Louis Dominique le Roy and the first documented and successful crural fracture osteosynthesis, performed in Antwerp in 1796.

METHODS: In 1796 the Antwerp surgeon Louis Dominique Le Roy (1755-1826) performed an osteosynthesis for an open crural fracture, using cerclage of the tibia with a golden thread. The written report, the first ever of such osteosynthesis, is documented by the publication in Dutch, and translated here in English language. RESULTS: The osteosynthesis proved successful. The patient completely healed. CONCLUSION: This is the first successful osteosynthesis and thereby antedates by far the late nineteenth century cerclage operations of long bones.

An approach to the milestones of spine surgery in Persian traditional medicine.

BACKGROUND: The diagnosis and treatment of spine disorders have been challenging for thousands of years in different nations and medical schools. Despite this long history, there are many information gaps in this regard. The current research deals with the milestones and progress of spine surgery from ancient times until now, emphasizing the innovations of sages in the Persian traditional medicine era. METHODS: The present study is based on searching original and library documents, data from databases such as PubMed, Scopus, and Science Direct, and search engines such as Google Scholar. RESULTS: In Persian traditional medicine, Rhazes (865-925 AD) was the first sage who applied spine surgery based on the innovative knowledge of Galen (second century AD) and Paulus Aegineta (seventh century AD). Hally Abbas (tenth century AD), by suturing two separated bones during spine surgery, and Albucasis (936-1013 AD), by inventing, describing, and drawing the surgical instruments involved in surgeries in this area, and also using cauterization in the treatment of children's hunchback, were the innovators of new methods. CONCLUSION: The modern knowledge of spine surgery is based on intelligent experiences and prominent thoughts from thousands of years worldwide. However, sometimes, these key points have remained hidden. This issue necessitates investigating this science in different schools and territories for comparative studies, identifying the firsts in the prominent points of this field, preserving the identity of sages and nations, and preventing scientific plagiarism.

The historical course of varicose vein surgery in the Persian medicine.

INTRODUCTION: Dawali (varicose veins) is the disease of chronic dilation of veins. The veins of the legs become dilated and blue due to excessive accumulation of blood. This disease and the effort to identify and treat it has a very long history. The condition may have first been described in the Ebers Papyrus more than 3500 years ago. The present study deals with the turning points and progress of varicose vein surgery since ancient times, emphasizing the innovations of the scholars of the Islamic period. METHODS: The present study is based on searching library documents and database data such as PubMed, Scopus, Science Direct, and search engines such as Google Scholar. In the end, the Prisma flow chart was drawn. RESULTS: Besides diagnosing different varicose veins (legs, thighs, abdomen, uterus, and testes), the scholars of the Islamic period were well-versed in their prevention, etiology, and treatment. In treating varicose veins, these physicians used methods such as cleansing, phlebotomy, compression, leech therapy, and surgery, and some of them were the founders of new treatments. CONCLUSION: The surgical treatment of varicose veins in the past was similar to modern surgical therapies. What distinguishes yesterday's varicose vein surgery from today's surgery is a more advanced tool. There is no denying the remarkable progress in using health principles, treatment techniques, and surgical instruments to facilitate surgery and reduce the disease's complications and recurrence. However, the treatment framework and foundation, such as phlebectomy and compression, were all invented and introduced in the distant past.

Cauterization's history in the Persian medicine school.

BACKGROUND: Cauterization has been used in various medical schools to prevent and treat diseases. Its application dates back to shortly after the invention of fire. Despite its long history, different aspects and the importance of cauterization in various medical schools have remained elusive. The present study addressed the milestones and progress of cauterization from ancient times to the present, emphasizing the innovations of the Persian medicine school. METHODS: The present study is based on searching in the library documents of famous Persian medicine scholars and data from databases such as Ovid, PubMed, Science Direct, Scopus, ProQuest, and Google Scholar search engines. RESULTS: Persian Medicine scholars used various cauterization methods such as hot metals and corrosive drugs to stop bleeding, prevent the development and spread of infection, and treat hydrocephalus and rabies. Cauterization has been associated with considerations to prevent irreversible tissue damage and whether or not it is internal or external. CONCLUSION: Cauterization has been associated with different practical purposes. With evolutionary progress and the use of different techniques and tools throughout history, the tools such as Electrocautery or Galvanocautery are some manifestations of new applications of cauterization. Numerous studies have indicated the continuation of newer applications, indicating the inexhaustible human interest in this ancient technique.

