The evolution of surgical virtual education and telementoring: One surgeon's journey.

The first era of the global proliferation of surgical advancements involved surgical infection rate and technique breakthroughs by Lister, Halsted, and others. This was propagated by letters, academic papers, and international visits. While success was achieved, it was at a suboptimal pace. In the current era of minimally invasive surgical approaches, these methods are inadequate. This paper chronicles the development and application of virtual learning and telementoring as force multipliers to speed procedural adoption and proliferation.

Missions, Humanitarianism, and the Evolution of Modern Global Surgery.

Modern global surgery, which aims to provide improved and equitable surgical care worldwide, is a product of centuries of international care initiatives, some borne out of religious traditions, dating back to the first millennium. The first hospitals (xenodochia) were established in the 4th and 5th centuries CE by the early Christian church. Early "missions," a term introduced by Jesuit Christians in the 16th century to refer to the institutionalized expansion of faith, included medical care. Formalized Muslim humanitarian medical care was marked by organizations like the Aga Khan Foundation and the Islamic Association of North America in the 20th century. Secular medical humanitarian programs developed in the 19th century, notably with the creation of the International Committee of the Red Cross (1863) and the League of Nations Health Organization (1920) (which later became the World Health Organization [1946]). World War II catalyzed another proliferation of nongovernmental organizations, epitomized by the quintessential humanitarian health provider, Médecins Sans Frontières (1971). "Global health" as an academic endeavor encompassing education, service, and research began as an outgrowth of departments of tropical medicine and international health. The American College of Surgeons brought a surgical focus to global health beginning in the 1980s. Providing medical care in distant countries has a long tradition that parallels broad themes in history: faith, imperialism, humanitarianism, education, and service. Surgery as a focus of academic global health is a recent development that continues to gain traction.

History of the Pan African Paediatric Surgery Association (PAPSA).

The Pan African Paediatric Surgery Association (PAPSA) was formed in 1994. The need for an organisation in Africa to voice children's surgery and the trials and tribulations in forming this organisation was covered in this journal 2 years ago (Heinz R, Kyambi J, Lakhoo K. Surg Int 34(5):499-504, 2018). This article covers the history of the organisation post inception in 1994 to date. The near disbanding of the organisation due to political unrest and wars in Africa, to its success in the recent decade is highlighted in this manuscript.

Milestones in the History of Pediatric Surgery During the Byzantine Times

During the Byzantine Times, medicine and surgery developed as Greek physicians continued to practice in Constantinople. Healing methods were common for both adults and children, and pediatrics as a medical specialty did not exist. Already Byzantine hospitals became institutions to dispense medical services, rather than shelters for the homeless, which included doctors and nurses for those who suffered from the disease. A major improvement in the status of hospitals as medical centers took place in this period, and physicians were called archiatroi. Several sources prove that archiatroi were still functioning in the late sixth century and long afterward, but now as xenon doctors. Patients were averse to surgery due to the incidence of complications. The hagiographical literature repeated allusions to doctors. Concerns about children with a surgical disease often led parents to seek miraculous healings achieved by Christian Protectors - Saints. This paper is focused on three eminent Byzantine physicians and surgeons, Oribasius, Aetius of Amida, Paul of Aegina, who dealt with pediatric operations and influenced the European Medicine for centuries to come. We studied historical and theological sources in order to present a comprehensive picture of the curative techniques used for pediatric surgical diseases during the Byzantine Times.

Contributions of Avicenna to surgery and anesthesiology.

Background: Avicenna, as the Persian physician has had a great contribution to the field of medical sciences, especially surgery in 10th and 11th centuries AD.Methods: In the present paper, a few translated quoted words of Avicenna were shared about his surgical practice. Indexing databases of PubMed and Google Scholar were searched using the keywords like Avicenna, surgery, and anesthesiology to find related papers and documents.Results: The first portion comprises of some most commonly used simple and compound herbal preparations to produce general and local anesthetics before the surgery and as dental anesthetic agents. In the second portion, practices regarding surgical management for skull fractures, spinal trauma, bone fracture, cataract, incurable urinary retention, bladder calculi, hemorrhoids, cancer as well as endotracheal intubation and tracheostomy have also been incorporated. Finally, it ends up with practices regarding the use of natural products as postoperative dressing for traumatic and surgical wounds and after cataract surgery.Conclusion: Findings of this review study will provide a brief insight on Avicenna's Canon of Medicine to the sciences of anesthesiology and surgery based on the recent investigations.

Mexican surgery in 20th century.

It is a remembrance about the main surgeons who have made that surgery have reached levels of excellence in Mexico, which worked mainly during the 1st half of the 20th century, although some of them are out of this period, the surgical specialties in which they stood out, as well as in which institutions they worked, and some of the surgical techniques recommended by them. Some great doctors who were their students are mentioned.

