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HISTORY OF ENDOUROLOGY

HISTORY OF ENDOUROLOGY. P. Venugopal. Leonardo di ser Piero da Vinci (1452 – 1519). Drawings of the Urinary System. ‘The noblest pleasure is the joy of understanding’ ‘Blinding ignorance does mislead us. Oh! Wretched mortals open your eyes’.

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HISTORY OF ENDOUROLOGY

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  1. HISTORY OF ENDOUROLOGY P. Venugopal

  2. Leonardo di ser Piero da Vinci (1452 – 1519) Drawings of the Urinary System ‘The noblest pleasure is the joy of understanding’ ‘Blinding ignorance does mislead us. Oh! Wretched mortals open your eyes’ ‘Leonardo da Vinci was like a man who awoke too early in the darkness, while the others were all still asleep’ Sigmund Freud

  3. Sushruta Statue at Haridwar SushrutaSamhita The work is attributed to Sushruta, historical surgeon of 6th century BC, although the Text as preserved dates to 3rd or 4th BC He is hailed as father of ‘Modern Surgery’ Among the innumerable varieties of surgeries he has performed (some even performed today), there is a mention in SushrutaSamhita that heknewCatheterisation, Urethral dilatation and there is mention of his performing Removal of Prostate glandbut his technique has not been described

  4. Urinary Catheters are the precursors of Urology Endoscopes developed many centuries later. People suffered from Retention of Urine since the evolution of Mankind on planet Earth. The word “catheter” comes from Greek, meaning “to let or send down.” Catheters were used as early as 3,000 B.C. to relieve painful urinary retention. Many materials were used to form a hollow catheter shape, including straw, rolled up palm leaves, hollow tops of onions, as well as, gold, silver, copper, brass, and lead.

  5. Roman Catheter first Century AD Silver Catheter from early days to day Metal Catheters Used by Dr. TMA Pai

  6. Benjamin Franklin is credited with making a flexible hinged metal catheter to relieve retention of his brother who had to be catheterised everyday to relieve his retention. Later when he developed retention he used it on himself He has been labeled as the inventor of modern catheters

  7. Pezzer self-retaining catheter Nelaton catheter Mercier catheter Tiemann catheter Couvelaire catheter Dufour catheter

  8. Hippocrates 460 BC to 377 BC is widely considered to be the ‘Father of Medicine’ ‘I will not use the knife, not even on sufferers from stone, but will withdraw in favour of such men as are engaged in this work’

  9. During the time of antiquity and medieval times Men were afflicted with retention of urine for which daily catheterisation could be effected. But Bladder calculi were the problem faced by many which needed removal as stated by even Hippocrates. History of Urological endoscopy cannot be complete unless we know something regarding removal of bladder stones. Dating from 30 AD, CELSUS Performed Perineal Lithotomy and was a prevalent surgery till the middle of 19th century when newer modalities of that time took shape. Urological Endoscopy developed due to the need to help these sufferers. The Famous LITHOTOMYPosition we use even now emanated from procedures aimed at removal of Bladder Calculi

  10. Probably the first documented Bladder stone in Egyptian Mummy 6000 BC

  11. James Polk (1795 to 1849), 11th President USA. He was behest with many health problems including Bladder Calculi. He had Perineal Lithotomy in 1812. The German Emperor Heinrich II was cut for a stone by a Benedictine Monk in 1022 at Monte casino Monastery

  12. Jean Civiale(1792–1867) His famous Trilabe was developed in 1818 Though many Lithotripists were famous having performed 1000’s of the procedure in their own different ways, the first successful instrument was developed by Jean Civiale. He had a Hospital exclusively for lithotripsy in Paris.

  13. With many failures of perineal lithotomy and recurrences which were common, attempts started for crushing the stones transurethrally and Transurethral Lithotripsy came into existence. Initially these Lithotrites were blindly introduced to crush the stones by percussing for stones

  14. Heurteloup Percussion Lithotrite 1860 Bigilow’s Lithotrite 1877 Civiele Lithotripsy 1860 Sir Henry Thompson Lithotrite

  15. Evacuatorswere introduced initially for removal of crushed calculi and later they were needed for removal of TUR Chips Bigelow introduced his evacuator in mid 1800’s to evacuate crushed bladder stones. He is also credited with inviting Morton to demonstrate use of Ether for non dental use. This was demonstrated by using Ether for removal of a tumour from the neck in 1846.

