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Ethics of Fetal Surgery

Surgeons sometimes operate on the developing fetuses in utero of pregnant women as a medical intervention to treat a number of congential abnormalities, operations that have ethical aspects. A. William Liley performed the first successful fetal surgery, a blood transfusion, in New Zealand in 1963 to counteract the effects of hemolytic anemia, or Rh disease.

Format: Articles

Subject: Ethics

The Development of Silicone Breast Implants for Use in Breast Augmentation Surgeries in the United States

In the 1960s, two plastic surgeons from the United States, Thomas Dillon Cronin and Frank Judson Gerow, collaborated with the Dow Corning Corporation, which specialized in silicone products, to create the first silicone breast implant. Surgeons used the implant, named the Cronin-Gerow implant, to improve the look of a woman’s breasts, by correcting for asymmetry, augmenting the size, or creating a more uplifted profile.

Format: Articles

Subject: Technologies, Processes

Fetal Surgery

Fetal surgeries are a range of medical interventions performed in utero on the developing fetus of a pregnant woman to treat a number of congenital abnormalities. The first documented fetal surgical procedure occurred in 1963 in Auckland, New Zealand when A. William Liley treated fetal hemolytic anemia, or Rh disease, with a blood transfusion.

Format: Articles

Subject: Disorders, Ethics, Reproduction

Endoscopic Fetoscopy

Endoscopic fetoscopy is a minimally invasive surgical procedure performed during pregnancy that allows physicians to view the fetus in-utero. Physicians use endoscopic fetoscopy to evaluate, diagnose, and treat fetal abnormalities. Physicians use an endoscope, or a thin, flexible surgical device with a light attached to its end, to perform endoscopic fetoscopy procedures. In 1954, Björn Westin performed the first endoscopic fetoscopy in Sweden.

Format: Articles

Subject: Technologies

Twice Born–Stories from the Special Delivery Unit (2015), by the Public Broadcasting Service and Trailblazer Studios

In 2015, the Public Broadcasting Service, or PBS, released a three-part documentary series, Twice Born–Stories from the Special Delivery Unit, hereafter Twice Born, that follows several pregnant women and their experiences with fetal surgery. Trailblazer Studios produced the film, which predominantly features two women, although it includes the stories of many women. The two main women are pregnant with fetuses diagnosed with physical deformities. One woman’s fetus is diagnosed with spina bifida, an incomplete closure of the fetus’s spinal column.

Format: Articles

Subject: Publications

William Stewart Halsted (1852-1922)

William Stewart Halsted was a surgeon at Johns Hopkins Hospital in Baltimore, Maryland, during the late 1800s and early 1900s. In 1894 Halsted described his procedure for treating breast cancer by removing the breast tissue, chest muscles, and lymph nodes in the armpit, a procedure he named radical mastectomy, and that became the standard of care for treating breast cancer until 1970.

Format: Articles

Subject: People

Endoscopy

Endoscopy is a medical procedure that enables the viewing and biopsy of, and surgery on, internal tissues and organs. Endoscopic examinations are characterized by the introduction of a tube containing a series of lenses into the body through either an incision in the skin or a natural opening or cavity. During the mid-twentieth century, photographer Lennart Nilsson used endoscopes to capture the now-familiar images of embryos and fetuses.

Format: Articles

Subject: Technologies, Reproduction

Management of Myelomeningocele Study Clinical Trial (2003–2010)

From February 2003 to December 2010, researchers of the Management of Myelomeningocele Study, or MOMS, clinical trial compared the safety and efficacy of different treatments for a specific type of spina bifida, called myelomeningocele. Myelomeningocele, the most frequent and severe form of spina bifida, is a condition in which the bony spinal column does not develop correctly, which causes an opening of the spine, exposure of the spinal cord, and formation of a small sac containing cerebrospinal fluid.

