Source: I’m an anesthesiologist and watch these operations regularly.
Because limbs are full of blood vessels that need to be identified and tied off, or else the patient will just bleed to death.
If you dissect down to where you know the major vessels are, you can cleanly find them, tie them off, then cut them.
If you just whack the whole thing off with a butcher knife, you will be staring at a ragged bloody mess trying to figure out where those things are.
You also need to close the wound when you’re done. If you do it properly, you’ll have excess muscle and skin beyond the bone you can pull over the bone and sew shut. If you guillotine it, everything is exposed with no good way to close.
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