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I'm not sure you can even do surgeries with herbal meds, but set that to herbal meds and see if it lets you.
The problem is not, that the operation is greyed out or anything, it isn't showing up at all.
https://steamcommunity.com/sharedfiles/filedetails/?id=850428056
He answers
I was building a simple prosthetic arm (btw these are added by RBSE) but lost track of it and my doctor dissected a corpse and that got me a natural arm. I mistook the arm for a prosthetic one and was thinking of a conflict.
After I tested it in devmode, after seeing that I got a natural arm and not a prosthetic one, researching all technologies, I came up with the conclusion, that I need to research a technology, to install natural arms (somehow makes sense).
And although I don't know yet, which technology, the mods seem to work as intended, so no problem after all, just me not reading carefully.
Sorry for the fuss.
meh....Had the same thing with EPOE+Psychology....colonist (in a mental fit) cut off the leg I gave her....