Radiofrequency surgery: 3500 years old and still young.

PURPOSE: To review the history of Radiofrequency surgery, delineate the actual situation and describe the applications in eyelid surgery. DESIGN: Review. METHODS: Review of literature, personal communication with several pioneers in the field, and own experience. CONCLUSION: Radiofrequency surgery has evolved from rude burning to a sophisticated surgical technique.

A history of the surgical management of glaucoma.

Many new surgeries have been devised since 1856, when von Graefe discovered that iridectomy is an effective surgical method for acute glaucoma treatment. Two years later, De Wecker presented sclerotomy as a procedure for chronic glaucoma. In 1900, internal filtration (cyclodialysis) was developed. In 1932, ciliodestruction was suggested. The four approaches, relief of pupillary block, external filtration, internal filtration, and ciliodestruction, are still the basic techniques of glaucoma surgeries over 100 years later. There have been two basic approaches to lowering eye pressure surgically: increase outflow and decrease inflow of aqueous humor. Although the majority of surgeries used nowadays were introduced in the 1960s, their roots can be traced to the work of surgeons in the 19th century. Trabeculectomy, in use since the mid-1960s, is the most effective glaucoma surgery in terms of intraocular pressure reduction but carries its own limitations. Non-penetrating glaucoma surgeries emerged at the same time trabeculectomy was presented, but they are not used as commonly as trabeculectomy. Molteno introduced the first effective shunt and followed by others. Since 1995, the majority of new surgeries have consisted of new implantable devices including SOLX, iStent, and Ex-PRESS shunt. This article will review the history of glaucoma surgery and describe the fundamentals of different glaucoma procedures.

Historical development of bipolar coagulation.

In 1926, a physicist at Harvard named William T. Bovie created an instrument, which revolutionized the medical profession--the unipolar electrocautery device. This incredible device could make surgical incisions and provide hemostasis as well. It came with a price, however, as it also created new risks and dangers in the operating room, such as electrical burns and fires. To resolve some of these problems, a bipolar electrocautery device was developed. The historical development and principles of both unipolar and bipolar electrocautery will be discussed in this article.

Early evolution of neurological surgery: conquering increased intracranial pressure, infection, and blood loss.

At the end of the 19th century, the early evolution of the specialty of neurological surgery was restricted by complications related to infection, increased intracranial pressure, and excessive intraoperative blood loss. These complications often caused mortality rates of 30 to 50%. An improved understanding of pathophysiological factors involved in increased intracranial pressure, along with meticulous surgical techniques learned from William Halsted, allowed Harvey Cushing to increase the safety of neurosurgical procedures that were then in their infancy. Cushing's later development of the "silver clip" and incorporation of electrosurgical techniques facilitated safe resection of brain tumors previously assumed to be inoperable. These pivotal accomplishments paved the way for the establishment of our specialty.

Effect of hemostasis and electrosurgery on the development and evolution of brain tumor surgery in the late 19th and early 20th centuries.

Hemostatic options available to the surgeon in the late 19th and early 20th centuries were limited. The surgical ligature was limited in value to the neurological surgeon because of the unique structural composition of brain tissue as well as the approaches and operating angles used in this type of surgery. In this manuscript the authors review the options available and the evolution of surgical hemostatic techniques and electrosurgery in the late 19th and early 20th centuries and the impact of these methods on the surgical management of tumors of the brain and its coverings.

Tonsillectomy: haemorrhaging ideas.

Tonsil surgery has been described for over 3000 years. Haemorrhage following tonsillectomy remains the most serious complication of surgery. Over recent years several audits have been gathering data on current trends in tonsil surgery and clinical outcomes throughout England, Scotland and Northern Ireland. The results support a return to traditional dissection with ties to reduce the risk of post-operative haemorrhage. We describe the changes that have occurred to improve efficacy and safety during the evolution of the modern tonsillectomy.

[Galvanocautery in the 19th century otorhinolaryngology service]. / Galwanokaustyka na uslugach XIX-wiecznej otorynolaryngologii.

