The history of esophageal surgery.

BACKGROUND: Esophageal surgery has always been considered extremely demanding, given the surgical experience and skills required, due to the anatomic location of the esophagus as well as the impact of such extensive operations on patients' homeostasis. The intention of the present study is to review all historical time points of esophageal surgery, from its inception to the modern era of minimally invasive esophageal surgery. METHODS: The first clear description of esophageal surgery is dated back to 1738, in an attempt to remove a foreign body from the thoracic esophagus. However, the high morbidity and mortality rates of esophageal surgical operations led to the invention and application of less invasive surgical procedures. RESULTS: Esophageal surgery has evolved from extensive surgical operations to minimally invasive esophagectomies, aiming exclusively to reduce perioperative morbidity and mortality, while maintaining surgical effectiveness. Despite the fact that benign esophageal pathologies were the main stimulus for this evolution, minimally invasive esophageal surgery is now applied even in patients with esophageal cancer, with outcomes comparable to those of traditional surgical approaches. CONCLUSION: It would be interesting to see how all these new surgical techniques may evolve, altering further the current status of esophageal surgery in the future.

John Watson (1807-1863) and his Pioneer Work On the Surgery of Esophagus.

Backround. John Watson (1807-1863) was the first surgeon in USA who performed and published his results on esophagotomy. Methods. His pioneer surgical work was a gold standard reference for the later surgeons. Results. Watson was a devoted surgeon and his innovative operating techniques secured him a place in the hall of fame of the history of medicine.

Paul of Aegina (ca 625-690 ad): Byzantine Surgeon and Pioneer of Surgical Management of Congenital Atresia of the External Auditory Canal.

Diseases of the ear have been recorded and treated since ancient times. Ex-votos have been offered to heal deafness. Noninvasive treatments have evolved into minor, and later more advanced, surgical techniques to treat head and neck issues. Paul of Aegina (ca 625-690 ad) perfected his medical skills in the School of Alexandria in Egypt. His medical encyclopedia, Medical Compendium, described a broad series of surgical operations, including a chapter "On the atresia of the auditory canal," which vividly described a surgical technique to open the ear canal. This surgery is particularly interesting, as it exceeds the limits of resection and amputation known at that time and describes a novel surgical technique. His innovative methods paved the way for future surgeons.

Professor William Macewen (1848-1924): The Scottish Pioneer of Surgery.

Professor William Macewen (1848-1924) is one of the most important figures in world's surgery during 18th and early 19th century. He managed to provide numerous innovative techniques and instruments in various fields of surgery such as general surgery, orthopedic surgery, neurosurgery, and thoracic surgery. His innovations had a great impact after his time and constituted the fundaments for further surgical developments. He also was a pioneer in clinical photography with the creation of a huge archive. During his surgical career, he received many honors.

Sir William Arbuthnot Lane (1856-1943) and His Innovations to Femoral Surgical Anatomy and Surgery.

Sir William Arbuthnot Lane (1856-1943) is considered a pioneer in orthopedic surgery, especially for his breakthrough for the time technique for bone and mainly femoral surgery, the so-called screw and plates technique, which was also accompanied by his aseptic surgical approach. Apart from his innovations in colon, nose, ear, throat, and reconstructive surgery, his treatises on orthopedic surgery were considered as masterpieces. Femoral anatomy and surgical anatomy attracted mainly his interest as seen in his treatises.

Mathieu Jaboulay (1860-1913) and His Innovations in Vascular and General Surgery.

Mathieu Jaboulay (1860-1913) was an inventor in vascular and general surgery. He fabricated many new surgical techniques and instruments such as Jaboulay method for vascular sutures, Jaboulay anastomotic button, and Jaboulay amputation, known also as hemipelvectomy. In addition, he was a pioneer in heterologous transplantation and sympathectomy. He found death suddenly in a terrible train crash. He was a reputable Professor of Surgery at Lyon Faculty of Medicine with prestigious students in vascular surgery.

The pioneer ophthalmologist Johann Friedrich Horner (1831-1886) and the clinical anatomy of the homonymous syndrome.

Johann Friedrich Horner is remembered in ophthalmology due to his brief report in the German scientific journal 'Klinische Monatsblatter fur Augenheilkunde', in which emphasized the clinical value of a cluster of external signs of damage to the cervical sympathetic nerve. Although J .F .Horner was not the first to describe such a syndrome, he was credited with the nomination. For the French, Francois Pourfour du Petit was the pioneer in that case. Born in Zurich, travelled Europe to be further educated, becoming later on Professor and Director of the University Clinic of Ophthalmology in his native city. In conclusion, J .F .Horner's adamantine character, hard work, assiduous teaching and skills in eye surgery made him one of the main contributors for the evolution of ophthalmology in the nineteenth century Central Europe.

