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Background: This study aimed to investigate the safety and efficacy of laparoscopic anatomical left hemihepatectomy guided by the middle hepatic vein (MHV) for the treatment of patients with hepatolithiasis who had a history of upper abdominal surgery. Methods: Retrospective data analysis was performed on patients who underwent laparoscopic left hepatectomy for hepatolithiasis and with previous upper abdominal surgery at the Second Affiliated Hospital of Nanchang University from January 2018 to April 2022. According to the different surgical approaches, patients were divided into laparoscopic anatomical left hepatectomy guided by the MHV group (MHV-AH group) and laparoscopic traditional anatomical left hepatectomy not guided by the MHV group (non-MHV-AH group). Results: This study included 81 patients, with 37 and 44 patients in the MHV-AH and non-MHV-AH groups, respectively. There was no significant difference in the basic information between the two groups. Five cases were converted to laparotomy, and the remaining were successfully completed under laparoscopy. Compared to the non-MHV-AH group, the MHV-AH group had a slightly longer operation time (319.30 min vs 273.93 min, P = 0.032), lower bile leakage rate (5.4% vs 20.5%, P = 0.047), stone residual rate (2.7% vs 20.5%, P = 0.015), stone recurrence rate (5.4% vs 22.7%, P = 0.028), and cholangitis recurrence rate (2.7% vs 22.7%, P = 0.008).There were no significant differences in the results of other observation indices between the groups. Conclusions: Laparoscopic anatomical left hepatectomy guided by the MHV is safe and effective in the treatment of left hepatolithiasis with a history of upper abdominal surgery. It does not increase intraoperative bleeding and reduces the risk of postoperative bile leakage, residual stones, stone recurrence, and cholangitis recurrence. [ABSTRACT FROM AUTHOR]

The quality movement in 21st century healthcare—quality, patient safety, and the value equation (value equals quality divided by cost)—had their start with Ernest Amory Codman (1869-1940), the quixotic surgeon who started it all a century before. He was on track for prosperity and success, given a Boston Brahmin pedigree and his impeccable credentials from Harvard College, its medical school, and the Massachusetts General Hospital. In 1910, nearing 40, Codman instead detoured toward a revolutionary idea that he called the End Result system, the seemingly unachievable goal of reaching "perfection" in surgery: complete recovery without death, complications, or lasting disability. He scrutinized any case that fell short, seeking honest explanations and improvements so that his next case would more likely reach a perfect outcome. The system that was so clear to him was audacious to his colleagues, who summarily rejected it. When Codman suspected greed and self-interest, he was ostracized from the Boston medical community. To apply his concepts, he opened a proprietary hospital called the End Result Hospital that drove him to insolvency. His career never recovered from the debacle even when he later reached prominence as an authority on bone malignancies and shoulder pathology. When he died, his resting place went unmarked. As quality became central to healthcare at the end of the 20th century, Codman's prescient End Result system was recognized as a fundamental contribution to medicine. [ABSTRACT FROM AUTHOR]

Joseph Lister's (1827–1912) use of carbolic acid to prevent wound infection in open fractures of the extremities (1865) provided a basic science rationale for the practice of surgery. His series of 11 patients included 4 children, aged 7 to 13. Children, today known to better survive a given injury when compared with adults, may have biased his results in favor of survival, and led him to conclude that his method of carbolic-soaked dressing changes prevented fatal wound sepsis. His success with antisepsis may have been less a testament to his application of germ theory to surgery than to the physiological resilience of his young patients. [ABSTRACT FROM AUTHOR]

This paper comes as the final stage of the several-months long project titled “Expansion of MUW Library database to include surgery publications from the 19th and the first half of the 20th century”, implemented by the Main Library of the Medical University of Wrocław as part of the programme titled “Social Responsibility of Science – Supporting Research Libraries”. The idea originated in relation to the potential of the resources held by MUW Library, as the information about them had not been compiled and they had not been made available to the public. The task involved 300 publications from the 19th as well as the first half of the 20th century, in the area of broadly conceived surgery, most of them unique in nature; it consisted in compiling information about them in formal and substantive terms as well as including them in the collections and online catalogues. This paper provides an overview of the project, presents photographs of the most interesting items in the newly created collection, and also highlights the role of MUW Library in promoting both the history of Wrocław as a vibrant centre of medicine and the development of medicine itself by using those invaluable resources.

