Heineke, Mikulicz, Jaboulay, and Finney: Innovators of Surgical Pyloroplasty.

This historical retrospective explores the history of the gastric pyloroplasty through the lives of the 4 surgeons whose eponymous procedures have defined the operative management of pyloric strictures: Heineke, Mikulicz, Jaboulay, and Finney. Today's gastrointestinal surgeons employ a combination of techniques that highlight the rich and colorful history of their field.

The history of surgery for esophageal atresia.

Until the successful repair of esophageal atresia (EA) and distal tracheoesophageal fistula (TEF) in 1941 by Cameron Haight of Ann Arbor, MI, every infant operated upon for this anomaly died within days and often hours of surgery. A key step was the posterior extrapleural approach to the mediastinum pioneered by Charles Mixter of Boston in 1929 that gave direct exposure of the anomaly without entering the pleural cavity and collapsing the lung. From 1936 to 1939 Thomas Lanman, also of Boston, made five unsuccessful attempts at primary repair of EA. His experience established the basic principles of early radiological diagnosis and prompt surgical intervention to minimize the risks of aspiration pneumonia, dehydration, and inanition. In 1939 N. Logan Leven of Minneapolis and William Ladd of Boston independently had the first long-term survivors of EA with a series of operations to construct skin-lined tubes on the anterior chest wall that connected an esophagostomy to a gastrostomy. Haight first tried primary repair in 1939, finally succeeding in his fourth case in March 1941. In their publications Lanman (1940), Haight (1943 and 1944), and Ladd (1944 and 1947) presented case-by-case chronologies. The evolution of surgical management thus can be traced from a fatal condition to one where survival became the expected outcome. History recognizes Haight for his work with EA, not only for its first successful primary repair, but also his lifelong dedication to its surgical management.

Jules Pean (1830-1898)-A Pioneer Surgeon: His Achievements and His Total Shoulder Arthroplasty.

The purpose of this study is to summarize the life and work of the French surgeon Jules Pean (1830-1898). Pean made an impact in the history of surgery through his work and especially with his innovative surgical techniques in abdominal surgery and in orthopedics as well as with the invention of numerous surgical instruments. He also made an impact with his pioneering total shoulder arthroplasty.

Lesiones quísticas pancreáticas. Origen y evolución histórica / Cystic pancreatic lesions. Origin and historical evolution

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[A decade's review for the foundation, establishment and development of the Department of Minimally Invasive Gastrointestinal Surgery in Peking University Cancer Hospital].

Department of minimally invasive gastrointestinal surgery in Peking University Cancer Hospital (also named as Department of Gastrointestinal Surgery IV) was established on April 7, 2009. Up to now, ten years have passed since its foundation. As the first department built in specialized cancer hospital, which mainly focuses on laparoscopic surgery, its foundation and development has a very important historical and practical significance in the development of surgical oncology in China. Reviewing the rapid growth of the Department of Minimally Invasive Gastrointestinal Surgery over the past decade, on the one hand, it has benefited from the opportunities of the times and the support of leaders in Peking University Cancer Hospital at that time. More importantly, the progress owes to the pioneering Professor Su Xiangqian, who is brave and innovative, with indomitable spirit and advanced management philosophy. With rigorous training, the ability of the team has been steadily enhanced, the competitiveness has been gradually improved, and the development direction which focuses on laparoscopic gastric cancer surgery and laparoscopic colorectal cancer surgery has been established. Now, the Department of Minimally Invasive Gastrointestinal Surgery has become a well-known domestic gastrointestinal tumor center. In the past ten years, under the leadership of Professor Su Xiangqian, the growth of this team is innovative and comprehensive: (1) Introduce the internationally advanced Baldrige medical service management framework, and propose the "management by principle" concept to improve the core competitiveness of the department; (2) Establish an academic brand by laparoscopic standardized surgery training courses for gastrointestinal tumors, promote cooperation and exchange at home and abroad, and participate in international multi-center clinical research projects; (3) Adhere to the "formation of a research-oriented department, conducting clinical and basic research simultaneously" as the development direction; (4) Stick to the core development concept of team building and cultivate professional talents. Looking forward to the future, our team will not forget the beginning of the heart, and move forward! In the next ten years, we will break through ourselves and continue to pursue the higher level!

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.

Endoscopic foregut surgery and interventions: The future is now. The state-of-the-art and my personal journey.

