Sushruta: The Father of Surgery – Immortalised in Bronze at the Royal College of Surgeons of Edinburgh

On June 19, 2026, a bronze statue of Maharishi Sushruta was unveiled at the Royal College of Surgeons of Edinburgh, one of the oldest surgical institutions in the world, founded in 1505. Weighing approximately 90 kilograms and crafted in Tamil Nadu using traditional techniques, the statue now stands in the Playfair Auditorium as a powerful symbol of India's ancient contribution to medical science. The ceremony, attended by medical professionals, academics, and dignitaries from India and the United Kingdom, celebrated the long-standing links between India and Scotland in medicine and surgery.

Yet beyond the ceremonial tribute lies a far more profound question: What exactly did Sushruta contribute to surgery, and why do his techniques—developed over 2,600 years ago—remain irreplaceable even in the age of robotic surgery and advanced medical technology?

Who Was Sushruta? Sushruta was a distinguished surgeon who flourished around 600 BCE in the ancient city of Kashi (modern-day Varanasi), India. Long before the renowned figures of Hippocrates, Celsus, and Galen, Sushruta was already making remarkable advancements in the field of surgery. He served as a teacher of medicine at Benares University, where he not only imparted his wisdom but also established the original code of medical ethics.

His magnum opus, the Sushruta Samhita, is the oldest surviving surgical text in the world. It contains descriptions of 1,120 illnesses, 700 medicinal plants, 64 preparations from mineral sources, and 57 preparations based on animal sources. The text discusses surgical techniques of making incisions, probing, extraction of foreign bodies, alkali and thermal cauterization, tooth extraction, and excisions. It enumerates six types of dislocations, twelve varieties of fractures, and provides a classification of bones and their reactions to injuries.

The Eight Foundational Surgical Procedures (Ashtavidha Shastra Karma) Perhaps Sushruta's most enduring contribution is his codification of the eight fundamental surgical procedures, known as Ashtavidha Shastra Karma. These eight procedures form the foundation of all surgical practice and continue to be used in modern surgical science. They are:

The first procedure is excision (Chedana) , which involves the removal of a part or whole of tissue. This is the foundation of modern surgical excision and the use of the scalpel. The second procedure is incision (Bhedana) , which means making an incision to open a cavity for draining pus, blood, or removing calculus—a technique directly correlating to modern surgical incision and drainage.

The third is scraping or debridement (Lekhana) , referring to the scraping or scarification of tissue, which is the basis of modern debridement and curettage. The fourth procedure is probing (Eshana) , which involves exploring wounds or cavities—the foundation of modern surgical probing and exploration.

The fifth is extraction (Aharana) , the removal of foreign bodies or diseased tissue, which is the basis for all modern foreign body removal and extraction procedures. The sixth procedure is drainage (Visravana) , the evacuation of fluids, which remains fundamental to modern drainage procedures. The seventh is suturing (Seevana) , bringing together wound edges with sutures—the foundation of all modern wound closure. The eighth and final procedure is cauterization (Agnikarma) , thermal cauterization, which has its modern equivalent in electrocautery and thermal ablation.

What makes these eight procedures truly remarkable is that they are still being used in modern surgical science to combat surgical disorders. Modern surgery may have advanced with technology, but the fundamental actions a surgeon performs—cutting, incising, scraping, probing, extracting, draining, suturing, and cauterizing—remain exactly the same.

Sushruta also described the three stages of surgery: Poorva Karma (pre-operative measures), Pradhan Karma (the operative procedure), and Paschat Karma (post-operative measures). This tripartite framework—pre-operative preparation, the surgery itself, and post-operative care—remains the standard protocol in every operating theatre worldwide.

Irreplaceable Surgical Technique I: Nasal Reconstruction (Rhinoplasty) Sushruta is universally recognized as the "Father of Plastic Surgery" for his pioneering work in reconstructive surgery. His description of nasal reconstruction, or rhinoplasty, is perhaps his most famous contribution and remains fundamentally irreplaceable.

In ancient India, the nose symbolisedhonour and dignity, and nasal mutilation was a common punishment for crimes like adultery, resulting in both physical disfigurement and social ostracism. Sushruta's rhinoplasty addressed this profound need.

His technique, later coined the "Indian method" , involved first using a "creeper leaf" to measure the size of the nasal defect. He then sliced a "patch of living flesh" from the patient's cheek and prepared the nasal stump by scarifying it with a knife. The cheek flap was then wrapped around the nasal stump and sewn at the edges. To maintain airway patency, two hollow reeds or pipes were inserted into the nostrils. Ghee (clarified butter) and honey were used to cleanse the wound and promote healing. After several weeks, when healing was complete, the connection to the cheek was severed.