The outstanding Russian scientist and teacher in the field of topographic anatomy and operative surgery, one of the initiators of the creation of the Academy of Medical Sciences of the USSR and its full member (1944), Honored Scientist of the RSFSR (1935), winner of the Stalin Prize of the first degree (1943), Lieutenant General of the Medical Service (1943), Professor (1912) Viktor Nikolayevich Shevkunenko was born on February 17 (29 new style), 1872 in the county town of Mezen, Arkhangelsk province. In 1895, he graduated from the Imperial Military Medical Academy. From 1912 to 1948, he headed the Department of Operative Surgery and Topographic Anatomy of the Academy. V.N. Shevkunenko is the founder of the doctrine of the type and age variability of human anatomy. As a result of many years of research carried out by the staff of the department, atypical forms of the structure and location of organs and anatomical structures were described in detail, optimal accesses and rational technique were justified when performing surgical interventions on different organs, depending on the typical, sexual and age topographic and anatomical features of patients. V.N. Shevkunenko is the founder of a major Russian school in the field of operative surgery and topographic anatomy: 44 of his students became professors. Academician V.N. Shevkunenko died on July 3, 1952 and was buried at the Theological Cemetery in Leningrad.

Despite the enormous progress in the development of medical sciences in recent decades, surgery is still associated with manual dexterity. The oldest surgical procedures were performed primarily with the hands, and only later with the use of tools that came up as a result of the adaptation of everyday devices. Scientifi c and technological progress, along with the growing experience of surgeons, infl uenced the evolution of surgical instruments, which changed both quantitatively and qualitatively. As in other areas of human activity, the most useful surgical tools have constantly evolved and have survived to our times in a form reminiscent of their most ancient precursors. Others, which did not work in practice, today are a curiosity and a trace which allows us to follow the development of surgical thought in the past. [ABSTRACT FROM AUTHOR]

The manuscript aims to clarify the origins of Western rhinosurgery through the ancient texts of the greatest physicians of the past, up to the Byzantine Era, focusing on the "exchange of knowledge" between peoples. This excursus is carried out by quoting the texts of the greatest doctors of the past, such as Hippocrates, Galen and Celsus and by analysing the works of Byzantine authors such as Oribasius, Aetius, Antillus, which, more than others, represent the moment of fusion and interpenetration of Ancient Medical knowledge, paving the way for the Medieval Scholae Medicae in the West. The aim, therefore, is to fill that sort of "great gap" (from the foundation of Constantinople in the 4th century AD to the early Arab culture in the 11th century AD) due to the fact that figures such as Branca, Vianeo and, finally, Tagliacozzi, are considered direct actors of a recovery of the "ancient knowledge" of classic authors. This literature tends to less evaluate, instead, that important and huge cultural exchange -literally osmotic- in medical and surgical knowledge between peoples and civilizations, that find a trait d'union in the application of medical knowledge and surgical practical techniques matured in the Byzantine, Arab and Early Medieval period. In final analysis, through the History of Rhinosurgery, this paper aims to highlight how Western medical knowledge is made up of the ensemble of cultures which are apparently distant and different from each other, which merge themselves in a truly universal and transcultural knowledge: the Medical knowledge. Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

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Received 25.02.2022; accepted 09.03.2022 An outstanding Soviet surgeon, one of the founders of military field surgery – participant in six wars, Hero of Socialist Labor (1976), academician of the USSR Academy of Medical Sciences (1971), Honored Scientist of the RSFSR (1964), laureate of the Lenin Prize (1961) and the USSR State Prize (1985), Major General of the Medical Service (1953), Professor Ivan Stepanovich Kolesnikov was born on December 2 (15), 1901 in the village of Podosinovka, Novokhopersky District, Voronezh Province. In 1931, he graduated from the Military Medical Academy, in 1932 he entered the adjunct course at the Department of Hospital Surgery of the Military Medical Academy headed by Professor S. P. Fedorov, and in 1936, defended his PhD thesis «Transfusion of conserved blood». During the Great Patriotic War, he held the positions of army surgeon and chief surgeon of the Karelian Front. Together with P. A. Kupriyanov, in the period from 1946 to 1955, he published the «Atlas of Gunshot Wounds» in 10 volumes. In 1946, he defended his doctoral dissertation on the topic: «Removal of foreign bodies from the pleural cavity, pleural junctions and indurations, lungs and mediastinum». In 1953, I.S. Kolesnikov was appointed head of the Department and Clinic of Hospital Surgery of the Military Medical Academy, since 1976 – professor-consultant of the Academy. He was the author and co-author of more than 170 scientific papers, including 25 monographs, manuals and textbooks. Under his leadership, 26 doctoral and 43 candidate dissertations were prepared and defended. I.S. Kolesnikov is rightfully recognized as the founder of the national scientific school of thoracic surgery and one of the world luminaries of military field surgery. Academician Ivan Stepanovich Kolesnikov died on May 18, 1985 and was buried at the academic site of the Theological Cemetery in Saint Petersburg.