Surgical treatment of the cancer of the optic nerve and orbit. An historical overview.

Introduction: Aim of the present study is to present an historical overview of the surgical techniques introduced for the treatment of the cancer of the optic nerve and orbit.Methods: From the late 19th and early twentieth century there were introduced many novel surgical techniques for the treatment of the cancer of the optic nerve and orbit. The majority of these techniques concerned for the cure of orbital malignance, while optic nerve cancer many times was treated by enucleation of the eyeball.Results: Except of the extraction of the malignant tumors the surgeons of the time tried to present the best aesthetic result, fact which points the progress of the surgery those years.Conclusions: Many of the techniques introduced those years are still in use.

Praxagoras of Cos (4th Century BC) and His Innovative Method of a Diverting Enterocutaneous Fistula to Relieve Small Bowel Obstruction.

Born in an island with huge medical tradition in ancient Greece, Praxagoras of Cos became an esteemed medico-philosopher and surgeon. The evolution made by the Hippocratic School of Medicine further boosted his talent and helped him perform surgical operations, which were believed impossible for his era. Praxagoras introduced an innovative surgical technique to confront small bowel obstruction, by creating an enterocutaneous fistula. This historical review connects all available data to present the life and work of an important medical figure of the ancient Hellenic School.

Fedor Krause (1857-1937) and His Innovations in Neurosurgery.

Although Ernst von Bergmann (1837-1907) is considered the father of neurosurgery in Germany, Fedor Krause (1857-1937) should be considered as its main founder. He was principally a general surgeon but he had a special interest in neurosurgery, a field in which he introduced many new techniques. He also fabricated innovative surgical methods for the treatment of patients with epilepsy.

Philip Henry Mules (1843-1905) and his innovations in ocular surgery.

INTRODUCTION: The aim of the present study is to present an historical overview of the innovations in ocular surgery introduced by the very important surgeon, but mainly unknown, Philip Henry Mules (1843-1905). METHODS: Philip Henry Mules introduced the Mules' evisceration operation and the Mules' ptosis operation. He also invented surgical instruments such as Mules' scoop, Mules' repository, and Mules' enucleation scissors. He was interested also in ocular infection. RESULTS: Many of the innovations in ocular surgery introduced by Philip Henry Mules are still in use. CONCLUSIONS: Philip Henry Mules (1843-1905) was a respectable English ophthalmologist, who despite his short life, only 62-years-old, his innovations in ocular surgery were considered a breakthrough in the late nineteenth century, because in almost every textbook of ophthalmology they were cited and deserved a great merit.

Wilhelm Fabricius von Hilden (1560-1634): The Pioneer of German Surgery.

Wilhelm Fabricius von Hilden (1560-1634) or also known with his Latinized name Guilielmus Fabricius Hildanus is considered the founder of scientific German surgery. He introduced new surgical techniques and invented new surgical instruments for the surgical treatment of nasal polyps, stone bladder, breast and ocular cancer, hydrocele, and ascites, while very ingenious were his amputation techniques. His most important surgical treatise was Observationem et curationem chirurgicam centuriae sex ( Six Hundred Surgical Observations and Treatments) first published in 1606.

Professor Samuel David Gross (1805-1884) and His Innovations in Surgery and Medicine.

Professor Samuel David Gross (1805-1884) is considered as one of the founders of American surgery. He was a skillful surgeon who could excellently perform a lithotomy, an amputation, and a cataract surgery. He introduced many new surgical techniques and designed new surgical and medical instruments. He expertise was not limited to surgery alone; he also published studies concerning internal medicine, pathology, experimental physiology, and pharmacology. His most important treatise was his 2-volume work, A System of Surgery, Pathological, Diagnostic, Therapeutic and Operative (1861), which was a standard reference book in surgery in the United States during the second half of 19th century. Gross received many honors during his life. He was active in the operating room until his death.

Professor William Wayne Babcock (1872-1963) and His Innovations in Surgery.

Professor William Wayne Babcock (1872-1963) is considered as a leading figure of American surgery during early 20th century. He introduced many innovative surgical techniques such as Babcock operation for the treatment of varicose veins, the Babcock-Bacon operation for the treatment of cancer of the rectum and sigmoid colon preserving anal sphincters, the "soup bone" cranioplasty technique, and the nerve disassociation technique for the relief of certain forms of paralysis or parasthesia due to injury or inflammation. He invented many surgical instruments such as Babcock forceps, which is widely used in everyday surgical practice, the Babcock probe, and also sump drain and lamp chimney sump drain, which also bear his name. In 1947, he received the Master Surgeon Award from the International College of Physicians and Surgeons and in 1954 the American Medical Association presented him with the Distinguished Service Medal.

