The oldest known operation was a leg amputation performed 31,000 years ago—and it worked!
A young boy, likely 8-12 years old, had a catastrophic leg injury that destroyed his lower leg. It came about either due to a crushing injury like a rock collapse, or he had suffered a severe animal bite, leaving the boy with a deep wound that damaged blood vessels beyond repair. The surgeons removed the leg because it was the only way to save the child's life—and save they did. The boy survived miraculously almost until the average life expectancy, which at that time was only 25-35 years. The boy lived another 6-9 years without his leg & died around 20. This operation took place in Liang Tebo Cave, East Kalimantan, Borneo, Indonesia.
The surgeons used sharpened stone blades (likely razor-sharp flaked stone made from silica rock). These could be as sharp as modern surgical steel when freshly honed. They may have given the boy plant-based antiseptics as well as herbal sedatives during the operation. Keep in mind that such endeavors have never been attempted before & the next surgery would not occur for another 24,000 years: a trepanation (skull surgery). The Borneo amputation is so advanced that it doesn't fit the timeline—it's a medical outlier thousands of years ahead of its time. Remember, this is still the era commoners call the "Caveman" era. We call it the Pleistocene Era, which began 2.6 million years ago and ended 11,700 years ago. They were cave dwellers; societies were hunter-gatherers; they used stone tools; they still had Ice Age megafauna, & early Homo sapiens coexisted alongside Neanderthals.
The Borneo child's surgery was so sophisticated that it rewrote the history of medicine. It shows that cavemen had medical knowledge; they understood healing; they cared for injured children for years, & they performed surgery long before agriculture, cities, or writing. They had a wide cornucopia of herbal plants & potions to choose from because Borneo's rainforest is one of the most chemically rich ecosystems on Earth. Even today, Indigenous groups still use many of those same plants they used back then.
For example, turmeric is a natural antiseptic and is a strong anti-inflammatory, contains curcumin, & is used today on wounds. Ginger has pain-reducing & antimicrobial properties; cinnamon bark contains cinnamaldehyde, a powerful antimicrobial. Tea tree oil (Melaleuca species), its oils & leaves kill bacteria & fungi. Neem species have antibacterial & antifungal properties. Pain control was essential, so they likely used kava kava, which is a mild sedative that reduces anxiety & numbs pain. Betel leaf has psychoactive compounds & is widely chewed today in India & Indonesia, used as a wrapper for paan—a combination of areca nut, slaked lime, & catechu—a reddish-brown paste extracted from the acacia tree. (It's catechu, which stains teeth a horrid reddish-brown.)
They may have used kratom, native to Southeast Asia, which has opioid-like pain relief properties & acts as a mild sedative. It was very available in the region. They perhaps also used clove, which is rich in eugenol, a natural anesthetic & is still used today in dentistry. The child's bone showed no infection; there was full healing of the tibia/fistula. The leg was removed at the mid-tibia, roughly 12-14 inches (30-35 cm) below the knee. These tropical rainforest plants are extremely potent and necessary for a person undergoing amputation.
