Wiliam and John Hunter …
Scottish brothers … born in 1718 and 1728; William was a dedicated educated person .. John never enjoyed books but was fund of natural observations … William established anatomy school .. John joined in … and under William’s guidance, john became a professional anatomist and teacher …
John Hunter is well known for popliteal aneurysm repair. Potts noticed by that time that no matter how judiciously performed, proximal and distal ligation of aneurysm would not save the patient’s life. However, John realised that ligating very distally might be able to preserve the collaterals; hence his famous operation, published in London Medical Journal 1786. he decided to approach medially (not posteriorly). He did at St George’s Hospital.
Hunter’s pupils were numerous, including Astley Cooper.
However, his curiosity lead him to inoculate his own penis with a specimen taken from a patient suffering from urethritis. Years later, he developed syphilis and a syphilitic ascending aortic aneurysm.
He then was informed about the appointment of a predecessor in St George’s hospital; he suffered a major angina which proved fatal.
first vein graft –
Alfred Exner from Austria (used canine external jugular vein) then Alexis Carrel from France (University of Lyon). They published their revolutionary idea of using vein as a bypass in 1906 (Surgery, Gyn, and Obst).
Carrel designed the technique, that is still in use now:
A rigid asepsis is absolutely essential for success. . . . The dissection of the vessel is not dangerous if the wall of the vessel is not crushed or roughly handled with metallic forceps of other hard instruments . . . it is necessary that these clamps [vascular] be smooth-jawed and not too strong in the spring . . . by using very sharp, rough needles, only extremely small wounds are made . . . great care is taken not to include fragments of the connective tissue layer in the line of suturing, and to obtain a smooth union and approximation of the endothelial coats.
First clinical anastomosis, however, is sone/published by Jose Guyanese from Madrid. He used an adjacent popliteal vein piece to repair a popliteal aneurysm.
to be continued …
Scottish brothers … born in 1718 and 1728; William was a dedicated educated person .. John never enjoyed books but was fund of natural observations … William established anatomy school .. John joined in … and under William’s guidance, john became a professional anatomist and teacher …
John Hunter is well known for popliteal aneurysm repair. Potts noticed by that time that no matter how judiciously performed, proximal and distal ligation of aneurysm would not save the patient’s life. However, John realised that ligating very distally might be able to preserve the collaterals; hence his famous operation, published in London Medical Journal 1786. he decided to approach medially (not posteriorly). He did at St George’s Hospital.
Hunter’s pupils were numerous, including Astley Cooper.
However, his curiosity lead him to inoculate his own penis with a specimen taken from a patient suffering from urethritis. Years later, he developed syphilis and a syphilitic ascending aortic aneurysm.
He then was informed about the appointment of a predecessor in St George’s hospital; he suffered a major angina which proved fatal.
first vein graft –
Alfred Exner from Austria (used canine external jugular vein) then Alexis Carrel from France (University of Lyon). They published their revolutionary idea of using vein as a bypass in 1906 (Surgery, Gyn, and Obst).
Carrel designed the technique, that is still in use now:
A rigid asepsis is absolutely essential for success. . . . The dissection of the vessel is not dangerous if the wall of the vessel is not crushed or roughly handled with metallic forceps of other hard instruments . . . it is necessary that these clamps [vascular] be smooth-jawed and not too strong in the spring . . . by using very sharp, rough needles, only extremely small wounds are made . . . great care is taken not to include fragments of the connective tissue layer in the line of suturing, and to obtain a smooth union and approximation of the endothelial coats.
First clinical anastomosis, however, is sone/published by Jose Guyanese from Madrid. He used an adjacent popliteal vein piece to repair a popliteal aneurysm.
to be continued …