  16. Ellik Evacuator 1937 Freyer Evacuator 1880 Toomey Syringe

  17. Philipp’ Filliform and followers Clutton’s sound (1850 – 1909) Maisonneuve Urethrotome Otis threaded on Filliform Otis Urethrotome (1825 – 1900)

  18. Man’s curiosity knows no bounds. This was true even in the past. In antiquity and middle ages normal orifices were studied with great interest for evaluating disorders. Development of Urological endoscopes did not start for males but they were initially designed for females. Miniaturized versions were developed to accommodate urethra and thus started urological endoscopy in males. In 1710 by Conradi of Nuremberg spoke and published regarding some form of optics and this became the beacon for further developments in this area.

  19. The first endoscopic ideologist was Philipp Bozzini (1773 to 1809) He was contemplating on viewing the interior of abdomen had he lived longer Desormeaux endoscope around 1850 Philipp Bozzini'sLichtleiter 1807 Wales urethroscope 1860

  20. Karl Powlik 1894 Air Cystoscopy Air Cystoscopy – 19th century Technique in 21st Century Satoshi Hori, CJ Shukla and Colin Kennedy, 2008, ARCS Department of Urology, West Suffolk Hospital, Bury St. Edmunds, Suffolk, UK Howard Kelly 1898

  21. Braach in 1904 revolutionized Direct vision Cystoscopy. He not only refined catheterizable channel but also developed a light carrier to make internal illumination possible if needed. He developed a glass protector to prevent flow of irrigant outwards

  22. In 1879, Max Nitze First conceived the idea of Introducing the source of Illumination down to the bottom of the tube The lamp consisted of an Incandescent Platinum wire Nitze Original Urethroscope Oberleander Urethroscope

  23. Thomas Alva Edison (1847 – 1931)Invented his electric bulb and patented it on November 4, 1879

  24. Edison revolutionized Illumination needed for Endoscopy. Nitze charged ahead and made many models suitable for Diagnostic and Operating purposes. He made many models between 1891 to 1894

  25. Sir Eric Riches Cystoscopes Ringleb Cystoscope

  26. In 1899, F Tilden Brown introduced a catheterizable scope on which Leo Buerger expanded on this idea of passing different instruments down the same outer sheath and the Brown-Buerger Cystoscope, introduced in 1907, became a standard instrument for years. Leo Buerger 1879 – 1943 Brown-Buerger Cystoscope

  27. Single Channel Joachim Albarran (1860 – 1912) Invented 1897 Double Channel

  28. Illumination of Cystoscope Reinhold Wappler 1870 – 1932 Wappler Unit Bulb Housing

  29. Bottini is credited with the first bladder neck burning using Galvano-cautery in 1874. Incision of Bladder neck was yet another method Practiced Concealed knives of Civiale and Mercier Guthrie’s concealed knife

  30. Earlier instruments used for Prostate Resection

  31. Tolypenkneipe" by Joseph Grunfeld (1885) Hugh Hampton Young’s Punch Gershom Thomson’s combination diathermy and punch Dissembled

  32. In 1926 Stern of New York constructed the a resectoscope, although its design and function werecumbersome. Only when McCarthy also ofNew York added a lever in 1931 to move the cutting loop didthis instrument become suitable for routine and easy use. Maxmillian Stern 1878 – 1946 Joseph Francis McCarthy 1874 – 1965

  33. The Stern-McCarthy resectoscope Nesbit Resectoscope (Modified)

  34. It is difficult to credit one individual with the pioneering of the laparoscopic approach. In 1902 Georg Kelling, of Dresden, Saxony, performed the first laparoscopic procedure in dogs and in 1910 Hans Christian Jacobaeus of Sweden reported the first laparoscopic operation in humans. Georg Kelling 1902 and his apparatus

  35. Electrohydraulic Lithotripsy concept was first described byGeorge Robinson of Newcastle upon Tyne in1855. Though the work was experimental, he was able to fragment calculi. Wappler reported in 1913 that when this spark is brought in contact with both hard and soft stones, it causes them to disintegrate EHL was Rediscovered by Victor Goldberg of Riva, USSR in 1959

  36. The first Prototype was developed in 1970

  37. First Robot Designed in 1495 by da Vinci Based on Anatomical Knowledge

  38. Summary of some Historical Events

  39. ThanQ

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