Placebo surgery

When trialling a new medicine, it’s standard practice to test it against a placebo medicine. But what do you do if you’re trialling a new surgery instead?

I’m going to assume that you’re familiar with a placebo: a neutral treatment used with a control group so that you can better test the effectiveness of something with another group. For example, everyone in a study takes a pill, but half of the people are actually just taking sugar pills. Because the mere act of taking a pill – and thinking that you’re taking medicine – may have its own effect, introducing a placebo eliminates those confounding factors.

Okay, cool, that all makes sense, right? If it’s a potentially life-saving medicine it might feel a bit squicky to give some people a sugar pill instead, but this is how we find out whether these things actually work or not. So far so good. But… what if you are testing a surgical intervention instead? How do you control for all of the standard and generic parts of the surgery experience?

Yup, that’s right. Placebo surgery, also known as sham surgery, is one way that a few studies have controlled for the whole surgery experience. People go into hospital, go under anaesthetic, and are cut open. Then they’re immediately sewn back up again, they wake up, and go on their way.

On the one hand, I cannot think of a better way to control for all this, and so retain the integrity of the study. And including sham surgery has exposed a few ineffectual interventions. On the other hand… fake surgery? For science? Creepy.

• Sham surgery
• Use of placebo controls in the evaluation of surgery: A systematic review