Placebo surgeries: what are they and how do they take advantage of suggestion?

Placebo surgeries are operations based on suggestion. Let's see how they work.

Usually surgeries are surgical processes used to correct a physical alteration of the subject's organism.

However, there is another type of surgery in which the effect of suggestion is much more important than the operation itself. These are placebo surgeries.. We are going to know better what these approaches consist of, what their usefulness is and their level of efficacy for certain types of patients.

What are placebo surgeries?

Placebo surgeries are a type of surgical intervention in which the operation is totally simulated, with the exception of those elements indispensable for the patient to believe that it is real.The objective is to make the person believe that he/she has undergone a real operation, such as the generation of a scar, sedation or all the environmental elements of an operating room (gowns, protective material, etc.). The objective is to make the person believe that he or she has undergone a real operation.

But why would we want to simulate a surgical procedure instead of performing a real one? This is where the usefulness of placebo surgeries comes into play. The placebo effect, in general, consists of an improvement in the patient's physical or mental state after the administration of an innocuous element that the patient believes to be beneficial to his or her health.

Therefore, what would be generating the improvement would not be, in this case, the placebo surgeries, but rather the expectations that the person himself would have of experiencing a positive effect after such an intervention.. In other words, what improves the patient's health is the suggestion generated by believing that he is undergoing an operation designed to bring about a change for the better. He gets better because he believes he is going to get better.

Do placebo surgeries work?

The first problem we encounter when we talk about placebo surgeries is that it is a phenomenon that has not yet been studied in all its depth. The reasons are obvious, and it is that as a matter of ethics, it is not always possible to perform a fictitious treatment on a person, depriving him/her of the real intervention, in order to test the usefulness of the same..

Even so, some tests have been carried out that allow some conclusions to be drawn, always limited to the specific ailments present in these studies, so they cannot be extrapolated with certainty to other types of diseases. One of the most surprising cases took place in 2016, when. a team at the University of Florida designed an intervention to treat a patient suffering from Parkinson's disease..

This operation involved the implantation of a small wire whose purpose was to transmit electrical impulses to a specific area of the brain. The point is that the doctors in charge of the case knew perfectly well that the application of this wire was irrelevant in physical terms to treat Parkinson's disease, but they made the patient believe otherwise.

This placebo surgery was a complete success and the person quickly noticed the improvement, to the point of showing a visible reduction in his body tremors caused by the disease.How was this possible? Because of the powerful suggestion he was subjected to. He was so convinced that he was going to be made to improve with the operation that in fact he was.

Similarly, the efficacy of placebo surgeries has been observed in patients with cardiac ailments. In this case, the study was conducted at Imperial College London. The researchers managed a group of two hundred patients suffering from myocardial ischemia. Half of them underwent the usual surgical intervention in these cases, while the other half were simply simulated.

The results were surprising: both the patients in the control group and the experimental group experienced a similar improvement in their myocardial infarction.Is the conclusion, therefore, that suggestion is just as powerful as a real surgical operation? Not exactly. The underlying issue is that the doctors already suspected that this particular intervention was not as physically effective as originally believed.

What they were actually demonstrating was that it was not the surgery that caused the improvement, but the expectations that patients had about the surgery. Therefore, when the placebo surgeries were applied, the positive effect was the same as in the other cases, demonstrating that it was not necessary to perform an actual physical intervention to achieve the improvement they were seeking for the patient.

More studies on the efficacy of these operations

But these are not the only studies that have been carried out to prove the efficacy of placebo surgeries. Another example is the one that Scientific American magazine published in 2013. This article involved a meta-analysis of 79 other studies that studied the efficacy of different placebo techniques to relieve headache pain in patients.

The conclusions were equally clear. Administration of innocuous pills decreased pain in 22% of cases.. The application of needles (acupuncture) in the form of a placebo worked for 38% of patients. But the most powerful of all the solutions that relied on suggestion was the one involving placebo surgery, that is, a sham surgical intervention. Some 58%, more than half, saw their constant Migraines disappear after the operation.

Shortly thereafter, doctors from Cambridge and Oxford universities in England conducted a new meta-analysis, this time of 53 studies of placebo surgeries to treat knee ailments. Almost three out of four patients experienced some improvement when they underwent placebo surgery and, moreover, half of the total had the same positive feelings as those who actually underwent surgery to repair their physical alteration.

What conclusions do the experts draw? That there are certain interventions that, in the light of the facts, are not as effective as previously believed and therefore are shown to be unnecessary, due to the physical risk, however minimal, that any operation may involve. These could be replaced by placebo surgeries, since the suggestion of improvement is what generates it, in a sort of self-fulfilling prophecy..

However, another question arises, this time of an ethical nature: is it right for a physician to deceive a patient about the treatment he/she is going to receive, relying solely on the effects of suggestion? This is a debate that is beyond the scope of the data, but it is open for the reader's reflection.

Beyond placebo surgeries: the fraud of psychic surgery

Although all the examples we have seen so far belong to studies conducted by prestigious universities, where medical professionals strive to achieve the best results for the health of patients, there are other techniques used by people of dubious reputation that, although they share features with placebo surgeries, are not the same. This is known as psychic surgery.

This type of technique emerged in the 1950's in the Philippines, although it later became popular in Brazil and was even practiced in the United States, always by gurus.It was always performed by gurus who were not very good doctors. These healers claimed to be able to perform psychic surgeries, operations where they did not use scalpels, but their own bare hands and apparently extracted from the body malignant elements such as residues and even tumors.

The method, obviously fraudulent, gained much popularity as a result of television expositions and especially through the experience of the American comedian, Andy Kauffman, suffering from lung cancer, who believed he was getting better after one of these experiences, but died soon after, as the state of his illness was devastating and suggestion had no power to change in that case.

In any case, it must be made clear that psychic surgeries and placebo surgeries are not the same thing.. In the first case there is clear evidence of fraud and deception for the mere profit of the shaman, who is nothing but a swindler. On the contrary, placebo surgery is a technique that uses the psychological power of suggestion to achieve physical improvement in the patient.

In both cases lies are used, it is true. However, there is a clear difference in the intentionality of the person who exercises the technique and in the person who will receive the benefit of the technique. Therefore, we should not apply the same category, because one is a pseudotherapy and the other is a technique that can be one is a pseudotherapy and the other is a technique that can be tremendously useful to improve the quality of life of some people who are suffering, without using their pain as a reason for their pain., without using their pain to achieve an economic benefit in return.

Bibliographical references:

• Al-Lamee, R., Thompson, D., Dehbi, H.M., Sen, S., Tang, K., Davies, J. (2017). Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial. The Lancet.
• Horng, S., Miller, F.G.. (2002). Is placebo surgery unethical? Mass Medical Soc.
• Kaptchuk, T.J., Goldman, P., Stone, D.A., Stason, W.B. (2000). Do medical devices have enhanced placebo effects? J Clin Epidemiol.
• Wartolowska, K., Judge, A., Hopewell, S. (2014). Use of placebo controls in the evaluation of surgery: systematic review. BMJ.