Abu Al Qasim Al Zahrawi (Albucasis) and types of his used surgical knives.

BACKGROUND: Surgical incisions require surgical knives. Different surgical knives have been used for surgical practice since its first appearance in surgical science, and evolved according to its progress. Albucasis, Spanish physician (936-1013 AD), is one of the surgical science pioneers whose initiatives in therapeutic and surgical methods are appreciable, as are his surgical instruments including numerous surgical knives. This study aims at thoroughly investigating the appearance, specifications, innovations, and applications of knives in specific surgical techniques. METHODS: Volume 30 of the Al-Tasrif li-man ajaza'an al-ta'lif (Al-Tasrif) of Albucasis was complemented with findings in Google Scholar, Ovid, PubMed, Science Direct, and Scopus databases to assess the types of surgical knives used by Albucasis and individualized for different diseases. RESULTS: The majority of the knives in Al-Tasrif have special names such as Mesbar, Maghdah, and Meshel. He chose a special knife dependent on the type of surgery and the incision needed, and adapted the shape of each knife to its use. CONCLUSIONS: Albucasis, more than previous physicians, such as Paulus Aegineta (625-690 AD), has invented surgical knives on basis of his own experiences and observations. His accurate knowledge of surgical techniques has resulted in appropriate designing and making functional knives.

The influence of Arabic medicine on surgery in the Low Countries1.

The influence of Arab Medicine on Western science has recently been challenged. Using the example of two Flemish surgeons, Jan Yperman in the early 14th and Thomas Fijens in the late 16th century, this article argues that Arab physicians and surgeons have imposed a long lasting influence on the surgical practitioners in the Low Countries.

The relationship between Vesalius and the Borgarucci family.

Two of the four brothers Borgarucci were medical doctors and in one way or another, be it distantly, connected with the great master Vesalius. Giulio Borgarucci was a physician, who became a Calvinist and emigrated to England where he treated many noblemen and friends of Queen Elisabeth I. He was present at a conversation between the Italian writer and traveler Pietro Bizzari and the Venetian jeweler who witnessed Vesalius' death in Zakynthos. Prospero Borgarucci became professor of anatomy and surgery in Padua, some 20 years after Vesalius. He published several treatises on anatomy, pestilential disease, and materia medica. Prospero Borgarucci became physician to Queen Catherine de Medicis in France, and to Archduke Karl II of Habsburg in Graz. His most important work is the so-called Chirurgia Magna of Vesalius. Text and illustrations of this spurious Vesalian work point to the use of passages of the Epitome, surgical college notes and copied Vesalian images in Borgarucci's Chirurgia Magna.

The Influence of Vesalius' Fabrica on Surgery in the 16th & 17th century.

The innovation in anatomy, brought about by Andreas Vesalius1, particularly by means of his Fabrica, has had an important influence on the practice of surgery2. Various surgeons of the 16th and the 17th century have implemented different approaches in operative techniques, based on the anatomical knowledge drawn upon the Fabrica. Examples are given in this paper concerning Pierre Franco, Ambroise Paré, Giovanni Andrea della Croce, Girolamo Fabrici d'Acquapendente, Wilhelm Fabry von Hilden and Paul Barbette, who all, in one way or another, have proposed surgical techniques that required precise anatomical understanding, which was provided by the new Vesalian anatomy of the human body. The concept, adopted by many medico-historical scholars, that the anatomy of Vesalius had only limited repercussions on Modern Surgery, therefore needs reconsideration.

The art of human anatomy: Renaissance to 21st century.