This method of nasal repair using an adjacent flap of skin from the cheek is described as "a remarkably modern technique". The fundamental principle Sushruta established—using a pedicled flap with its own blood supply to reconstruct a defect—remains the cornerstone of modern reconstructive surgery. The cheek flap technique eventually evolved into the forehead flap, which became the preferred method due to superior blood supply and flexibility. However, the core principle—using a vascularized flap of living tissue to reconstruct a defect—was Sushruta's invention and remains irreplaceable. No synthetic material or advanced technology has been able to replicate the natural, functional, and aesthetic results of a living tissue flap.

Irreplaceable Surgical Technique II: Cataract Surgery Sushruta may have been the first physician in the world to perform surgery for cataracts. What is particularly striking is that his method appears to have been more akin to extracapsular lens extraction than to simple couching.

The procedure, described in the Sushruta Samhita, Uttar Tantra, involved several meticulous steps. Pre-operative care included oily massage followed by a heat-bath. The patient sat on a high stool, with the surgeon sitting in front. A sharp-pointed needle (Yau Vakra Shalaka) held between thumb, index, and middle finger was used to enter the anterior chamber at the junction of the medial and lateral two-thirds of the outer portion of the sclera. The tip of the needle then incised the capsule of the lens. The patient was asked to blow down the nostril while closing the opposite nares, which caused lens material to come out alongside the needle. Indigenous medicines were applied post-operatively, the eye was bandaged, and the patient was instructed to lie flat and avoid movement, particularly sneezing and coughing.

The general belief that Sushruta's technique was simple "couching" (displacing the cloudy lens into the vitreous cavity) is "no longer tenable". A study of the original text suggests that the method was more closely allied to the extracapsular extraction of recent times.

What makes this technique irreplaceable is not the specific steps—modern cataract surgery uses phacoemulsification and intraocular lens implantation—but the fundamental surgical principles Sushruta established: precise pre-operative preparation, meticulous surgical technique, attention to anatomical landmarks, and rigorous post-operative care. These principles remain the gold standard in ophthalmic surgery today.

Irreplaceable Surgical Technique III: Perineal Lithotomy (Bladder Stone Removal) Sushruta's procedure for the removal of bladder stones (Ashmarya) is another example of a surgical technique whose principles remain irreplaceable. His knowledge of bladder stones, surgical complications, and instrumentation identifies him as the originator of vesicolithotomy.

The Sushruta Samhita contains elaborate instructions for making the perineal incision, as well as detailed guidance on the care and general management of the patient after the operation. What is particularly remarkable is that modern researchers have experimentally reproduced Sushruta's perineal lithotomy in a cadaver model and found the surgical anatomy to be perfectly sound.

The lithotomy position—where the patient lies on their back with legs elevated and separated—was first portrayed in Sushruta's surgical procedures and remains in use today for gynecological examinations and surgery. This patient positioning, developed over 2,600 years ago, is irreplaceable because it provides optimal surgical access that no alternative position has been able to replicate.

Irreplaceable Surgical Technique IV: Fracture Management Sushruta's approach to fracture management was remarkably sophisticated and biomechanically sound. He described a fourfold treatment sequence. The first step was Anchana (traction), which corresponds to modern fracture reduction by traction. The second was Pidana (compression), applying compression to the fracture site. The third was Sankshepana (alignment), achieving anatomical reduction. The fourth and final step was Bandhana (immobilisation), which is the equivalent of modern splinting and casting.

This sequence provides "a biomechanically sound approach to fracture management, remarkably aligned with modern reduction and stabilisation protocols". For complex and compound fractures, Sushruta recommended surgical exposure, removal of foreign bodies, debridement, and suturing.

What makes this approach irreplaceable is that the fundamental principles of fracture management—reduction, immobilization, and rehabilitation—have not changed in over two millennia. Modern orthopaedic surgery may use titanium plates, intramedullary nails, and external fixators, but the underlying principles remain exactly as Sushruta described them.

Irreplaceable Surgical Technique V: Suturing Techniques Sushruta defined the suturing procedure as "a process of tying two ends of thread for union of wound edges with the help of needle and appropriate suturing material". He described four methods of suturing techniques.

The first is the straight or interrupted technique (Riju Granthi), where individual stitches are placed separately. The second is the continuous technique (Vellitaka), a running stitch along the wound. The third is the zigzag or subcuticular technique (Tunnasevani), a hidden stitch beneath the skin surface. The fourth is the interlocking or blanket technique (Gophanika), an interlocking stitch for wound edges.

These four suturing techniques—interrupted, continuous, subcuticular, and interlocking—remain the foundational suture patterns used by surgeons today. No surgery is complete without suturing, and the basic techniques Sushruta described have proven irreplaceable.

