First Filmed Surgery Sparks New Era of Medical Cinema

The 19th century was a period of technological innovation and profound transformation in science. As medical knowledge expanded, significant advances were made in medical procedures, equipment, and the understanding of human physiology.¹ At the same time, a new technology—“moving images”—emerged and began to transform the way the world perceived reality.

In 1895, the Lumière brothers (Auguste and Louis) introduced the cinematograph in Paris, marking the birth of cinema. What they likely never imagined was that within just 4 years, their revolutionary invention would be adopted for an unforeseen purpose—medical education and scientific documentation—which, today is a fundamental component of modern surgical practice.

In 1899, at the original Hospital de Clínicas in Buenos Aires, Argentina, visionary surgeon Alejandro Posadas, MD, collaborated with French cinematography pioneer Eugenio Py to film a pulmonary operation performed under general anesthesia.

The silent 35-mm film, Operaciones del Dr. Posadas, is recognized by the Cinémathèque française and Royal Belgian Film Archive as the earliest-known surviving motion picture of a surgical operation.² This film represents the moment when surgery first met the camera, giving birth to medical cinema and forever changing how surgical knowledge could be preserved, shared, and taught.

Medicine at Dawn of Moving Images

By the late 19th century, the practice of surgery was experiencing an era of rapid but uneven transformation. Antiseptic principles were gaining acceptance, sterile gloves were only beginning to be introduced, surgical masks were not yet routine, and general anesthesia was administered with chloroform allowing surgeons to attempt more complex procedures, but with significant risk that demanded technical precision and speed.¹

Simultaneously, a new visual era was emerging. The Lumière brothers’ early films documented factory workers and, urban and everyday life.³ However, the potential of films as a scientific and educational tool had not yet been realized.

At the time, medical teaching relied primarily on direct observation in crowded operating theaters, hand-drawn illustrations, and large photographic prints. Since the mid-19th century, photographic documentation of the human body had already entered the scientific medical discourse, establishing visual representation as a fundamental component of medical knowledge.³ It was within this context that Dr. Posadas conceived a revolutionary idea. He envisioned film not as entertainment but as a powerful instrument for education and scientific documentation. His decision to record a surgery on motion picture film, just 4 years after the Lumière brothers’ invention, would place Buenos Aires at the center of a global milestone in the history of surgery and medical education.

Visionary Surgeon

Born in Saladillo, a small town in Buenos Aires province, Dr. Posadas entered the Faculty of Medicine at the Universidad de Buenos Aires in 1888 and quickly distinguished himself as both a clinician and an investigator.⁴

While still a medical student, he described the world’s first case of what would later be recognized as coccidioidomycosis in a patient with recurrent cutaneous lesions. He dedicated his thesis to this research, historically known as Posadas-Wernicke disease. The fungal pathogen was later identified and named Coccidioides posadasii in his honor.^5-7

Dr. Posadas is considered the father of thoracic surgery in Argentina. He developed pioneering techniques such as the temporary partial thoracoplasty with pulmonary harpooning to the parietal pleura. This method prevented pneumothorax, eliminating the need for postoperative drainage and making thoracic surgery safer at a time when it was considered high risk.⁸ He presented his innovative technique at the First Latin American Congress of Surgery in Buenos Aires.^3,9

Dr. Posadas also was a master educator who improved surgical teaching by systematically adopting visual tools long before they became standard. In addition to his use of detailed hand-drawn anatomical illustrations and large photographic prints, he introduced the use of x-ray imaging in Argentina, integrating radiographic studies into both clinical practice and education.^3,8,9 This dedication to visual pedagogy would lead him to explore a new visual technology: cinematography.

Unfortunately, Dr. Posadas’s career was tragically brief. After developing pulmonary disease, he sought treatment in Europe and the US, but he ultimately succumbed to tuberculosis in Paris in 1902, at just 31 years of age.⁹

Birth of First Medical Film

Due to the technical limitations of early cinematography, the pulmonary operation suggested by Dr. Posadas could not be filmed indoors. Therefore, it was performed and recorded under natural light in the hospital’s internal courtyard. The footage provides an authentic visual record of late-19th-century surgical practices, with surgeons wearing long white gowns and rolled-up sleeves, without gloves, masks, or caps, reflecting the standards of asepsis as understood at the time.

The silent film was shot on 35-mm film using a fixed-position French Elgé camera manufactured by French inventor and engineer Léon Gaumont. With a duration of approximately 3 minutes and 46 seconds, Operaciones del Dr. Posadas documents Dr. Posadas performing his innovative thoracic surgical technique: a temporary partial thoracoplasty with pulmonary harpooning to the parietal pleura, performed to treat a right pulmonary hydatid cyst.

The footage shows a male patient with an open right hemithorax, exposing the operative field. The operation is carried out with calm precision and notable speed, an essential requirement to minimize the risks associated with long exposure to chloroform anesthesia and the limitations of natural light.

Interestingly, this film also documents the administration of general anesthesia by the Argentine medical trainee Rodolfo S. Roccatagliata using the open-drop technique, applying chloroform with a Schimmelbusch mask. At the time, anesthesia was commonly administered by medical practitioners, nurses, or religious sisters, known as chloroformists, while anesthetized patients were described as “chloroformed.” This recording, therefore, represents not only the first filmed surgical operation, but also the first filmed general anesthesia in medical history.²

Enduring Legacy

For decades, these original films faded into oblivion after their initial exhibition and limited circulation. Their historical significance remained unrecognized for much of the 20th century. The survival of the world’s first film surgical operation was secured thanks to a fortuitous rediscovery.

In the 1970s, during the demolition of the original Hospital de Clínicas, Dr. Florentino Sanguinetti discovered the original 35-mm reel documenting Dr. Posadas’s pulmonary surgery while sorting through an abandoned archive.^2,3,9 Had the demolition not been scheduled, the film could have been lost forever and, with it, a fundamental chapter in the history of surgery, anesthesia, and medical education would have disappeared.

A second film, documenting a left inguinal hernia repair, was rediscovered in March 1987, by Dr. Fermín García Marcos, from the Department of History of Medicine at the Faculty of Medicine Sciences of the Universidad de Buenos Aires. Today, both films are currently preserved by the Fundación Cinemateca Argentina.^2,3,9

In recent years, the historical legacy of these films has gained renewed visibility. Dr. Posadas’s filmed surgery is now exhibited at the Museum of the Hospital de Clínicas of Buenos Aires, where it continues to educate and inspire new generations of surgeons.

What began in a sunlit hospital courtyard in Buenos Aires in 1899 stands today as a global milestone in the history of surgery, medical education, and documentation. It marks the genesis of a visual legacy that has become an integral part of modern surgical practice, through operative recording, academic lectures, livestreamed surgeries, and online surgical tutorials.

This historic event, nearly lost to time, represents the moment when the camera first entered the operating room and is remembered not as a curiosity but as a turning point in the art of seeing, knowing, and teaching surgery.

Dr. Tamara Almada is a surgeon and educator in Buenos Aires, Argentina, a member of the Asociación Argentina de Cirugía, and an ACS Fellow. She serves as a Captain in the Argentine Army Medical Corps and a member of the ACS Argentina Chapter Executive Board, with academic interests in surgical education, history, and innovation.

Editor’s note: This article is based on the second-place winning entry in the 2025 History of Surgery Poster Competition, which occurred in conjunction with Clinical Congress.

References

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