In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic, the content will progress as follows: "lessons learned", "technical considerations" and "future opportunities". Lessons learned will provide a brief background and update on the most current literature. Technical considerations will include my personal experience, including tips and tricks that I have learned over the years. Finally, future opportunities will address current unmet needs and potential new areas of development. The foregut is defined as "the upper part of the embryonic alimentary canal from which the pharynx, esophagus, lung, stomach, liver, pancreas, and part of the duodenum develop". Foregut surgery is well established in treating conditions such as gastroesophageal reflux disease (GERD), achalasia, esophageal diverticula, Barrett's esophagus (BE) and esophageal cancer, stomach cancer, gastric-outlet obstruction, and obesity. Over the past decade, remarkable progress in interventional endoscopy has culminated in the conceptualization and practice of endoscopic foregut surgery for various clinical conditions summarized in this paper. Regarding GERD, there are now several technologies available to effectively treat it and potentially eliminate symptoms, and the need for long-term treatment with proton pump inhibitors. For the first time, fundoplication can be performed without the need for open or laparoscopic surgery. Long-term data going out 5-10 years are now emerging showing extended durability. In respect to achalasia, per-oral endoscopic myotomy (POEM) which was developed in Japan, has become an alternative to the traditional Heller's myotomy. Recent meta-analysis show that POEM may have better results than Heller, but the issue of post-POEM GERD still needs to be addressed. There is now a resurgence of endoscopic treatment of Zenker's diverticula with improved technique (Z-POEM) and equipment; thus, patients are choosing flexible endoscopic treatment as opposed to open or rigid endoscopy options. In regard to BE, endoscopic submucosal dissection (ESD) which is well established in Asia, is now becoming more mainstream in the West for the treatment of BE with high grade dysplasia, as well as early esophageal cancer. In combination with all the ablation technologies (radiofrequency ablation, cryotherapy, hybrid argon plasma coagulation), the entire spectrum of Barrett's and related dysplasia and early cancer can be managed predominantly by endoscopy. Importantly, in regard to early gastric cancer and submucosal tumors (SMTs) of the stomach, ESD and full thickness resection (FTR) can excise these lesions en-bloc and endoscopic suturing is now used to close large defects and perforations. For treatment of patients with malignant gastric outlet obstruction (GOO), endoscopic gastro-jejunostomy is now showing better results than enteral stenting. G-POEM is also emerging as a treatment option for patients with gastroparesis. Obesity has become an epidemic in many western countries and is becoming also prevalent in Asia. Endoscopic sleeve gastroplasty (ESG) is now becoming an established treatment option, especially for obese patients with body mass index between 30 and 35. Data show an average weight loss of 16 kg after ESG with long-term data confirming sustainability. Finally, in respect to endo-hepatology, there are many new endoscopic interventions that have been developed for patients with liver disease. Endoscopic ultrasound (EUS)-guided liver biopsy and EUS-guided portal pressure measurement are exciting new frontiers for the endo-hepatologists.

Retracing our STEPs: Four decades of progress in intestinal lengthening procedures for short bowel syndrome.

The surgical management of intestinal failure secondary to short bowel syndrome has undergone tremendous evolution in the last several decades. From the landmark description of an intestinal lengthening procedure by Bianchi in 1980 to the multidisciplinary modern care paradigm known as intestinal rehabilitation, innovative new treatments in this field have vastly improved patient outcomes. Initial attempts to treat short bowel syndrome surgically saw the birth of reversed intestinal segments, artificial valves and colonic transposition, all aimed at decreasing transit time and thus increasing absorption. In the long term, a common pitfall of these approaches, and intestinal adaptation itself, is bowel dilation and the associated poor motility, dysfunction and propensity for bacterial overgrowth. The development of techniques to mitigate these unfavorable conditions was a prelude to the birth of modern day operations aimed at increasing bowel length and improving function. This review examines the relevant historical approaches to short bowel syndrome and how they provided the foundation for the development of current intestinal lengthening surgery, followed by an in-depth discussion of surgical techniques and their outcomes.

The evolution of pelvic dissection for rectal cancer from blunt dissection to total mesorectal excision.

"Modern" rectal cancer treatment began in the 18th century. However, initial results of the pioneer surgeons were very poor. During the next several decades, significant progress was made towards the cure of rectal cancer. Improvements have included lowering mortality, reducing recurrence, and optimizing functional outcomes. This article reviews the individuals and their advancements in rectal cancer treatment. It describes the changes in the surgical approach for tumor resection, the study of the lymphatic spread of rectal cancer and the advances in sphincter preservation procedures from the era of blunt dissection until the paradigm changing revolution of total mesorectal excision.