Format: Articles

Subject: Experiments

Breast Augmentation Techniques

Breast augmentation involves the use of implants or fat tissue to increase patient breast size. As of 2019, breast augmentation is the most popular surgical cosmetic procedure in the United States, with annual patient numbers increasing by 41 percent since the year 2000. Since the first documented breast augmentation by surgeon Vincenz Czerny in 1895, and later the invention of the silicone breast implant in 1963, surgeons have developed the procedure into its own specialized field of surgery, creating various operating techniques for different results.

Format: Articles

Subject: Technologies, Processes, Reproduction, Ethics

Twin-to-Twin Transfusion Syndrome

Twin-to-Twin Transfusion Syndrome (TTTS) is a rare placental disease that can occur at any time during pregnancy involving identical twins. TTTS occurs when there is an unequal distribution of placental blood vessels between fetuses, which leads to a disproportionate supply of blood delivered. This unequal allocation of blood leads to developmental problems in both fetuses that can range in severity depending on the type, direction, and number of interconnected blood vessels.

Format: Articles

Subject: Disorders, Reproduction

“Infant Survival After Cesarean Section for Trauma” (1996), by John A. Morris, Jr. et al.

In the May 1996 edition of The Annals of Surgery, John A. Morris and his collaborators published “Infant Survival After Cesarean Section for Trauma,” in which they evaluate the use of emergency cesarean sections for the treatment of pregnant trauma patients. During a cesarean section, a physician removes a fetus from a pregnant woman through an incision in her abdomen and uterus. When a pregnant woman experiences trauma, physicians can perform an emergency cesarean section to remove the fetus and administer medical treatments that would not be possible while the woman is pregnant.

Format: Articles

Subject: Publications

Ephraim McDowell (1771-1830)

Ephraim McDowell was an US abdominal surgeon who in 1809 performed one of the first successful ovarian surgeries. McDowell conducted his medical practice in Danville, Kentucky, where he used novel methods of ovariotomy to remove a twenty-two and a half pound ovarian tumor from his patient, Jane Crawford. At the time, surgeons performed ovariotomies by making an incision into each patient’s ovary to remove a mass. However, their patients often died from infection or blood loss.

Format: Articles

Subject: People

"The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894" (1894), by William Stewart Halsted

In 1894, William Stewart Halsted published The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894, in the medical journal Annals of Surgery. In the article, Halsted describes the results from fifty of his operations on women with breast cancer, performed at Johns Hopkins Hospital in Baltimore, Maryland. Those operations involved a surgical procedure Halsted called radical mastectomy, which consists in removing all of the patient’s breast tissue, chest muscle, and underarm lymph nodes.

Format: Articles

Subject: Publications

Weber v. Stony Brook Hospital (1983)

The New York Court of Appeals' 1983 case Weber v. Stony Brook set an important precedent upholding the right of parents to make medical decisions for newborns born with severe congenital defects. A pro-life New York attorney, Lawrence Washburn, attempted to legally intervene in the case of Baby Jane Doe, an infant born with disorders. When the infant's parents chose palliative care over intensive corrective surgery, Washburn made repeated attempts to have the New York courts force through the surgery.

Format: Articles

Subject: Legal, Reproduction

Alexis Carrel (1873-1944)

Alexis Carrel was a doctor and researcher who studied tissue cultures. He continued Ross Granville Harrison's research and produced many improvements in the field of tissue culture and surgery. He was the recipient of the 1912 Nobel Prize in Physiology or Medicine for his development of surgical techniques to repair blood vessels. Carrel was born on 28 June 1873 in Sainte-Foy-les-Lyon, France, to Anne-Marie Ricard and Alexis Carrel Billiard. His father died when he was five years old.

Format: Articles

Subject: People

William Thornton Mustard (1914-1987)

William Thornton Mustard was a surgeon in Canada during the twentieth century who developed surgical techniques to treat children who had congenital heart defects. Mustard has two surgeries named after him, both of which he helped to develop. The first of these surgeries replaces damaged or paralyzed muscles in individuals who have polio, a virus that can cause paralysis. The other technique corrects a condition called the transposition of the great arteries (TGA) that is noticed at birth.

