|Year : 2022 | Volume
| Issue : 4 | Page : 307-308
Friedrich Trendelenburg (1844–1924): A surgeon who opened the door for venous disorders
Devender Singh, Shalini Aryala
Department of Vascular and Endovascular Surgery, Yashoda Hospitals, Hyderabad, Telangana, India
|Date of Submission||03-Nov-2021|
|Date of Acceptance||16-Nov-2021|
|Date of Web Publication||8-Nov-2022|
Department of Vascular and Endovascular Surgery, Yashoda Hospitals, Hyderabad, Telangana
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh D, Aryala S. Friedrich Trendelenburg (1844–1924): A surgeon who opened the door for venous disorders. Indian J Vasc Endovasc Surg 2022;9:307-8
Professor Friedrich Trendelenburg is a famous surgeon who had a special interest in surgeries for vascular system. His contribution in surgical management for pulmonary thrombosis and varicose veins opened the door for various vascular surgical procedures. His contribution in bringing out the history of Indian surgery to the world plate form through his dissertation entitled “De veterum Indorum chirurgia” (about ancient Indian medical practices) in 1866 was very well appreciated.
Friedrich Trendelenburg was born in Berlin on May 24, 1844, the son of professor of philosophy Adolf Trendelenburg. He followed medical courses first in Edinburgh and Glasgow (candidatures for the degree) and subsequently in Berlin (doctoral studies), where he graduated in 1866 with a thesis entitled “De veterum Indorum chirurgia” (about ancient Indian medical practices). The advance and progress of medical history would be a topic that fascinated and inspired him for the rest of his long life. After 2 years of military service as a doctor and surgeon in the hospitals of Görlitz to Kiel, Friedrich Trendelenburg was appointed in 1868 as assistant to the Berlin Professor Bernhard von Langenbeck (1810–1887), a figurehead in experimental and general clinical surgery, founder of the “Archiv für klinishe Chirurgie” and cofounder of the “Deutsche Gesellschaft für Chirurgie.” In 1874, after a training programme that lasted 6 years, Friedrich Trendelenburg was appointed Director of the Surgical Department at the 'Krankenhaus Friedrichshain (a hospital in Berlin), after which he forged for himself a strikingly rapid academic career as professor of surgery in Rostock (1875), Bonn (1882) and, finally, in Leipzig (1895), where he remained until his retirement in 1911. Subsequently, he went to live in Nikolassee, near Berlin, where on 15 December 1924, he passed away as a result of mandibular sarcoma.
Friedrich Trendelenburg became a surgeon at a historically favorable moment, that is, after the introduction of inhalation narcosis and asepsis, two milestones that accelerated the pace of advances in surgical procedures. In addition, he had received a thorough training and was very versed in all branches of his discipline. As we know from eponyms associated with his name, it is especially in the fields of orthopedic, vascular, urological, and gynecological surgery that he has made his most significant contributions.
It is certainly justified to date the modern pathophysiology of venous insufficiency to Friedrich Trendelenburg. In 1890, he published two clinical tests to detect venous valve insufficiency and introduced the concept of the “private cycle” and thus founded the solitary ligature of the saphena to eliminate reflux. Ligature of the vena saphena magna. In 1891, he described his procedure in Brun's contributions to clinical surgery under the title: “On the prevention of the saphenous vein magna in lower leg varicosities.” Neither an extirpation of the stem vein nor a crossectomy was associated with this procedure.
Professor Friedrich Trendelenburg made his significant contribution though his experimental observations in the production and surgical management of pulmonary embolism. This work was combined with one of the first reports of clinical pulmonary embolectomy and was presented at the 37th Congress of the German Surgical Society in 1980. It is astonishing to note the scope and depth of the diagnostic, physiological, and therapeutic aspects of pulmonary embolism recognized at such an early date by this surgical master. It is fascinating that he also recognized the variability in the length of time between the onset of symptoms and death following massive pulmonary embolism. His technique was based on limited opening of the left side of the chest directly over the common or undivided pulmonary artery and encircling the proximal aorta and pulmonary artery together through the transverse sinus of the pericardium. Both vessels were to be occluded by traction on the encircling band. Emboli were to be extracted through a small pulmonary arteriotomy, which then was to be controlled by a tangentially applied clamp, while occlusion of the great blood vessels was released.
While working as an assistant in Langenbeck's Clinic in Berlin in 1871, with his invention of Cone and Cannulas, he made a highly significant contribution to endotracheal anesthesia. His cone and cannulas helped during operations on the buccal and pharyngeal cavities and larynx, which prevented the aspiration of blood and debris.
The name Trendelenburg shall remain eponymously associated with diverse surgical interventions, instruments, and clinical signs, but it is “his” “Beckenhochlagerung,” the “Raised Pelvic Position,” ultimately known as the Trendelenburg Position, that is still being employed by all gynecologists, surgeons, and other health practitioners worldwide and that has secured his name indelibly into the annals of medical history. Apart from this, his name is attached to a gait and sign, popularly known as Trendelenburg's gait (an abnormal gait caused by weakness of the abductor muscles of the lower limb, including the gluteus medius muscle and gluteus minimus muscle) and sign (congenital dislocation of the hip).
Professor Friedrich Trendelenburg will always be remembered in our vascular fraternity of his significant contribution for vascular disorders and Indian medical professionals appreciate his work on bringing out the history of Indian surgery.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Trendelenburg F. Ueber die Unterbindung der Vena saphena magna bei Unterschenkelvaricen. In: Beiträge zur klinischen Chirurgie. Vol. 7. 1891. p. 195-210.
Meyer JA. Friedrich trendelenburg and the surgical approach to massive pulmonary embolism. Arch Surg 1990;125:1202-5.
Trendelenburg F. Beiträge zu den Operationen an den Luftwegen. Tamponade der Trachea. Arch Klin Chir 1871;12:121-33.
Thiery M. Friedrich Trendelenburg (1844-1924) and the trendelenburg position. Gynecological Surgery 2009;6:295-7.