Eugène Louis Doyen (1859-1916): The Reformer of French Surgery.

Eugène Louis Doyen (1859-1916) is considered as the reformer of French surgery at the end of 19th and early 20th century. Although he had a short life, dying at the age of 57, he left his mark in the history of French medicine and especially surgery, not only because he introduced many new medical instruments but also for his innovative idea to introduce cinematography in surgical education, which is crucial until today in the education of every surgeon in the world.

Karl Ludloff (1864-1945): An Inventive Orthopedic Surgeon, His Work and His Surgical Technique for the Correction of Hallux Valgus.

The purpose of this article is to summarize the work and pioneering achievements in the field of orthopedic surgery of the German orthopedic surgeon Karl Ludloff. Ludloff had an impact in the diagnostics, physical examination, orthopedic imaging, and orthopedic surgical technique of his era. He was a pioneer in the surgical treatment of dysplastic hip, anterior cruciate ligament reconstruction, and hallux valgus. His surgical technique for the correction of hallux valgus, initially stabilized with plaster of Paris, remained unpopular among other orthopedic surgeons for decades. In the 1990s, the advent and use of improved orthopedic materials for fixation attracted the interest of numerous orthopedic surgeons in the Ludloff osteotomy for its ability to correct the deformity in all 3 dimensions, its anatomic outcomes, and its low recurrence rate and patient satisfaction.

Anti-platelet effects of vitamin supplements in age-related macular degeneration: an in vitro study.

OBJECTIVE: The purpose of this experimental study was to investigate the role of vitamin supplements (Ocuvite, Vitalux Omega, and Nutrof Total) as possible inhibitors of the onset of age-related macular degeneration (AMD). MATERIALS AND METHODS: The anti-aggregating effect of each vitamin was determined against four accumulative factors namely, platelet activating factor (PAF), adenosine diphosphate (ADP), thrombin receptor-activating peptide (TRAP), and arachidonic acid (AA) in the platelet rich plasma (PRP) of healthy volunteers. RESULTS: Ocuvite, Vitalux Omega, and Nutrof Total were more potent inhibitors against PAF and ADP compared to TRAP and AA. Among the three vitamins, Nutrof Total displayed more potent inhibitions against TRAP and AA, while against PAF and ADP all the three vitamins revealed similar IC50 values. CONCLUSIONS: The vitamins Ocuvite, Vitalux Omega, and Nutrof Total have anti-aggregating effects and therefore can be used against AMD in healthy volunteers.

Antonio Scarpa (1752-1832) and his study on ocular cancer.

Antonio Scarpa (1752-1832) is known in the history of medicine as a distinguished anatomist and surgeon. Apart from his anatomical studies that established him and especially in clinical anatomy, he focused also his interest on ophthalmology, therefore he was considered as the "father of ophthalmology in Italy". His study on ocular cancer is of particular interest, because he not only reviewed older approaches on this issue enriching them with his own clinical observations but his study served as a bridge connecting the previous tradition to the scientific study of ocular cancer which began at the second third of 19th century.

The distinguished Austrian ophthalmologist Ernst Fuchs (1851-1930) and the "sarcom des uvealtractus".

Born in Vienna, in mid 19th century, Ernst Fuchs became an innovative ophthalmologist and is currently considered as the father of modern ophthalmology. Conditions like heterochromic uveitis and endothelial dystrophy were discovered by Fuchs and a series of ocular diseases are named after him. His work dealing with eye pathology, entitled: "Textbook of Ophthalmology", became known as the masterpiece of the 19th century ophthalmology. In ocular oncology, Fuchs introduced first the "sarcom des uvealtractus" (uveal sarcoma), known today as uveal melanoma. His treatment approach by enucleation was in vogue for more than 100 years, while his theory for hepatic metastasis of ocular cancer remains valid.

The distinguished Greek born, French ophthalmologist Photinos Panas (1832-1903) and his views on ocular cancer.

Photinos Panas (1832-1903) was one of the world's most important ophthalmologists in the second half of the 19th century. In his leading work entitled, Traité des maladies des yeux (Treatise of ophthalmic diseases), he made an in depth analysis of the various types of ocular cancer. His ideas on the subject were important for their tutorial character, their connection to the clinical work and very helpful for the everyday clinical practice of physicians of that time.