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A survey is presented of the introduction of Western surgery in feudal Japan. From 1639 to 1853, through fear of foreign influence, Japan's isolation policy withheld all foreigners with the exception of the Dutch, who were permitted to establish a trading post on the island of Decima. Western culture and science reached the Japanese exclusively through the Dutch on Decima. Dutch ship's surgeons on Decima advanced surgical practice in Japan, which, at that time, was quite unknown to the Japanese. The study of the Dutch language enabled the Japanese to translate various Dutch anatomical and surgical texts, thus providing the basis for the spread of so-called 'Dutch surgery'.