From historical viewpoint, manufacturing of surgical instruments initially started in the regions that were traditionally involved in forging of metals, particularly for knives and swords etc. The surgical instruments manufacturing started in this region at the turn of the 19th century, when the American Mission hospital in Sialkot for the first time got its scalpels and other instruments repaired from the local artisan community of blacksmiths. These craftsmen successfully replicated these imported instruments, which were being used by the hospital.
Sialkot surgical industry started exporting surgical instruments in 1930s. To institutionalize the local expertise of manufacturing surgical instruments and provide common facilities to the manufacturers, the British Government established the Metal Industries Development Centre (MIDC) in 1941. This helped the industry to shift from manufacturing of basic metal products to precision surgical instruments. After Independence in 1947, Pakistan inherited a total of 17 registered surgical instruments manufacturers in Sialkot.
In 1958, the Surgical Instruments Manufacturers Association of Pakistan (SIMAP) was incorporated as a representative body of the exporters and manufacturers of surgical industry; which would safeguard the interests of the industry. The association since then has played a central role in addressing issues at the government level, nominating trade delegations and participants for trade fairs and exhibitions, handling inter-industry issues and representing the industry at various local and international forums.
During 1960s, various fiscal incentives like higher subsidies and credit incentives such as bonus voucher scheme; by the government gave a real boost to local surgical industry. Consequently the industry witnessed wide scale technological up-gradation and increase in productivity and quality.
During 1970s the changes in the labour laws resulted in industry wide layoffs which led to the development of vendor segment in the surgical industry. This segment plays a very pivotal role in the industry as majority of the surgical industry relies on this segment for various manufacturing processes. The 1980s witnessed the high demand for surgical instruments world wide and especially US.
However, a ban on imports of surgical instruments from Pakistan in 1994 by US authority Food and Drug Administration (FDA) forced the industry to improve its manufacturing and management systems and acquire certifications like GMP, ISO, and CE.
On the global level, centres of surgical instrument manufacturing were found in the early 20th century in Sheffield in England, Nogent-sur-Marne in France, and Solingen & Tuttlingen in Germany. With the exception of Tuttlingen, these clusters no longer exist as important centres for surgical instruments manufacturing. However, the last quarter of the 20th century has witnessed Pakistan, emerging as a key manufacturer of conventional surgical instruments. More recently, Malaysia, Poland, Hungary, China, Korea, and India have emerged as important manufacturers of surgical instruments as well.
