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According to Aristotle, medical practice relies on practical knowledge to care for individual patients. This is especially true for surgery, where the surgeon directly acts on a patient using not only technical skills but also acquired experience. We first describe the surgeon’s technical activity, which is directly linked to surgical tools and their historical evolution. Second, given that surgical activity aims at treating patients, we analyze which techniques and concurrent knowledge the surgeon must rely on to perform successful surgical operations. These characteristics are analyzed by using concepts from philosophy of technologies by André Leroi-Gourhan, Gilbert Simondon and John Dewey.