Standing the test of time: long-term results of standard procedures in urology

Excerpt

The Old Operating Theatre Museum is one of London’s most intriguing historic interiors. It is found in the garret of St Thomas’s Church, Southwark, which was originally a part of St Thomas’s Hospital. It is the oldest of its kind in Great Britain (dating from 1822, a similar age to the Etherdome in Boston) and perfectly illustrates why operating rooms in the United Kingdom are traditionally called ‘theatres’: they tended to be semi-circular amphitheatres with the operating table in the centre to allow students to observe the surgical procedures (Fig. 1). It is only a logical extension of this amusing analogy to the performing arts to note that there are premieres, debuts, re-runs and flops, triumphs and tragedies also in surgery. In this issue of the World Journal of Urology we focus on what in theatrical realms is called the repertoire, i.e. ‘a list of pieces, which a company has rehearsed and is prepared to perform’. Like an opera, a surgical procedure has to stand the test of time, surviving fashions, seasons and cycles before it becomes part of the repertoire. In some cases, it even has to overcome the embittered resistance (and envy) of the opinion-leading establishment: When the young physician Werner Forssmann of Berlin, pioneer of cardiac catheterization (and a urologist), later winner of the Nobel prize, performed his spectacular self-experiments in 1929 [1], his famous fellow-countryman and chief Ernst-Ferdinand Sauerbruch commented scornfully that ‘One does not shove spokes up the vessels. That’s for the circus. A German surgeon does not do such a thing!’ and dismissed him from the Charite. Similar reactions were observed, when extracorporeal shockwave lithotripsy [2], ureterorenoscopy and, most recently, laparoscopy were introduced in urology.

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