · NHS: Liposuction

Removes loose skin, fat and stretch marks from the belly and tightens the stomach muscles. Mostly cosmetic.

How it is done

• Hip-to-hip cut. A large cut across the lower belly from hip to hip, just above the pubic area, and a second cut to free the belly button.

Anaesthetic

General.

Time in theatre

2 to 5 hours

Hospital stay

Most stay a few nights

Recovery

About 4 to 6 weeks off work and exercise; about 6 weeks to recover fully and see the result.

Cost (private, UK)

£5,000 to £10,000 in the UK

How often

352 operations a year in England’s NHS hospitals (2024-25); 9% went home the same day; average age 48.

Risks

Small risks of heavy bleeding, blood clots and infection. General information, not advice: your surgeon will explain your own risks.

Sources: NHS: Tummy tuck

Cuts out a skin cancer with some healthy skin around it. Mohs micrographic surgery is a specialist type that aims to remove all of the cancer. Surgery is the main treatment for non-melanoma skin cancer, especially when it is found early.

How it is done

• Cutting it out. The cancer is cut out with some surrounding healthy skin; if a large area is removed, skin may be taken from another part of the body.
• Mohs surgery. The cancer is removed in stages, each layer checked under a microscope while the patient waits, until no cancer cells are left. For a first basal cell carcinoma, most studies find cure rates between 97% and 99.8% (Wikipedia).

Anaesthetic

Usually local, as a day patient; larger operations may need general.

Hospital stay

Usually a day patient

How often

2,844 operations a year in England’s NHS hospitals (2024-25); 98% went home the same day; average age 67. England’s figure counts Mohs operations only.

Since when

• 1938: Frederic Mohs develops the method

Sources: Wikipedia: Mohs surgery · NHS: Non-melanoma skin cancer treatment · Cancer Research UK: Surgery for small skin cancers