The essence of galvanocautery, the such instruments as loops, cauteries and others are presented first of all. The achievements of such doctors as Albrecht Theodor Middeldorpf (1824-1868), Victor von Bruns (1812-1883), Friedrich Eduard Voltolini (1819-1889) and others in development of galvanocautery are depicted. The observations of such Polish physicians as Antoni Bryk (1820-1881), Jan Sedziak (1861-1932) and Zygmunt Srebrny (1860-1941) were very valuable. The good points and shortcomings of galvanocautery and principles of post-operational procedures are pointed out. The use of galvanocautery in otorhinolaryngology especially in strictures of external auditory meatus, aural polyps, aural granulations, in hypertrophy of nasal concha, nasal polyps, in atresia of nasal cavities, in hypertrophy of palatine tonsils, in tumors of naso-pharyngeal cavity, in tuberculosis laryngis are described with full particulars.

Scleral strength impairment and recovery after diathermy.

Compression force rupture experiments were conducted in dog eyes at varying time intervals after scleral diathermy to determine the time variable of scleral weakening and recovery. The sclera was weakened immediately after the diathermy, and there was progressive further weakening for three weeks and then gradual partial recovery to 60% of control eye strength at eight months, at which point the experiment was terminated.

Inauguration of pediatric neurosurgery by Harvey W. Cushing: his contributions to the surgery of posterior fossa tumors in children. Historical vignette.

Development of posterior fossa surgery remains Harvey Cushing's hallmark contribution to pediatric neurosurgery. During the era before Cushing, posterior fossa lesions were considered inoperable, and only osseous decompressive surgery was offered. The evolution of Cushing's surgical expertise from subtemporal decompressions to total extirpation of vascular fourth ventricular tumors, combined with a dramatic decrease in his operative mortality rate, reflects the maturation of modern neurosurgical techniques. A comprehensive review of the medical records of Cushing's pediatric patients treated between 1912 and 1932 revealed that procedures such as lateral ventricular puncture (to decrease cerebellar herniation), transvermian approach to midline tumors, and electrocoagulation were the key factors punctuating the path to his pioneering achievements in posterior fossa surgery. The outcome of such operations was improved by his recognition of the importance of tumor mural nodule in cyst recurrence, as well as elucidation of the histogenesis of pediatric posterior fossa tumors to tailor treatment including radiotherapy.

Historical considerations of the diagnosis and treatment of facial pain.

Most forms of facial pain remain neurologic disorders that, although not life threatening, can be debilitating. Modern descriptions of the various forms of facial pain according to their clinical and anatomic patterns did not develop until after the contributions of the early modern neuroanatomists and physiologists in the first quarter of the nineteenth century. These contributions allowed the recognition of relatively distinct painful afflictions of the face, and permitted surgeons in the late nineteenth century to embark confidently on a variety of approaches to cranial and peripheral nerves using decompressive or destructive procedures to alleviate facial pain.

Minimally invasive spinal surgery: a historical perspective.

The concept of minimally invasive spinal surgery embodies the goal of achieving clinical outcomes comparable to those of conventional open surgery, while minimizing the risk of iatrogenic injury that may be incurred during the exposure process. The development of microscopy, laser technology, endoscopy, and video and image guidance systems provided the foundation on which minimally invasive spinal surgery is based. Minimally invasive treatments have been undertaken in all areas of the spinal axis since the 20th century. Lumbar disc disease has been treated using chemonucleolysis, percutaneous discectomy, laser discectomy, intradiscal thermoablation, and minimally invasive microdiscectomy techniques. The initial use of thoracoscopy for thoracic discs and tumor biopsies has expanded to include deformity correction, sympathectomy, vertebrectomy with reconstruction and instrumentation, and resection of paraspinal neurogenic tumors. Laparoscopic techniques, such as those used for appendectomy or cholecystectomy by general surgeons, have evolved into procedures performed by spinal surgeons for anterior lumbar discectomy and fusion. Image-guided systems have been adapted to facilitate pedicle screw placement with increased accuracy. Over the past decade, minimally invasive treatment of cervical spinal disorders has become feasible by applying technologies similar to those developed for the thoracic and lumbar spine. Endoscope-assisted transoral surgery, cervical laminectomy, discectomy, and foraminotomy all represent the continual evolution of minimally invasive spinal surgery. Further improvement in optics and imaging resources, development of biological agents, and introduction of instrumentation systems designed for minimally invasive procedures will inevitably lead to further applications in minimally invasive spine surgery.