Never a monarch nor head of state, Queen Caroline of Ansbach (1683-1737) is among the legendary women rulers of England and Great Britain alongside Queens Elizabeth I and II, Queen Victoria, and Lady Margaret Thatcher. As queen consort, she was the acknowledged power behind the throne of her husband, King George II (1683-1760), working with Robert Walpole, the first Prime Minister of England. George accepted her intellectual superiority and backstage dominance even before he acceded to the throne in 1727. "[He had] no pretensions toward intellect and [was] basically interested in little more than military glory, political power, and a wife who would do her duty by providing him with male heirs," wrote popular historian John Van de Kiste. After they were wed in 1705, Caroline carried out her task with a remarkable fecundity: a male heir, Frederick Louis, in 1707, followed by Anne (1709), Amelia (1711), Caroline (1713), George William (1717), William (1721), Mary (1723), and Louise (1724). With good reason she believed that her influence over George came from his sexual attraction to her. It was a conceit that proved to be her undoing as she strove to hide from common knowledge an unsightly umbilical hernia. The rupture caused her death in 1737 at age 54. It strangulated, perforated, and spilled feculent succus entericus and fetid fluid onto the royal bed, a vivid example of the consequences of an untreated surgical condition. [ABSTRACT FROM AUTHOR]

The distinguished representatives of the Samara (Kuibyshev) medical intelligentsia made a great contribution to the development of Russian medicine. The analysis of the social and cultural aspects of the formation of the leaders of major scientific and pedagogical school functioning at Kuibyshev Medical Institute named after D.I. Ulyanov makes it possible to identify value priorities, views, the development of professional motivation, attitudes to colleagues and patients. The examples of lives of the founders of the proctology school, A.M. Aminev, the ophthalmology school, T.I. Eroshevskij, the otorhinolaryngology school, I.B. Soldatov, helped to single out the main features of their socio-cultural image. Both published and unpublished documents which are kept in the Central Archive of the Ministry of Defense of the Russian Federation, the Central Archive of the Samara region, Samara State Medical University archive and in the personal archives were used for the research. In the course of the conducted study it was proved that high professionalism, commitment, constant scientific search, the developed sense of civic duty and responsibility, care for the patients served as the foundation of the great contribution to the Soviet medicine, of the achievement of significant medical discoveries and the formation of the Kuibyshev Medical University scientific and pedagogical schools.

Bruno da Longobucco (1200–1286) was born at the turn of the 13th Century in Longobucco (Calabria, Italy), at that time named Longoburgo. He was the first academic surgeon of the Middle Ages, a period when surgery was disregarded by mainstream physicians and was the practice of barbers, charlatans and phlebotomists. After training at the medical school of Salerno and the University of Boulogne, he was one of the founders of the University of Padua and became the first Professor of Surgery. His books Chirurgia Magna and Chirurgia Parva, were ones of the most disseminated surgical texts of the Middle Ages and it is argued helped surgery regain its reputation. Despite his importance to late medieval period, he has been essentially overlooked in the records of the history of surgery. Currently, there are no articles in English about his life indexed on PubMed, Scopus or Embase. One solitary article on Bruno's life and influence was published in 1960s in a small journal in Italian, but this is no longer active and there is no electronic means to access the original article. The aim of this article is to provide education and rediscovery of the impact of this critical figure, his works and his historic role to the development and renaissance of surgery for contemporary surgeons.

The descent of the testis and the development of an inguinal hernia were the earliest published scientific work by John Hunter, the Scottish surgeon and anatomist who is acknowledged as the father of scientific surgery. Hunter's anatomic descriptions are the ones we use today to describe the prenatal descent of the testis and to explain the pathogenesis of an undescended testis and inguinal hernia in infancy. His work appeared in print in 1762, not as a formal publication but as an addendum to a screed written by his older brother William publicly accusing Percival Pott of pirating John's observations on the pathogenesis of an inguinal hernia and publishing them as his own, an early example of scientific rivalry. [ABSTRACT FROM AUTHOR]

In the eighth century, Justinian II was overthrown from his position as ruler of the Byzantine Empire. The young ruler's nose was amputated, and he was exiled. Ten years later, he regained the throne in a bloody coup. For decades, researchers have debated if Justinian also regained his nose through the ancient Indian rhinoplasty surgical technique, largely based on the Carmagnola statue in modern Venice. While a fascinating possibility, we ultimately conclude that it is highly unlikely that this ever occurred., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: The views expressed in this study are those of the authors and do not reflect the official policy or position of the Department of Defense, the Department of the Army, or the US Government., (Copyright © 2024, Turner et al.)

