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Introduction: At the end of the nineteenth century, three prominent German surgical journals (i.e., "Deutsche Zeitschrift für Chirurgie," "Bruns' Beiträge," and "Langenbeck's Archiv für Klinische Chirurgie") dominated the surgical academic scene in Germany. While written exclusively in German, these publications were widely read in Germany as well as abroad. Today, only the oldest of these journals, Langenbeck's Archiv, remains. In 1913, the "Zentralorgan für die gesamte Chirurgie" was instituted in Germany as a separate publication specifically dedicated to improve the communication of foreign scientific contributions. However, on a number of occasions, landmark papers from outside the country were not fully appreciated by the German readership, just as nowadays, key surgical papers published in German are only infrequently acknowledged in the Anglo-American scientific literature. At all times, innovative scientific works had a difficult time finding open ears and minds if they challenged long-held academic preconceptions. It appeared hard to question dogmas that readers had believed to be true for so long. After 1945, German surgery found itself eclipsed in many areas by new developments in the anglophone surgical communities since the academic exchange of ideas had been largely curtailed for more than a decade. English-speaking surgeons were more numerous, and the flow of communication became easier and more and more rapid., Conclusion: Over time, the entire field of surgery in Germany began to emulate what had proven so effective in the English-speaking world. Langenbeck's Archiv is now published in English.

Every medical treatment which involves risk to the patient requires the informed consent of the patient. Taking into account the fundamental right of the patient to remain physically unscathed and the right of self-determination, proper information must be given to the patient regarding typical risks. This is a prerequisite to patient consent. In this regard, the law makes strong demands. Even in cases where medical treatment is unsuccessful due to complications beyond the physician's control, the physician is still held liable (even if there was no fault found in his medical treatment) if he had not properly informed his patient of the risk involved in the procedure or he cannot prove that he had informed the patient. The following paper explains the legal demands of the duty to inform patients along with examples of precedents.

DER CHIRURG is the most successful German surgical journal and, reaches with a circulation of more than 8400 copies approx. 60% (including secondary readers approx. 80%) of active surgeons in Germany. DER CHIRURG covers scientific information by highly qualified reviews (30%-35% of the content) as well as peer-reviewed original papers (60%). The rejection rate of original papers is currently 55%. Topics of the reviews are as follows: oncology (20%), benign gastrointestinal surgery (20%), traumatology (15%) and general topics (20%). The thematic spectrum of the original papers is similar. The current problems for this journal are quality control, the issue of double publication, the assurance of an adequate impact factor, and the recruitment of local and international experts for highly qualified reviews.

The present study analyses a selection of German and American surgical and cancer research journals from the years 1984 and 1994. The aim of the study was to evaluate the amount of publications by German surgeons in these journals. Furthermore, any influence of the impact factor on the publication criteria was analyzed. German surgical journals showed a high percentage increase in the impact factor but are, in absolute numbers, still significantly behind the American journals. In parallel, German surgeons are still the major contributors to German language journals, but increasingly publish in the American ones as well. The impact factor is one of the major selection criteria on to which journal a paper shall be submitted.

The actual situation regarding the education für MIS requires the optimisation and standardisation of the training system. This paper presents the results of an inquiry about the evaluation of the course of operative laparoscopy. 80-90% of those interviewed made the comments "very good" and "good", with regard to the imparting of the theoretic foundation of the technique of endoscopic operations, for sufficient possibility of manual training and for the realistic setting of the animal organ model compared with the clinical operation. Because of our experience, we recommend attending such training courses before starting laparoscopic operations.

The legal "contract for patient care" issued by the Federal Government for all hospitals interferes with graduate medical education (approbation order), postgraduate surgical training, the KMK paper for new structures and financing of university medicine, health politics of the Physicians Parliament and the Legal Health System, guidelines for surgical practice, internal and external quality measurement, and, last but not least, with clinical research in surgery. The different effects are outlined in detail.