On the 180th anniversary of Emil Theodor Kocher, a Swiss thyroid surgeon

August 25, 2021 marks the 180th anniversary of the birth of the renowned physician Emil Theodor Kocher. He was a man whose talent has manifested itself in various fields of medicine. Nowadays it is impossible to imagine a doctor who does not know the name of Kocher, because he is the author of many surgical methods and techniques that are still valid, despite advances in modern medicine. Furthermore, some of the instruments designed by Kocher are still used in surgery. In addition to the biography of Kocher, this article considers information about his work in the field of thyroidology, for which he received the Nobel Prize in 1909. Kocher has performed more than 5,000 thyroidectomies during his career. Thanks to the technique he developed, the mortality rate of that surgery decreased at least fortyfold. In those days there were not researches on functions of the thyroid gland, but Kocher noticed that total thyroidectomy leads to serious consequences. Therefore he refused to do such surgeries without invariable indications.

TIROIDECTOMÍA TRANS-ORAL ENDOSCOPICA CON ABORDAJE VESTIBULAR (TOETVA) VERSUS TIROIDECTOMÍA ENDOSCÓPICA: COMPLICACIONES POSTQUIRURGICAS.

Introduction: thyroid gland surgical excision has been performed since the 19th century, which was first employed by Theodor Kocher, this technique since its inception presented certain post-surgical complications and left an aesthetically uncomfortable scar in patients; however a few years ago new techniques have been carried out under laparoscopic approaches which leave less scarring; under this same concept, in 2016 the TOETVA technique (Endoscopic trans-oral thyroidectomy with vestibular approach) is presented, with which fewer postoperative complications have been evidenced. Objective: To identify post-surgical complications, surgical and hospitalization time between TOETVA versus endoscopic techniques. Materials and Methods: a retrospective study of two surgical interventions was carried out, which included patient’s surgery by Endoscopic Trans-oral Thyroidectomy and patient’s surgery by other endoscopic techniques at Hospital General IESS Ibarra in the period between January 2017 - March 2019. Thirty-three patients met the inclusion criteria, 19 patients were tested for Endoscopic Trans-oral Thyroidectomy with TOETVA vestibular approach, and 14 with cervical endoscopic thyroidectomy. Descriptive and inferential statistical analysis was performed using SPSS software. Version 19. Results: the entire studied population was female, with 45.3 years old in average, 42.42% resided in Ibarra, while 15.5% were from Otavalo, these two populations were the most representative. Regarding to the issue, 68.4% patient’s surgery by TOETVA technique and 71.42% % patient’s surgery by cervical endoscopic thyroidectomy technique did not present complications. The surgical time in which it was reported that Endoscopic Trans-oral Thyroidectomy with vestibular approach was also studied, TOETVA had a mean of 129.84 minutes, while the cervical endoscopic had a mean of 131.07 minutes. The hospital stay was shorter for cervical endoscopic thyroidectomy due to complications presented with TOETVA with a mean of 6.32 and 4.14 days respectively. Conclusions: trans-oral Endoscopic Thyroidectomy with vestibular approach (TOETVA) is a technique that is in the process of implementation and learning in Ecuador and that as a result of the present investigation it could be concluded that there are no significant differences regarding post-surgical complications between the techniques studied.

First person – Mariana Castro Dias

ABSTRACT First Person is a series of interviews with the first authors of a selection of papers published in Journal of Cell Science, helping early-career researchers promote themselves alongside their papers. Mariana Castro Dias is first author on ‘Brain endothelial tricellular junctions as novel sites for T cell diapedesis across the blood–brain barrier’, published in JCS. Mariana conducted the research described in this article while a PhD student in Britta Engelhardt's lab at the Theodor Kocher Institute, University of Bern, Switzerland. She is now an Associate Scientific Communications Manager working for Roche Diagnostics International. She is utterly fascinated by the brain, particularly the molecular mechanisms underlying the pathology of neurodegenerative disorders.

Tribute to Theodor Kocher: Far Beyond an Anatomical Reference

We know Kocher's name as an anatomical reference in neurosurgery. In fact, Theodor Kocher was a Swiss general surgeon, and his contributions were such that Kocher was honored in 1909 with the Nobel Prize in Medicine and Physiology, and he was the first surgeon to receive this honor. Kocher participated in the initial scientific phase of medicine, living with names that are in history, as well as him; Langenbeck and Virchow, Lucke, Billroth, Horsley, Lister, Halstedt, Pasteur, Osler, Lawson Tait, Verneuil, and a long list and other icons of the time. The present account rescues the many important facets and contributions of the Swiss surgeon Theodor Kocher, and his relationship with several of them. Kocher's memory, surgical instruments and literary production are preserved in a small wing of the University of Bern. The present article highlights how intense Kocher's dedication to the medical field was.

Professor Theodor Kocher (1841–1917) – one of the founders of european scientific surgery (on the 100th anniversary of death)

The main milestones in the life and work of T. Kocher are presented. Illuminated little-known interesting facts from the life of a professor. T. Kocher studied the problems of asepsis and antisepsis, abdominal surgery, thyroid surgery, traumatology. He deepened his teaching of the antisepsis and asepsis, introduced the concept of Implant Infection. It is noted that Kocher has developed sterilization methods suture material. He suggested operative access to the liver and biliary tracts, an original method of gastrectomy, methods for mobilizing the duodenum, surgical treatment of inguinal hernias, which are now described in textbooks. He also developed gentle surgical approaches for the procedure on large joints (hook-shaped incisions). The reduction of shoulder dislocations according to Kocher became a part of the daily practice of surgeons and traumatologists. T. Kocher's research on the problems of diseases of the thyroid gland is world famous. T. Kocher was awarded the 1909 Nobel Prize for his work on the physiology, pathology and surgery of the thyroid gland. He proposed some surgical instruments (hemostatic clamp, grooved probe, gastric clamp, etc.), a gastric tube was put into practice. The published manual on operative surgery has survived 5 reprints (1892–1907) and has been translated into many world's languages.

History of phlebology (Part II)

The article presents data about the history of phlebology development in the period from XV to XX centuries – the key time of the establishment of medicine, the most important discoveries and breakthroughs. In the Middle ages the development of surgery, particularly in Europe, slowed considerably, due to the dominance of the Church and the introduction of various restrictions. However, the stagnation of the Middle ages gave way to the flowering of the Renaissance – a time of rapid development of art, science and technology. Gradually surgery were included in University education, and this marked the beginning of further improvement. XVII-XVIII centuries can be considered the time of completion of the empirical approach in surgery. In this period the development of phlebology has had a huge impact discoveries in physiology, histology, pathological anatomy and clinical medicine. A crucial period in medicine began XIX-XX centuries – asepsis and antisepsis, general and local anaesthesia, techniques of blood transfusion etc. was opened. The development of phlebology in this period was influenced by such scholars as Jerome Fabrizi, Ambroise Paré, Max Schede, Alexei Trojans, Friedrich Trendelenburg, Georg, Perthes, Albert Narath, William Wayne Babcock, Otto Wilhelm Madelung, Emil Theodor Kocher, etc. The article describes their contribution to the history of phlebology.