Se hace un recuerdo de los principales cirujanos que han hecho que la cirugía en México haya alcanzado niveles de excelencia, que trabajaron principalmente en la primera mitad del siglo XX (aunque algunos de ellos se salgan de este periodo), las especialidades quirúrgicas en que destacaron, así como en qué instituciones trabajaron, y algunas de las técnicas quirúrgicas preconizadas por ellos. Se mencionan algunos grandes médicos que fueron sus alumnos.

Necessity is the mother of invention: William Stewart Halsted's addiction and its influence on the development of residency training in North America

Summary: William Stewart Halsted developed a novel residency training program at Johns Hopkins Hospital that, with some modifications, became the model for surgical and medical residency training in North America. While performing anesthesia research early in his career, Halsted became addicted to cocaine and morphine. This paper dissects how his innovative multi-tier residency program helped him hide his addiction while simultaneously providing outstanding patient care and academic training.

Taking a history: A roundtable discussion of APSA's past.

During the APSA 50th Anniversary Meeting, a panel of pediatric surgery legends and leaders captured our attention for a special session on the history of our organization. Learning from history is an important means of shaping the future. As APSA moves forward, we look to our past to understand how our organization and our specialty have emerged, evolved, and expanded. We had the privilege of hearing from Drs. Kathryn Anderson, Arnold Coran, Dick Ellis, Lucian Leape, and Alberto Peña, as well as other distinguished APSA members in the audience. They shared first-hand accounts of the origins of our organization, stories of adversity and growth, tales of caution, and words of advice. Their collective experiences from their remarkable careers in pediatric surgery offer invaluable insight into our mission of saving lifetimes.

Vignettes from the history of pediatric surgery.

A series of historical vignettes were shared with the membership of the American Pediatric Surgical Association (APSA) in the months leading up to its 50th anniversary meeting in May, 2019. Some stories were less-known episodes from the lives of such prominent figures as William Ladd and C. Everett Koop. Others highlighted were surgeons who made significant contributions but with time have been overlooked. Examples included Herbert Coe and Oswald Wyatt, the first surgeons to devote their practices entirely to infants and children; Helen Noblett, a pediatric surgeon in Melbourne who invented a now standard device perfectly suited to sample the rectal mucosa of infants suspected of having Hirschsprung Disease; and Barbara Barlow, who fed baby rats in her Manhattan apartment to show the protective effect of breast milk on the development of experimental necrotizing enterocolitis. Great achievements were commemorated, including Morio Kasai's operation for biliary atresia, Judah Folkman's discoveries, and Lester Martin's quest for a suitable operation for teenagers with ulcerative colitis. The golden anniversary of the founding of APSA made it appropriate to recount some of the backstories behind the effort to establish a board of pediatric surgery with certification authority and the organization of APSA itself. A few anecdotes were whimsical: the story behind the first central venous cannula; how the specialty came to be called pediatric surgery; and why Robert Gross' textbook was exactly 1,000 pages long and was published with one critical chapter missing. Taken together, the vignettes of the field's surgeons, both notable and lesser-known, and their achievements show the richness of the specialty's heritage.

CAPS at 50: Now comfortably seated with the grownups.

The Canadian Association of Pediatric Surgeons was established 50 years ago, with 30 founding members. Since then, the CAPS membership has grown nearly 10-fold and has developed a global presence with representation from 15 countries. CAPS has 8 pediatric surgery training programs which contribute not only to the North American workforce, but also to profoundly underserved low and middle income countries, particularly in Africa. On the occasion of our 50th Anniversary meeting, we celebrate our diversity and inclusivity as we reflect on our past, on the contributions of our Founding Members, the Women of CAPS, and others who have had a transformational impact on the practice of pediatric surgery. We look forward to our future, which while unknown, holds great promise for future generations of pediatric surgeons and the children and families in need of their care.

The Ochsner Legacy.

One of the iconic families in American surgery is the Ochsners. The youngest son of Swiss immigrants, Henry Ochsner (1877-1902) was the first to enter the medical profession. His promising internship at the Johns Hopkins Hospital ended when he died of cholera, a tragedy deeply felt by his mentor William Osler. On another branch of the family tree, Albert Ochsner (1858-1925) wrote authoritative textbooks on surgery and became president of the ACS and the American Surgical Association. His most significant achievement may have been his mentorship of his cousin's son Alton (1896-1981), guiding his medical education and training in surgery. The younger Ochsner succeeded Rudolph Matas as chair of surgery at Tulane University at the age of only 31 years. Under his leadership, Charity Hospital in New Orleans became a leading program for surgical training and Tulane earned a reputation for clinical excellence. Ochsner and four partners from the Tulane faculty created a multidisciplinary clinic to attract patients from a wider area, a facility that would become today's Ochsner Clinic. His son John (1927-2018) followed him in the profession and received specialty training in cardiovascular surgery under Michael DeBakey in Houston, a Tulane graduate and an Ochsner trainee. John Ochsner returned to the Ochsner Clinic to establish a major cardiothoracic and vascular surgery program. Further generations of the Ochsner family continued the family legacy in surgery and medicine, exemplified by M. Gage Ochsner (1954-2013), Alton's grandson and John's nephew, who became a leading traumatologist and surgical educator in Savannah.