Format: Articles

Subject: People, Disorders, Disorders

Adib Jatene (1929–2014)

Adib Jatene in Brazil was the first surgeon to successfully perform the arterial switch operation in 1975. The operation corrected a heart condition in infants called transposition of the great arteries (TGA). Left untreated, infants with TGA die, as their blood cannot supply oxygen to their bodies. Jatene’s operation became widely used to correct the condition. Aside from medical research, Jatene worked for years in politics and education, serving as Brazil’s minister of health and teaching thoracic surgery at the University of São Paulo.

Format: Articles

Subject: People

Jeffrey Weinzweig's Experiments on In Utero Cleft Palate Repair in Goats (1999-2002)

Jeffrey Weinzweig and his team, in the US at the turn of the twenty-first century, performed a series of experiments on fetal goats to study the feasibility of repairing cleft palates on organisms still in the womb. Weinzweig , a plastic surgeon who specialized in cleft palate repair, and his team developed a method to cause cleft palates in fetal goats that are similar to clefts that occur in human fetuses. Using their goat congenital model, the team developed a method to repair a congenital cleft palate in utero, or in the womb.

Format: Articles

Subject: Experiments, Disorders

Henry Morgentaler (1923-2013)

Henry Morgentaler was a physician who performed abortions, acted as a reproductive rights activist, and advocated for legal access to abortions in Canada during the twentieth century. In 1969, he opened his first abortion clinic in Canada and participated in the legal/court case of R v. Morgentaler (1988), which led Canada to decriminalize abortion. Morgentaler helped establish legal access to abortions for women in Canada and advocated for the protection of women's reproductive choices under the law.

Format: Articles

Subject: People

“Perimortem Cesarean Delivery” (1986), by Vern Katz, Deborah Dotters, and William Droegemueller

In 1986, Vern L. Katz, Deborah J. Dotters, and William Droegemueller published “Perimortem Cesarean Delivery,” an article in which they developed the Four Minute Rule for perimortem cesarean sections. The Four Minute Rule states that if a pregnant woman’s heart stops beating, physicians should begin an operation to deliver the fetus within four minutes and aim to have the fetus delivered within five minutes of cardiac arrest.

Format: Articles

Subject: Publications

Jesse Bennett (1769–1842)

Jesse Bennett, sometimes spelled Bennet, practiced medicine in the US during the late eighteenth century and performed one of the first successful cesarean operations, later called cesarean sections, in 1794. Following complications during his wife’s childbirth, Bennett made an incision through her lower abdomen and uterus to deliver their infant. Bennett’s biographers report that his operation was the first cesarean section where both the pregnant woman and the infant survived.

Format: Articles

Subject: People

Laparoscopy

Laparoscopy, a subfield of endoscopy, is a minimally invasive surgical procedure used to examine and operate on the internal organs of the abdomen through a small incision in the abdominal wall. The term "laparoscopy" is derived from two Greek words: laparo, meaning the soft space between hips and ribs, and skopie, meaning to examine. Today laparoscopy has broad clinical applications including for diagnosis, fertility procedures, visual representation, and surgery.

Format: Articles

Subject: Technologies, Reproduction

Heart of a Dog (1925), by Mikhail Bulgakov

Собачье сердце (Heart of a Dog) is a novella written in 1925 by author and playwright Mikhail Bulgakov in Moscow, USSR, later Russia. An early English translation was published in 1968. Heart of a Dog tells the story of a stray dog named Sharik, who is found by a surgeon, and undergoes extensive surgery for experimental purposes to create a New Soviet man, someone committed to the ideals of communism in the Soviet Union.

Format: Articles

Subject: Publications

David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case

In the mid-1960s, psychologist John Money encouraged the gender reassignment of David Reimer, who was born a biological male but suffered irreparable damage to his penis as an infant. Born in 1965 as Bruce Reimer, his penis was irreparably damaged during infancy due to a failed circumcision. After encouragement from Money, Reimer’s parents decided to raise Reimer as a girl. Reimer underwent surgery as an infant to construct rudimentary female genitals, and was given female hormones during puberty.

Format: Articles

Subject: Theories

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