The real development of modern surgery originated in the late 19th and early 20th centuries. With the perfection of blood transfusion and anesthesia techniques, surgery has improved qualitatively, and surgical instruments have continued to improve. Not only did the manufacturing process advance, such as the evolution of materials from iron to stainless steel, chromium, titanium, vanadium, etc.. The design of the blade was also clearly separated from the blade, and the blade was detachable; and there were essential changes in the comfort, dexterity and safety of use of the grip and control, and the standardization of the scalpel made it an exquisite tool for modern surgeons to perform miracles.
In 1920, Boviel first introduced electrocoagulation in brain surgery, ushering in the electronic age of surgery.
From the late 20th century, electrocoagulation, ultrasonic knife, and endoscopic surgical instruments were widely introduced into the clinic, which in turn gave a great impetus to the progress of surgical procedures.

The scalpel material is called alloy steel, and the arch-executing type is the most commonly used way to execute the knife, with a wide and flexible range of motion and force involving the entire upper limb, mainly at the wrist. It is used for longer skin incisions and incision of the anterior rectus abdominis sheath, etc.

The pen-holding style is gentle, flexible and accurate, easy to control the movement of the knife, and its movement and power are mainly in the fingers. It is used for short incisions and fine surgery, such as dissection of blood vessels, nerves and incision of peritoneum, etc.