One of the fundamental innovations of pediatric surgery is hepatic portoenterostomy for biliary atresia, widely known as the Kasai procedure for its originator, Morio Kasai (1922-2008), of Sendai, Japan. It was the first effective operation for the "uncorrectable" form of biliary atresia, where death within months from biliary cirrhosis was certain. His radical premise was that microscopic ductules present in the fibrous tissue of the porta hepatis, when transected, drained enough bile to relieve cholestatic jaundice. His first operations from 1955 to 1961 had a jaundice-free survival rate of only 8 percent, but the cures were durable. By 1982-1986 survival reached 55 percent. Adoption of his procedure in the West came slowly. The original operation in 1955 was reported in the Japanese literature in 1959, but the first English language communication came in 1968. Surgeons disbelieved his results. Scientific chauvinism held that advances in pediatric surgery came from America and Europe; Japan had little to add. Surgeons visited Sendai to learn from Kasai, notably John Lilly and R. Peter Altman, then of Washington, DC, Jacques Valayer in Paris, and Edward Howard in London. At first, mortality rates in their hands was high. As expertise developed in the West with the technically demanding operation, mortality fell and approached those reported by Kasai. Successes in America, France, and England proved Kasai's operation as effective and one of signal achievements in pediatric surgery., Competing Interests: Conflicts of interest The author declares no conflicts of interest in the preparation and submission of this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Abstract Background The improved prognosis of Crohn’s disease may increase the opportunities of surgical treatment for patients with Crohn’s disease and the risk of development of colorectal cancer. We herein describe a patient with Crohn’s disease and a history of multiple surgeries who developed rectal stump carcinoma that was treated laparoscopically and transperineally. Case presentation A 51-year-old man had been diagnosed with Crohn’s disease 35 years earlier and had undergone several operations for treatment of Crohn’s colitis. Colonoscopic examination was performed and revealed rectal cancer at the residual rectum. The patient was then referred to our department. The tumor was diagnosed as clinical T2N0M0, Stage I. We treated the tumor by combination of laparoscopic surgery and concomitant transperineal resection of the rectum. While the intra-abdominal adhesion was dissected laparoscopically, rectal dissection in the correct plane progressed by the transperineal approach. The rectal cancer was resected without involvement of the resection margin. The duration of the operation was 3 h 48 min, the blood loss volume was 50 mL, and no intraoperative complications occurred. The pathological diagnosis of the tumor was type 5 well- and moderately differentiated adenocarcinoma, pT2N0, Stage I. No recurrence was evident 3 months after the operation, and no adjuvant chemotherapy was performed. Conclusion The transperineal approach might be useful in patients with Crohn’s disease who develop rectal cancer after multiple abdominal surgeries.

In the nineteenth and early twentieth centuries, scientific and technological developments made surgery safer, more reliable, and, with the corresponding increase in experimentation permitted, more exploratory and successful than ever before. The age of the heroic surgeon, however, obscured procedures that relied on the patient's cooperation for a final, positive outcome. This essay focuses on the debates surrounding cleft palate surgery in Britain, Europe, and North America between about 1800 and 1930, where the constancy of failure dogged the surgeon, even with improved operative surroundings. Although an anatomical correction could eventually be secured by surgery, without the patient's participation in learning "normal" speech, the ultimate result was unsuccessful. Patient responsibility and self-control became, therefore, the key to success. By exploring what this meant for patients, their families, and surgeons, a new way of thinking about surgical outcomes, even during a period of increasing confidence in surgery, can be posited. [ABSTRACT FROM AUTHOR]

The operations involved in the repair of complete bladder exstrophy (CBE), familiarly known as the Kelly procedure, evolved over more than 100 years. Through repeated cycles of trial and error, some of the most prominent urologists in the world developed techniques that addressed each of the formidable surgical challenges presented by CBE and epispadias. A key figure is Justin H. Kelly of the Royal Children's Hospital, Melbourne, who made surgery for CBE his life's work. He took the lessons of his surgical predecessors, giants like: Friedrich Trendelenburg, Hugh Hampton Young, John Dees, and Guy Leadbetter, applied techniques for anorectal anomalies from his contemporary Alberto Peña, and saw his procedures improved by the next generation of leaders in paediatric urology that included Phillip Ransley, Peter Cuckow, Patrick Duffy, and John Gearhart. Over his long career, Mr Kelly modified and perfected his eponymous procedure patient-by-patient through a painstaking process of trial-and-error, bearing with his young patients and their families through every heart-breaking complication, and gradually creating the standard operation for children with CBE and epispadias. [ABSTRACT FROM AUTHOR]