This session examines the relationship between the art and science of anatomy from the time of Vesalius to the present with particular emphasis on the role of the medical artist and the changing nature of anatomical illustration over the last five centuries. Pivotal changes in the art of anatomy will be examined including the evolution of media and brain imaging from Golgi to Geschwind.

Biliopancreatic diversion in the surgical treatment of morbid obesity.

Biliopancreatic diversion is a malabsorptive technique of bariatric surgery that has gained wide acceptance in the Western world. It is performed in one of two ways: In its classic form it consists of partial gastrectomy with a Roux-en-Y gastroenterostomy; in its duodenal switch form a vertical sleeve gastrectomy is combined with a duodenoenterostomy. Both techniques realize diversion of biliopancreatic juice, thereby creating a mild form of malabsorption. Weight loss has been approximately 70% of initial excess weight, exceeding that obtained with most other bariatric procedures. Iron, calcium, and vitamin deficiencies may occur, especially with classic biliopancreatic diversion, and must be prevented with adequate supplements during vigorous follow-up. Weight loss is followed by a substantial reduction in the co-morbidities that are present in many morbidly obese patients. Biliopancreatic diversion should be included in each obesity clinic program and be proposed for morbidly obese patients who are having difficulty with the prospect of continuous restraint of food intake or problems due to failed gastric restrictive interventions. The postoperative results in such patients have been good and have substantially improved quality of life and self-esteem in this category of morbidly obese patients.

Contraceptive treatment after biliopancreatic diversion needs consensus.

BACKGROUND: An important population of patients who undergo biliopancreatic diversion (BPD) are fertile women. A consensus is needed with regard to contraceptive therapy after BPD by evaluating the risks of pregnancy, the safety of oral contraception and the changes in fertility after this bariatric surgery. METHOD: From May 1997 until May 1998, 40 women who underwent a BPD were included in a prospective study evaluating the hormone status preoperatively and postoperatively after 2 and 7 days, 3 and 6 months and 1 year. An extensive questionnaire, with regard to fertility and obstetric history, was sent at least 2 years after inclusion. A literature search was performed to understand the complex physiology of hormone changes after excess weight loss, as well as absorption and metabolism of oral contraceptives. RESULTS: Our laboratory results are consistent with hormone changes found in the literature, which show that rising levels of serum sex-hormone-binding globulin, follicle stimulating hormone and luteinizing hormone and decreasing levels of testosterone and dehydroepiandrosterone sulphate result in an improved fertility status, regulated through complex interactions, in particular with the gonatotropin-releasing-hormone pulse generator. The questionnaire shows the use of different types of contraception. From the 9 patients who only used oral contraception, 2 patients developed an unforeseen pregnancy after BPD. Although miscarriages and neonatal complications were seen in other patients in our hospital, none of these problems were seen in our study. CONCLUSION: Pregnancy should be avoided for 12 to 18 months after BPD. Fertility increases after BPD. As oral contraception is most popular and less reliable, we strongly believe that large multi-centre, prospective, randomized studies are necessary to come to a consensus about the use of contraceptive therapy after BPD.

A technique for prevention of port complications after laparoscopic adjustable silicone gastric banding.

BACKGROUND: Laparoscopic adjustable gastric banding is a safe and effective treatment method for morbid obesity. Injection port dislocation, tube perforation and access port infection are generally classified among the minor complications, although they can require a reoperation at the port-site or even at the level of the band which may have to be removed. We designed a technique to fix the port, that can avoid unnecessary complications. METHODS: The port is sutured onto a polyprophlene mesh, which is then cut into shape and attached to the rectus fascia in the left hypochondrium with a Tacker stapling device. From February 2000 to January 2001, 25 patients (BMI 35-60) were operated using this technique. RESULTS: No injection port dislocation, tube perforation or access port infection has been found in these patients. CONCLUSION: With the larger surface area by which the port is attached to the fascia, a stable position of the port is obtained and dislocation avoided. Multiple failed attempts at port access, with resulting risk of infection, are avoided. Due to port stability, risk of incidental tube perforation is reduced. Moreover, a considerable gain of time is obtained compared with the classical suturing of the port.