Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81

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History of Surgical Stapling (2)

Published: Thursday, April 30, 2015 07:00 | Written by: Efrain A. Miranda, Ph.D. | Hits: 11667

Before the invention of the first surgical staplers some inroads where towards the development of automated suture devices and clamps that allowed surgeons to manipulate the tissues to obtain proper suture placement. These devices, some of them based on the first sewing machines did not survive the test of time. 

The first true and successful surgical stapler was developed in 1908 by Dr. H?mer H?ltl (1868 – 1940) in Hungary. Although heavy and cumbersome, this stapler had some of the concepts that are found today in modern surgical staplers: “B" shaped staples, staggered rows of staples, and attention to the avoidance of leakage through the staple line. H?ltl’s stapler placed four staggered rows of wire staples. Today’s surgical staplers usually place two or three staggered rows of surgical titanium staples. History tells us that Dr. H?ltl sold only 50 of his instruments because of high price, difficulty in reloading, and most importantly, the reticence of surgeons to adapt to this new technology. 

In 1920 the H?ltl stapler was improved by Dr. Alad?r Petz (1888 – 1956), also Hungarian. The “Von Petz stapler” was lighter, easier to use, used silver staples, more affordable in price, and sold all over the world, allowing for surgeons to see this new technology in use. 

History of Surgical StaplingPioneers of Surgical Stapling
Unfortunately, the Von Petz stapler could only be used once in surgery, as it needed to be cleaned, reloaded, and sterilized before reusing it. 1934 Dr. H Friedrich of Ulm Germany invented the replaceable cartridge, so that a surgical stapler could be reused multiple times in one surgery. This opened the way for a “triangular” type end-to-end anastomosis that until this time could not be performed.  Also, Dr. Friedrich’s stapler had adjustable tissue compression.

Personal note: In 1987 I had the opportunity to scrub in one of the last uses of a Von Petz stapler in surgery (Chile, South America). This instrument was used to perform an “in toto” stapling and transection of the pulmonary hilum for a pneumonectomy. The instrument, after almost 40 years of its development, performed flawlessly. Dr. Miranda

Continued...

The history of surgical stapling [1] ; [2]; [3]; [Video]

Sources
1. "Surgical stapling" Mallina, R F   1962 Scientific American 207, 48
2. “Science of Stapling: Urban Legend and Fact” Pfiedler & Ethicon EndoSurgery
3. “Cholecystointestinal, gastrointestinal, enterintestinal anastomosis, and approximation without sutures” Murphy JB. Med Rec (1892) 42: 665
4. “Study of Tissue Compression Processes in Suturing Devices” Astafiev, G. (1967 (USSR Ministry of Health, Ed.)
5. “Rese?as Hist?ricas: John Benjamin Murphy” Parquet, R.A. Acta Gastroenterol Latinoam 2010;40:97
6. “The Science of Stapling and Leaks” Baker, R. S., & et al. (2004) Obesity Surgery, 14, 1290-1298.
7. “John Benjamin Murphy – Pioneer of gastrointestinal anastomosis”Bhattacharya, K., & Bhattacharya, N. (2008). Indian J. Surg., 70, 330-333.
8. “The Story of Surgery” Graham, H. (1939) New York: Doubleday, Doran & Co.. Inc.
9. “Compression Anastomosis: History and Clinical Considerations”Kaidar-Person, O, et al, e. (2008) Am J Surg, 818-826.
10. “Current Practice of Surgical Stapling”Ravitch, M. M., Steichen, F. M., & Welter, R. (1991) Philadelphia: Lea& Febiger.
11. “Aladar Petz (1888-1956) and his world-renowned invention: The gastric stapler” Olah, A. Dig Surg 2002: 19; 393-399
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