Background: The medical fascination with the appendix vermiformis dates from the clandestine prosectors of the fifteenth century. The surgical management of appendiceal inflammation dates from 1735, but acceptance that acute appendicitis (AA) should be treated primarily by resection with or without drainage would not follow for 150 years. Recent publication of several randomized clinical trials (RCTs) of non-operative management (NOM) of AA affords the opportunity to review the historical record, describe the evolution of AA management toward NOM, and assess what is in the best interest of the patient. Methods: Review and synthesis of historical and contemporary English, French, German, and Italian literature with expert opinion. Results: Modern understanding of AA dates to the landmark 1886 clinico-pathologic correlative study by Reginald Fitz, which coined the term appendicitis and coincided with recognition by surgeons that AA could be diagnosed pre-operatively and managed surgically, with mortality rates of approximately 10%. Not until 1901 did Albert Ochsner advocate NOM, paradoxically for severe cases unlikely to survive operation. Markedly decreased mortality coincided with the introduction of sulfanilamide in 1935 and penicillin and curare in 1942. The first large series of patients with AA treated primarily with NOM was published in 1956 by Eric Coldrey. Modern management evolved rapidly in the late twentieth century, including effective anti-anaerobic antibiotic agents (1970s), laparoscopic appendectomy (LA; 1980), and pelvis computed tomography with rectal contrast (1998) all representing important contributions. Randomized controlled trials of NOM of AA date to 1995, with one large trial (2015) showing that open appendectomy was not non-inferior to NOM, and another (2020) demonstrating non-inferiority between (mostly) LA and NOM. However, one-year failure rates are high (∼30%) and appear to increase further with longer follow-up. Conclusions: Laparoscopic appendectomy is curative and cost-effective management for AA, with low morbidity. Results of recent RCTs of NOM of AA indicate that LA remains the treatment of choice, particularly if a fecalith is present. However, patient preferences must be taken into account; some may prefer NOM for the 60%-70% chance that surgery may be avoided, which should be considered when providing informed consent. Non-operative management should be undertaken in the outpatient setting if possible. Antibiotic management-whether or not for NOM-should adhere to the principles of stewardship. [ABSTRACT FROM AUTHOR]

Despite persistent critiques of the rigor of surgical research, surgeons have actually pursued careful empirical studies for centuries. Their work has enriched not only surgical science but also the development of evidencebased medicine. From conducting landmark controlled trials, to using statistics, alternate patient allocation, randomization, and sham controls, surgeons have long embraced innovative trial approaches and played important roles in the development of key methods of RCTs. However, historical contexts unique to surgery have shaped the implementation of RCTs in this field. Unlike the history of pharmaceuticals, in which substantial research funding has been devoted to testing new drugs before their approval, surgical trials have followed a different trajectory. New operations have repeatedly come into wide use in the absence of RCTs. On many occasions, when established procedures have become controversial, surgeons have then marshaled the resources to conduct RCTs reassessing the operations. Such trials have triggered powerful debates in which proponents of surgical RCTs battled against ingrained practices and preferences. In such cases, RCTs often were not decisive factors in determining the fate of surgical practices but supporting tools that followed and reflected changes in surgical judgment already underway. Surgical trialists also have encountered specific, recurring challenges, especially with the methodological and ethical complexity of blinded and sham-controlled trials. The history of surgical trials thus reveals major contributions from surgeons to the advancement of evidence-based medicine, as well as ongoing challenges. Strengthened and systematic trial support could advance the future of surgical RCTs. [ABSTRACT FROM AUTHOR]

The origins of higher education in Kaunas began in 1919, during a difficult period for the country, during the struggle for its independence. The young state of Lithuania laid the first foundations of higher education and sought to restore the health care system. The article presents a brief history of the establishment of a higher school in Kaunas, the establishment of higher medical courses and a university. One of the initiators of this work, along with other prominent Lithuanians, was the famous surgeon and public figure at the time Juozas Žemgulys. The emergence of the first departments of surgery at the then University of Lithuania in Kaunas and the beginning of their work is reviewed, the first supervisors Janis Dzirne, Hans Boit, Aleksandr Hagentorn are presented. They significantly contributed to the development of surgery in the country, helped to grow a new generation of Lithuanian surgeons.

Anal fissure is one of the most common proctological pathologies. It consists of the formation of a longitudinal tear in the anoderm, causing pain and bleeding during and after defecation. When chronic, it can significantly negatively impact the quality of life of the affected patient. Currently, multiple therapeutic options are available, both medical and surgical. The objective of this article is to highlight the historical evolution in the physiopathological understanding and treatment of this disease, underlining the key moments in this history. This is the first article to summarize the milestones in the treatment of anal fissure from ancient to current times.

