Rudolf Virchow: the father of today's pathology.

This year marks the 200th anniversary of the birth of Rudolf Ludwig Virchow, a pathologist and polymath who, among other things, coined the terms leukaemia, embolism and thrombosis.

Advances in general surgery 50 years ago.

In 1971, some of the new advances that were set to change the field of general surgery included theories about the development of peptic ulcers, new treatments for varicose veins and pioneering work in the introduction of day case surgery.

'An operation under difficulties' 100 years ago.

In a change from recalling births, deaths or medical discoveries, this article looks at a paper published in The Lancet 100 years ago. Occupying a little more than a single column, its vivid description of an operation carried out successfully under primitive conditions will be of great interest.

Richard Wiseman: the best known English surgeon of the 17th century.

This year marks the 400th anniversary of the birth of Richard Wiseman, acknowledged to be the best known surgeon in this country in the 17th century. His authorship of the surgical textbook Several Chirurgical Treatises gave him the well-deserved reputation for being regarded as the father of English surgery.

Academic surgery in the UK and the Surgical Research Society 50 years ago.

Fifty years ago, in 1970, academic surgical units had finally been established throughout the universities in the UK. Such departments had been created in the Scottish university cities in the 19th century; some medical schools in London had resisted this custom, but by now these bastions of the old system had surrendered!

James Syme: distinguished Edinburgh surgeon of the 19th century.

This year marks the 150th anniversary of the death of James Syme, one of the most distinguished members of the Edinburgh school of surgery in the 19th century.

State of the art urology 100 years ago.

One hundred years ago, on 27 May 1920, the inaugural meeting of the Section of Urology was held at the Royal Society of Medicine in London. The lecture, by Sir Peter Freyer KCB, paints a vivid picture of the state of art of urological surgery a century ago.

Management of breast cancer 50 years ago.

In 1970, 50 years ago, I had headed the newly established Academic Unit of Surgery at the Westminster Medical School for 10 years. Since my appointment there in 1960, and for the next 30 years, one of my main interests as a general surgeon was the management of diseases of the breast - breast cancer in particular.

Adhesion-related readmissions after open and laparoscopic surgery: a retrospective cohort study (SCAR update).

BACKGROUND: Adhesions are the most common driver of long-term morbidity after abdominal surgery. Although laparoscopy can reduce adhesion formation, the effect of minimally invasive surgery on long-term adhesion-related morbidity remains unknown. We aimed to assess the impact of laparoscopy on adhesion-related readmissions in a population-based cohort. METHODS: We did a retrospective cohort study of patients of any age who had abdominal or pelvic surgery done using laparoscopic or open approaches between June 1, 2009, and June 30, 2011, using validated population data from the Scottish National Health Service. All patients who had surgery were followed up until Dec 31, 2017. The primary outcome measure was the incidence of hospital readmissions directly related to adhesions in the laparoscopic and open surgery cohorts at 5 years. Readmissions were categorised as directly related to adhesions, possibly related to adhesions, and readmissions for an operation that was potentially complicated by adhesions. We did subgroup analyses of readmissions by anatomical site of surgery and used Kaplan-Meier analyses to assess differences in survival across subgroups. We used multivariable Cox-regression analysis to determine whether surgical approach was an independent and significant risk factor for adhesion-related readmissions. FINDINGS: Between June 1, 2009, and June 30, 2011, 72 270 patients had an index abdominal or pelvic surgery, of whom 21 519 (29·8%) had laparoscopic index surgery and 50 751 (70·2%) had open surgery. Of the 72 270 patients who had surgery, 2527 patients (3·5%) were readmitted within 5 years of surgery for disorders directly related to adhesions, 12 687 (17·6%) for disorders possibly related to adhesions, and 9436 (13·1%) for operations potentially complicated by adhesions. Of the 21 519 patients who had laparoscopic surgery, 359 (1·7% [95% CI 1·5-1·9]) were readmitted for disorders directly related to adhesions compared with 2168 (4·3% [4·1-4·5]) of 50 751 patients in the open surgery cohort (p<0·0001). 3443 (16·0% [15·6-16·4]) of 21 519 patients in the laparoscopic surgery cohort were readmitted for disorders possibly related to adhesions compared with 9244 (18·2% [17·8-18·6]) of 50 751 patients in the open surgery cohort (p<0·005). In multivariate analyses, laparoscopy reduced the risk of directly related readmissions by 32% (hazard ratio [HR] 0·68, 95% CI 0·60-0·77), and of possibly related readmissions by 11% (HR 0·89, 0·85-0·94) compared with open surgery. Procedure type, malignancy, sex, and age were also independently associated with risk of adhesion-related readmissions. INTERPRETATION: Laparoscopic surgery reduces the incidence of adhesion-related readmissions. However, the overall burden of readmissions associated with adhesions remains high. With further increases in the use of laparoscopic surgery expected in the future, the effect at the population level might become larger. Further steps remain necessary to reduce the incidence of adhesion-related postsurgical complications. FUNDING: Dutch Adhesion Group and Nordic Pharma.