Lithotomy. Historical artwork of a lithotomy patient being held down by two men prior to surgery. Lithotomy involves making an incision into a duct or organ, especially the bladder, for the removal of a stone (calculus). These stones consist largely of insoluble calcium salts. Surgery before the discovery of effective anaesthetics and antiseptics was painful and risky. The accepted medical practice was for surgeons to complete their work as quickly as physically possible. However, post-operative infections often killed patients. This woodcut is from the Ten Books of Surgery by Ambroise Pare published in 1563.