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Classic pages in Obstetrics and Gynecology

1974; Elsevier BV; Volume: 120; Issue: 5 Linguagem: Inglês

10.1016/0002-9378(74)90616-4

1097-6868

Ureteral procedures and complications

As a surgical specialty, gynecology developed during the second half of the nineteenth century. To a great extent this resulted from several developments that followed closely on one another. These were the discovery of inhalation anesthesia, ovariotomy (oophorectomy) becoming a practical procedure (as well as surgery of the uterus, cervix, and vagina), and the advent of women's hospitals. As much as any other individual, James Marion Sims (1813-1883) pioneered in this transformation. Sims not only devised the first practical repair of vesicovaginal fistula but developed or cham pioned many other gynecologic procedures. He also invented or modified various instruments and worked to establish the first hospital devoted to the diseases of women in America. In this report Sims (1813-1883) presented his original description of his operation for the cure of vesicovaginal fistula. After repeated, fruitless attempts (about 40) to cure several wretched creatures who were victims of fistulas, Sims ultimately succeeded with the aid of sutures, the improved exposure provided by the knee-chest position, and a vaginal speculum now named for him. Sims' technique, here reported in 1852, initiated a new era in the history of gynecology, which offered hope to women suffering from this scourge. In Silver Sutures in Surgery (Sims, 1858), his 1857 anniversary discourse before the New York Academy of Medicine, Sims reviewed some of the trials and tribulations that led to his success in vesicovaginal fistula repair. He also presented his experience with sutures for other operative procedures. In addition, he recited some of the events leading to establishment of the Women's Hospital of New York, and he vigorously attacked his former colleague Nathan Bozeman (18251905), whom he held had wrongly claimed credit for his contributions. Not one to minimize his contributions, Sims declared that the use of silver as a suture is the greatest surgical achievement of the nineteenth century and that he would live to see the day when . . . the whole profession of the civilized world would accord his discovery that honor. In his original communication of 1852 Sims had not presented specific case reports; rather he had limited himself to describing his method. Thus it was not until this later publication that he gave the first, albeit brief, account of his original three successful cases, which were the result not of a mere accident, but of long, laborious and persevering e f fo r t . . , forming one of the most beautiful examples of inductive philosophy. Sims also enumerated modifications in his method since his original communication of 1852. These included everything from the suture itself, the speculum, needle, and catheter to the patient's position. As Sims noted, this surgical challenge ind e e d . . , has been the theme of my life for the last twelve years. Sims also described numerous other uses for