During the period from 1962 to 1977, several antigens, notably carcinoembryonic antigen and prostate‐specific antigen, were discovered and entered clinical use. Ultrasonography, positron emission tomography scanning, and magnetic resonance imaging were introduced, and adjuvant radiation and chemotherapy after limited surgery became routine procedures. Radioimmunoassay and immunohistochemistry techniques were standardized. The announcement in England and the United States that tobacco is a potent lung carcinogen was long delayed, important news. The US Cancer Act of 1971 made it possible to experiment with newly discovered drugs, transfer promising therapeutic agents from the laboratory to the clinic, and finance randomized clinical trials. Oncologists achieved a series of successes with combination chemotherapy in childhood cancers, adult lymphomas, and testis tumors. Clinical trials demonstrated that breast‐conserving therapy is as effective as mastectomy. The discovery of retroviruses, reverse transcriptase, and vascular endothelial growth factor was coupled with learning about oncogenes. The 2‐hit theory and the reciprocal translocation of chromosomes helped to solve some of the riddles of oncogenesis. The staging classification of cancers by the American Joint Committee on Cancer unified clinical and pathologic handling and prognostication of malignant tumors. The progress made in oncology between 1962 and 1977 came about through the dedicated work of many individuals. However, there were 9 pathfinders (3 medical oncologists, 2 surgeons, 1 medical nuclear physicist, 1 pediatrician geneticist, 1 hematologist geneticist, and 1 virologist) who, despite their diverse backgrounds, personalities, and interest, made extraordinary contributions to oncology. A concise review of the publications and achievements of individual pathfinders in oncology during the period from 1962 to 1977 is provided as a continuum of prior publications. During the historic period studied, cigarettes were named carcinogens, and it was demonstrated that limited surgery is as effective as radical procedures. [ABSTRACT FROM AUTHOR]

This article examines three English surgical treatises compiled between the late fourteenth and mid-fifteenth centuries. The earliest, a Middle English treatise dated 1392, appears to have been compiled by a surgeon practising in London (MS Wellcome 564). Near contemporary with this is a Latin treatise, Philomena , compiled by London surgeon John Bradmore in the first decade of the fifteenth century (BL MS Sloane 2272). The latest of the three, dated 1446, represents a translation/adaptation of Bradmore's Philomena into Middle English (BL MS Harley 1736). All three treatises contain anecdotes of surgical cases, and just one of these anecdotes is common to all three manuscripts. Close analysis of this story is used to explore aspects of the practice and regulation of surgery in late medieval London, and also to examine the relationship of the three treatises and the implications this has for the sharing of texts and information among surgeons. [ABSTRACT FROM AUTHOR]

History of surgery: A personal and professional account of the influence of John Hunter pioneer surgeon, comparative anatomist and scholar on a contemporary surgeon's life. A reflective paper on the grand contribution a mighty mind made to the art and science of surgery. The author has a dual scholastic background which opened additional sources of biographic interest. [ABSTRACT FROM AUTHOR]

Background: The improved prognosis of Crohn's disease may increase the opportunities of surgical treatment for patients with Crohn's disease and the risk of development of colorectal cancer. We herein describe a patient with Crohn's disease and a history of multiple surgeries who developed rectal stump carcinoma that was treated laparoscopically and transperineally. Case presentation: A 51-year-old man had been diagnosed with Crohn's disease 35 years earlier and had undergone several operations for treatment of Crohn's colitis. Colonoscopic examination was performed and revealed rectal cancer at the residual rectum. The patient was then referred to our department. The tumor was diagnosed as clinical T2N0M0, Stage I. We treated the tumor by combination of laparoscopic surgery and concomitant transperineal resection of the rectum. While the intra-abdominal adhesion was dissected laparoscopically, rectal dissection in the correct plane progressed by the transperineal approach. The rectal cancer was resected without involvement of the resection margin. The duration of the operation was 3 h 48 min, the blood loss volume was 50 mL, and no intraoperative complications occurred. The pathological diagnosis of the tumor was type 5 well- and moderately differentiated adenocarcinoma, pT2N0, Stage I. No recurrence was evident 3 months after the operation, and no adjuvant chemotherapy was performed. Conclusion: The transperineal approach might be useful in patients with Crohn's disease who develop rectal cancer after multiple abdominal surgeries. [ABSTRACT FROM AUTHOR]

Pétrequin was a French surgeon born in the town of Villeurbanne, near the city of Lyon. He lived in an era when surgery was evolving towards a more complex and modern specialty. His magnificent career was shared between surgical pathology and history of surgery. His two most significant works were “Traité d’anatomie médico-chirurgicale et topographique” (An Assay of Medical and Surgical Anatomy and Topography) and “La chirurgie d’Hippocrate” (The Surgery of Hippocrates). Having realized the need for surgery to be combined with anatomy, he was the scholar who introduced the concept of surgical anatomy. His innovations, travels and publications won him a series of nominations and a place among th greatest European surgeons and philosophers of all times.

