Traditional surgery using traditional instruments, is performed for curative, cosmetic, ritual, judiciary or for some other social reasons. The need for alleviating pain for these surgical procedures has long been recognized, and pain-killers and hypnotics have been used. Curative surgery is mainly wound surgery and includes suturing and dressing of wounds, incision of abscesses and boils, couching, bone-setting, amputation of limbs, extraction, pointing, paring and separation of teeth, uvulectomy, trepanation, and tatwish (castration). In addition, surgical problems such as inguinal herniae and hydrocoeles are managed conservatively with the application of locally-made trusses. Haemorrhoids and fistulae are cauterized. Ritual surgery includes male and female circumcision. Cosmetic operations include washm (tattooing), shulukh (facial scarring) and perforation of the nose, lips and lobes of the ear. Judicial surgery includes amputation of limbs and sometimes extraction of teeth.
 Hydrocele was said to be so common among the Koma tribe of southeast Sudan that it was almost a tribal characteristic. It is known by the name kuk [kuka in northern Sudan]. Though very common, yet little in the way of treatment is done by the natives.
 Theodor Krump, a German missionary, observing the customs of the Sudanese (1700-1702), namely of the Danaqla, wrote that 'on their foreheads, cheeks, thumbs, breasts and calves they tattoo designs with pins.' Krump, Theodor (1660-1724). High and fruitful palm-tree of the Holy Gospel … [German]. Augusburg; 1710. Page 227.
 Several names of tribal chiefs and sufi shaikhs, for example dabi al-wa'ar, al-khishin, are reminders of these attributes.