Surgeons and their tools: a history of surgical instruments and their innovators--Part II: The surgeon's wand-evolution from knife to scalpel to electrocautery.

This is the second of five articles reviewing the historical origins of some of the more commonly used surgical instruments and takes "time out" to remind current surgeons about the surgical pioneers on whose shoulders they now stand and whose inventions they now use.

Antoni Christian Bryk (1820-1881) - professor of forensic medicine at Jagiellonian University (1852-1860), and director of the surgical clinic of Jagiellonian University in Cracow (1860-1881).

scientific discipline. In the 19th century two milestones revolutionised surgery: the development of narcosis, which enabled painless surgery, and the introduction of antisepsis and asepsis. The author presents the beginnings of academic surgery in Cracow. Its pioneer surgeons are presented. Extensive research was undertaken to collect the literature and documents in Polish, Austrian and German archives and libraries in order to prepare this study. Biographical details of the director of the Surgical Clinic, Prof. Antoni Bryk, are provided. He was the first person in Poland to introduce antisepsis and galvanocautery as routine procedures in the Cracow Clinic. The introduction of antisepsis contributed to a reduction in infection during surgery, and a reduction in postoperative mortality in Cracow Surgical Clinic. In this way Professor Bryk became the first Polish surgeon to apply Lister's antiseptic method in the treatment of wounds. Thus enlarged, the scope of surgery for intracranial, bone and other procedures became routine. Surgery is the oldest discipline in medicine. Poland's first university chair of surgery was established in the 18th century. Surgery, which until then had been the domain of barbers and bath house attendants, became a clinical,

The life and legacy of William T. Bovie.

This Historian's Address, presented at the North Pacific Surgical Association 2012 meeting, held in Spokane, Washington, on November 9, 2012, briefly reviews the life and surgical contributions of the inventor William T. Bovie and his collaboration with Dr Harvey Cushing, which led to the widespread acceptance of surgical electrocautery for dissection and hemostasis.

Controversy over the etiology and therapy of retinal detachment: the struggles of Jules Gonin.

Retinal tears were recognized as soon as ophthalmoscopy became available. They were initially considered to be secondary events, from choroidal exudation and pressure behind the detached retina. This led von Graefe and others to recommend cuts in the retina to drain subretinal fluid into the vitreous cavity. De Wecker (1875, 1879) and Leber (1882) first proposed that intrinsic tears within the retina are the cause of retinal detachment, but they faced extreme and long lasting opposition for this view. Surgical results at this time were uniformly disastrous, and therapeutic nihilism still prevailed when Dufour and Gonin became convinced around 1904-1906 that the retinal tear was indeed the origin of the detachment. It took ten years, however, before Gonin figured out how to close tears by exact placement of heat coagulation ("thermopuncture") and provide therapeutic evidence for his beliefs. When he first presented his results in 1921, colleagues jeered at him, especially Deutschmann and Sourdille who, like the other ophthalmic surgeons, denied the role of the tear (and still made "therapeutic" incisions through the detached retina). Recognition of Gonin's approach finally came at the International Congresses in Amsterdam 1928 and in Madrid in 1933. Sourdille modified his approach when his son Gabriel convinced him to change after 1930, but Deutschmann stuck to his horrific procedure until his death in 1935. Then a new generation of retinal surgeons took over, with subsequent discussion focused on finding the best methods to close the tears.

[The Bulletin du cancer: the years before the First World War]. / Le Bulletin de l'Association française pour l'étude du cancer de 1909 à 1914 : le Bulletin du cancer dans sa première période.

Three years after its founding in 1909, the Association française pour l'étude du cancer is a major scientific society developing transdisciplinary debates particularly on innovative therapeutics in cancer, such as the developing use of radium. The Association at that time assembles together all the French medical elite. Reading the Bulletin offers a clear view of the brilliant monthly debates. First World War stopped the life of the Association for four years. After this break, the set up of dedicated centers for cancer treatment was responsible for a major turn in the Association's life.