During the period from 1942 to 1962, treatment attempts with single‐agent chemotherapy such as nitrogen mustard and urethan gained limited application. However, the groundbreaking success with aminopterin in the treatment of patients with pediatric acute leukemia and methotrexate in the treatment of gestational choriocarcinoma established single‐agent chemotherapy as a pioneering contribution to oncology. The landmark discovery that early‐stage Hodgkin disease is curable with radiation made radiotherapy into an essential specialty of oncology. Although radical surgical treatment dominated the field of surgery, the excision of localized cancers with or without adjuvant radiation emerged as new modality in therapy. Cytopathology and surgical pathology became new fields in medicine and pathologists became an integral part of the preoperative, intraoperative, and postoperative care of patients with cancer. The discovery of multiple new drugs demonstrated promising results and widened the field of oncology from the laboratory to the clinic. In the etiology of cancer, precancerous conditions were named and carcinoma of the lung was definitively linked to cigarette smoking. All things considered, the progress made between 1942 and 1962 came about through the dedicated work of many individuals. However, there were 7 distinguished pathfinders (2 pathologists, 1 pediatric pathologist–oncologist, 1 radiation therapist, 1 physician‐actuary, 1 gynecologist‐oncologist, and 1 chemist) who, despite their different backgrounds, interests, and sex, made groundbreaking contributions to oncology. Over the 2 decades reviewed herein, advancements in radiotherapy and medical oncology coupled with the discovery of new chemotherapeutic drugs and the introduction of less radical surgical procedures were the most momentous events. The biographies of 7 individuals who contributed the most to the progress of oncology from 1942 to 1962 are presented. [ABSTRACT FROM AUTHOR]

This article discusses how Claire Randall, RN, MD, the fictional protagonist of Diana Gabaldon’s widely popular Outlander series, uses her knowledge of twentieth century medicine in her adventures in eighteenth century Scotland, France, and America.

Bien des instruments chirurgicaux portent les noms de leurs inventeurs, chirurgiens du passé souvent émérites de par leurs découvertes et leurs contributions à l'avancée des techniques chirurgicales. Cependant, ce rappel quotidien à l'histoire de la chirurgie est bien souvent oublié des praticiens contemporains. Nous nous proposons donc d'étudier, à travers une sélection d'instruments, de brèves biographies de ces précurseurs. Ce quatrième article se consacrera aux inventeurs des instruments de la rhinoplastie : Joseph, Killian, Aufricht, Cottle et Claoué. Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This fourth original article will focus on the inventors of rhinoplasty instruments: Joseph, Killian, Aufricht, Cottle and Claoué. [ABSTRACT FROM AUTHOR]

Until the successful repair of esophageal atresia (EA) and distal tracheoesophageal fistula (TEF) in 1941 by Cameron Haight of Ann Arbor, MI, every infant operated upon for this anomaly died within days and often hours of surgery. A key step was the posterior extrapleural approach to the mediastinum pioneered by Charles Mixter of Boston in 1929 that gave direct exposure of the anomaly without entering the pleural cavity and collapsing the lung. From 1936 to 1939 Thomas Lanman, also of Boston, made five unsuccessful attempts at primary repair of EA. His experience established the basic principles of early radiological diagnosis and prompt surgical intervention to minimize the risks of aspiration pneumonia, dehydration, and inanition. In 1939 N. Logan Leven of Minneapolis and William Ladd of Boston independently had the first long-term survivors of EA with a series of operations to construct skin-lined tubes on the anterior chest wall that connected an esophagostomy to a gastrostomy. Haight first tried primary repair in 1939, finally succeeding in his fourth case in March 1941. In their publications Lanman (1940), Haight (1943 and 1944), and Ladd (1944 and 1947) presented case-by-case chronologies. The evolution of surgical management thus can be traced from a fatal condition to one where survival became the expected outcome. History recognizes Haight for his work with EA, not only for its first successful primary repair, but also his lifelong dedication to its surgical management. [ABSTRACT FROM AUTHOR]