Beyond the Procedures: Sushruta's Broader Contributions Surgical Instruments Sushruta described over 120 surgical instruments and 300 surgical procedures. He was "perhaps the first surgeon in the world to describe different types of surgical instruments including endoscopes"—a feat "far beyond the imagination of any other surgeon at that period of time". His instruments included scalpels, forceps, probes, catheters, sounds, syringes, and even bamboo forceps.

Emphasis on Cleanliness and Cadaver Dissection Sushruta's approach emphasized cleanliness, cadaver dissection, and innovative practices in anesthesia. He understood the importance of hygiene in surgery centuries before the discovery of germs. His emphasis on cadaver dissection for anatomical knowledge was revolutionary and remains the foundation of surgical education.

Medical Ethics Sushruta established the original code of medical ethics, predating the Hippocratic Oath by several centuries. He emphasized the importance of proper training, the duty of the physician to the patient, and the ethical responsibilities of the surgeon.

Why These Techniques Remain Irreplaceable The surgical techniques Sushruta described are irreplaceable for several fundamental reasons. First, Sushruta understood the biology of living tissue—its blood supply, its healing capacity, and its response to injury. These biological principles are universal and unchanging. Second, Sushruta's descriptions of human anatomy, derived from cadaver dissection, remain fundamentally accurate. Human anatomy has not changed in 2,600 years. Third, the logical sequence of surgical procedures—preparation, operation, and post-operative care—is timeless. Fourth, Sushruta's techniques are elegant in their simplicity. They work because they respect the body's natural healing processes rather than fighting against them. Fifth, modern surgical techniques are built upon the foundation Sushruta laid. Every incision, every suture, every flap, every reduction follows principles he first described.

As one scholarly article notes, "Ayurvedic Surgery prescribed by Sushruta are still followed by the surgeons even today". Another observes that "Many conventional surgical techniques are still useful today".

How Indians Can See the Statue For Indians wishing to visit and pay homage to the Sushruta statue at the Royal College of Surgeons of Edinburgh, here is a comprehensive practical guide:

Location and Address: The statue is located within the Playfair Auditorium at the Royal College of Surgeons of Edinburgh. The college's address is Surgeons' Hall Museums, The Royal College of Surgeons of Edinburgh, Nicolson Street, Edinburgh, Midlothian, EH8 9DW. The college is situated in the city centre, approximately a 10-minute walk from Princes Street or Edinburgh Castle.

Getting There: Edinburgh is well-connected by air, with direct flights from major Indian cities including Delhi, Mumbai, and Bengaluru to Edinburgh Airport. From the airport, travellers can take the tram or bus to the city centre. The college is also a 10-minute walk from Waverley train station, Edinburgh's main railway station. For those driving, the college is accessible by road, though parking in the city centre can be limited.

Visiting Hours and Admission: The Surgeons' Hall Museums, which house the Playfair Auditorium where the statue is installed, are open to the public 7 days a week from 10:00 AM to 5:00 PM. Last admission is at 4:30 PM, and visitors are advised to allow at least two hours to view the collections. Booking is not required to visit the museum. Admission fees are approximately £9.50 for adults, with concessions available for students and seniors. Some sources mention an admission price of £5 for adults and £3 for concessions (including students and NHS employees with valid ID), so it is advisable to check the official website for the most current pricing.

What Else to See: In addition to the Sushruta statue, visitors can explore the Surgeons' Hall Museums, which have been open to the public since 1832, making them one of Scotland's oldest museums. The museum is home to one of the largest and most historic pathology collections in the world, with over 3,000 preserved specimens. The college itself, founded in 1505 and given royal assent by King James IV in 1506, is a historic institution with records dating back to 1581 AD.

Special Considerations: Visitors are advised to check the official Royal College of Surgeons of Edinburgh website (rcsed.ac.uk) for any seasonal opening hour variations or special closures. While the museum does not require booking, group visits or special tours may have different arrangements. The college maintains a one-way system in operation and visitors are asked to maintain social distancing where applicable.

Cultural Significance: For Indian visitors, the statue represents not just a historical tribute but a profound connection to their cultural and scientific heritage. The statue was crafted by a sculptor from Tiruvannamalai in Tamil Nadu and donated by the Cheruvu Family Foundation, established by UK-based surgeon Professor Chandra Cheruvu. The ceremony was attended by Siddharth Malik, Consul General of India in Edinburgh, and Professor Clare McNaught, President of the Royal College of Surgeons of Edinburgh. On the same occasion, Professor Cheruvu released a comprehensive book titled Maharshi Sushruta: A Compendium – Father of Surgery, which is also available online as an e-book on platforms such as Amazon, Google Books, and Kindle. This book, featuring contributions from 36 experts from the fields of Ayurveda and modern medicine, provides evidence demonstrating that Sushruta's methods and practices remain highly relevant in the 21st century.