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

Normally, 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 the suggestion is much more important than the actual operation performed. These are placebo surgeries. We are going to learn more about what these approaches consist of, what is their usefulness and their level of efficacy for certain types of patients.

• Related article: "What is the placebo effect and how does it work?"

What are placebo surgeries?

Placebo surgeries are a type of surgical intervention in which the operation is completely simulated, except for those essential elements for the patient to believe that it is real, such as the generation of a scar, sedation or all the environmental elements typical of an operating room (gowns, protective material, etc.). The goal is for the person to believe that he has undergone a real operation.

But why might we want to simulate surgery instead of performing a real one? That is where the usefulness of placebo surgeries comes into play. The placebo effect, in general, consists of an improvement in the physical or mental state of the patient after the administration of an innocuous element that he believes is indeed beneficial for his health.

Therefore, what would be generating the improvement would not be, in this case, the placebo surgeries, but the expectations that the person himself would have to experience a positive effect after said 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 thinks he's going to get better.

Do placebo surgeries work?

The first problem we find when we talk about placebo surgeries is that it is a phenomenon that has not yet been studied in its entirety. The reasons are obvious, and it is that due to a question of ethics, it is not always possible to perform a fictitious treatment on a person, depriving him of the real intervention, to verify its usefulness.

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

This operation involved the implantation of a small cable whose objective 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 cable was irrelevant in physical terms to treat Parkinson's disease, but they made the patient believe so contrary.

This placebo surgery was a complete success and the person quickly noticed the improvement, to the point of showing a visible reduction in your body tremors, caused by the disease. How was it possible? Due to the powerful suggestion to which he was subjected. He was so convinced that they were going to make him better with the operation that in fact it was.

Likewise, the efficacy of placebo surgeries has been observed in patients with cardiac ailments. In this case, the study was carried out at Imperial College London. The researchers found a group with two hundred patients suffering from myocardial ischemia. Half of them underwent the usual surgical intervention in these cases, while the other half simply pretended to perform it.

The results were surprising: both control and experimental group patients experienced similar improvement. The conclusion, therefore, is that suggestion is just as powerful as actual surgery? Not quite. The underlying issue is that doctors already suspected that this particular procedure was not as physically effective as initially believed.

What they were actually demonstrating is that it was not the surgical operation that caused the improvement, but the expectations that the patients had about said intervention. Therefore, when applying placebo surgeries, the positive effect was the same as in the other cases, demonstrating that it was not necessary to carry out a real physical intervention to achieve the improvement they sought for the patient.

More studies on the effectiveness of these operations

But these are not the only studies that have been carried out in this regard to verify the effectiveness of placebo surgeries. Another example is the one that the Scientific American magazine published in 2013. This article was a meta-analysis of 79 other studies looking at the efficacy of different placebo techniques in relieving headache in patients.

The conclusions were equally clear. The administration of innocuous pills decreased pain in 22% of cases. Needle application (acupuncture) as a placebo worked for 38% of patients. But the most powerful solution of all those that relied on suggestion was the one that involved placebo surgery, that is, a fake surgical intervention. 58%, more than half, saw how their constant migraines disappeared after the operation.

Shortly after, doctors from the English universities of Cambridge and Oxford carried out a new meta-analysis, in this case on 53 studies of placebo surgeries to treat knee ailments. Nearly three out of four patients experienced some improvement when undergoing placebo surgery and furthermore half of the overall had sensations that were just as positive as those who actually underwent surgery to repair their alteration physically.

What conclusions do the experts draw? That there are certain interventions that, in light of the facts, are not as effective as believed and therefore so much it is shown that they are unnecessary, due to the physical risk, even if it is minimal, that any operation can to imply. Are they could be replaced by placebo surgeries, since the suggestion about their improvement is what generates it, in a kind of self-fulfilling prophecy.

However, another question arises, this time of an ethical nature. Is it correct for a doctor to deceive a patient about the treatment he is going to receive, relying solely on the effects of suggestion? This is a debate that escapes the data, but it remains open for reflection by the reader.

• You may be interested in: "Self-fulfilling prophecies, or how to make yourself a failure"

Beyond placebo surgeries: the fraud of psychic surgery

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

This type of technique arose in the 50s of the 20th century in the Philippines, although it later became popular in Brazil and was even practiced in the United States., always by gurus who had little of doctors. These healers claimed to be able to perform psychic surgeries, operations where they did not use scalpels, but with their own bare hands and apparently extracted from the body malignant elements such as residues and even tumors.

The method, obviously fraudulent, became very popular as a result of television exposures and especially through the experience of the American comedian, Andy Kauffman, a cancer patient. of the lung, which he believed to improve after one of these experiences, but died shortly after, since the state of his disease was devastating and suggestion had no power to change in this case.

In any case, It must be made clear that psychic surgeries and placebo surgeries are not the same. In the first case, there is clear evidence of fraud and deceit for the mere benefit of the shaman, who is nothing more than a fraudster. 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 terms of the intention of the person exercising the technique and the person who will receive the benefit of it. For this reason we should not apply the same category, because 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 their pain being used to achieve an economic benefit in return.

Bibliographic 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, randomized 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.