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During the period from 1922 to 1942, several carcinogens were identified in coal tar, industrial oils, and petroleum, and radium was added to x-ray as a potential carcinogen. It was proven that some viruses are capable of causing cancer, and the dependency of prostatic and mammary hyperplasia and carcinoma on naturally occurring hormones was established. Colon cancer was linked to hereditary and nonhereditary polyposis. A permanent place for diagnostic radiology was defined and radiation therapy advanced to preoperative and postoperative modalities using x-ray and radium. The trend toward the use of radical surgery for primary and metastatic cancers continued. Although several new radical surgical procedures were developed and advanced as far as the technical skills of surgeons and the anatomic setting permitted, several innovative, less radical procedures were introduced. In chemotherapy, the basic principle of the treatment of advanced cancers with hormones was inaugurated. Pathologists synthesized what was known in tumor pathology, named new microscopic entities, recognized carcinoma in situ, developed histologic grading and pathologic staging of cancers, and introduced aspiration cytology and exfoliative cytology as new fields in oncology. It is interesting that despite profound global economic, social, and political upheaval and wars and preparation for wars, writers and producers of musicals and movies presented more memorable works than ever before. In the fields of science and technology, particularly nuclear physics and chemistry, profound discoveries were made that became a permanent part of human life. The progress made in oncology between 1922 and 1942 came about through the dedicated work of many individuals. However, there were 7 pathfinders (3 surgeons, 2 pathologists, 1 physician-chemist, and 1 physician-cytologist) who, despite their widely diverse backgrounds, personalities, and interest, made outstanding contributions to oncology to the magnitude that they deserve a permanent place in the history of medicine and oncology. [ABSTRACT FROM AUTHOR]

Bien des instruments chirurgicaux portent les noms de leurs inventeurs, chirurgiens du passé souvent émérites de par leurs découvertes et leurs contributions à l'avancée des techniques chirurgicales. Cependant, ce rappel quotidien à l'histoire de la chirurgie est bien souvent oublié des praticiens contemporains. Nous nous proposons donc d'étudier, à travers une sélection d'instruments, de brèves biographies de ces précurseurs. Ce troisième article se consacrera aux inventeurs des ciseaux de Mayo, Metzenbaum, Stevens et Lister. Many surgical instruments are named after their inventors, acclaimed surgeons of the past, because of their discoveries and their contributions in the field of surgical techniques. However, these daily reminders of history of surgery are often forgotten by the modern practitioners. We propose to review, through a selection of instruments, short biographies of these precursors. This third original article will focus on the inventors of modern scissors: Mayo, Metzenbaum, Stevens and Lister. [ABSTRACT FROM AUTHOR]

Previously were published well-known data on Rijeka physician, Dr Ljubica Bosner, about her work in the Ogulin, Bjelovar, Petrinja and Rijeka hospitals during her excellent surgical and gynaecological and obstetric practice. The new and now accessible archives of personal and professional items complete incomplete and unknown biographical information. After her internship, Dr Bosner worked at a public county hospital in Velika Gorica as a secondary doctor at a well-known orthopaedic ward of that hospital. Circumstances of going to the Ogulin hospital with an oath to the reigning King Peter II for fidelity, then her professional activity as a surgeon at the newly opened Foundation Hospital Rebro Zagreb, with occasional departures to the position of director of the hospital and surgeon in Petrinja and Varaždin, and after the war to new positions at the Regional People's Board in Istria, are of particular social and historical interest. Recommendations from her bosses have been found to recognise the profession of surgeon specialist that particularly emphasise her skills, clinical judgment, and performance of major surgical procedures, especially during the war. Her life and medical career went through periods of great crisis between the two world wars (during the Kingdom of Serbs, Croats and Slovenes), then World War II (during the Independent State of Croatia), and after the war and the Republic of Yugoslavia in which she acted as a surgeon. The above data in the biography of Dr Ljubica Bosner are completed by previously unknown and unpublished photographs from her personal and professional surgical life. [ABSTRACT FROM AUTHOR]

Purpose: Recent studies showed that women after surgery are at higher risk of delivering small-for-gestational infants. Thus, this study aims to investigate longitudinal changes of fetal subcutaneous adipose tissue thickness (FSCTT) of fetuses conceived after gastric bypass surgery as compared to BMI-matched controls. Methods: Retrospective cohort study measuring ultrasound-derived longitudinal trajectories of abdominal FSCTT in 41 singleton pregnancies after gastric bypass surgery compared to 41 BMI-matched controls and 64 obese mothers. Results: FSCTT was significantly lower in fetuses of women after GB as compared to BMI-matched controls in the second (mean difference 1.38 mm, p < 0.001) and third trimester of gestation (mean difference 3.37 mm, p < 0.001). Longitudinal analysis revealed significant differences in mean FSCTT trajectories between offspring's in GB mothers, BMI-matched, or obese controls. The ratio of FSCTT and abdominal circumference remained constant in the BMI-matched control group whereas it significantly decreased in fetuses of women after GB. Despite remarkable differences were observed in longitudinally assessed FSCTT, further analyses in the GB subgroup revealed that FSCTT were not influenced by OGTT mean or 120 min glucose values, biochemically hypoglycemia, time since bariatric surgery, or weight loss since surgery. Conclusion: In fetuses of mothers with history of bariatric surgery, abdominal FSCTT was markedly reduced. While the underlying mechanisms are not fully understood, a multifactorial genesis including nutritional deficiencies and altered metabolism after bariatric surgery is assumed. [ABSTRACT FROM AUTHOR]