Vascular surgery


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The Vascular Surgery is the branch of surgery that deals with the recognition and surgical treatment and after-care and rehabilitation of diseases of the vascular system including injuries and malformations of blood vessels involved. The methods of vascular surgery include the operative treatment of vascular diseases and injuries through plastic procedures, especially as surgical therapy of the major arteries, including the abdominal aorta , as well as circulatory disorders of the peripheral arteries , but also surgery of the peripheral and central veins .

Coronary artery surgery , on the other hand, traditionally belongs to cardiac surgery .

Typical surgical interventions in vascular surgery are the creation of vascular bypasses for peripheral arterial occlusive disease or the insertion of prostheses for aneurysms located outside the brain . Vascular surgery also includes the surgical treatment of the vessels supplying the brain , such as the carotid artery , in the case of arteriosclerosis for stroke prophylaxis . In addition, dialysis shunts (short-circuit connections between artery and vein through which dialysis takes place) are used in vascular surgery .

According to the model training regulations of the German Medical Association , specialists in vascular surgery must also be able to operate on the venous system. The Phlebology concerned as additional training with the leg veins .

Development of vascular surgery

Until modern times, the (open) surgical treatment of blood vessels consisted primarily of hemostatic measures, such as vascular ligation , which has been known since ancient times . In 1897, the American surgeon John Benjamin Murphy successfully performed a circular suture on the femoral artery for the first time . The French physician Alexis Carrel with his vascular anastomosis described in 1902 is considered a pioneer of modern arterial vascular surgery . His method of vascular suturing, which is still used today, was only used clinically in exceptional cases. Carrel's student Ernst Jeger described in 1913 the surgery of the blood vessels and the heart, the technique of femoropopliteal venous bypass and heart transplantation, as it was carried out later by Christiaan Barnard . The German surgeon Erich Lexer introduced the insertion (interposition) of vein sections for the treatment of arterial injuries in 1907. Modern arterial blood vessel reconstruction (also with plastic implants) combines conventional, open surgical and interventional endovascular methods. Vascular surgical pioneering achievements were the ligature of a persistent ductus Botalli by Robert E. Gross and JP Hubbard in Boston in 1938 and the resection of a congenital coarctation of the aorta by Clarence Crafoord in Stockholm in 1945. Dubost first succeeded in reconstructing a ruptured aorta in 1951 in Paris. Vascular surgery became a recognized independent subject in the last third of the 20th century; the sub-area “vascular surgery” existed in Germany from 1977. The Würzburg surgeon Martin Sperling was one of the pioneers of vascular surgery in Germany.

See also

literature

  • Michael Staudacher: Great moments in vascular surgery . Vienna 2006.
  • Martin Sperling (ed.): Dangers, mistakes and successes in vascular surgery and its reality. Basel / Munich / Paris ... 1991.
  • Olga Aßmann, Margret Liehn, Annette Kormann: Vascular surgery. In: Margret Liehn, Brigitte Lengersdorf, Lutz Steinmüller and Rüdiger Döhler (eds.): OP manual. Basics, instruments, surgical procedure. 6th, updated and expanded edition. Springer, Berlin / Heidelberg / New York 2016, ISBN 978-3-662-49280-2 , pp. 275-319.

Web links

Commons : Vascular surgery  - collection of images, videos and audio files

Individual evidence

  1. www.gesundheit.de: Roche Lexicon Medicine: Vascular Surgery (2) .
  2. www.gefaesschirurgie.de: Further training as a specialist .
  3. See also Gundolf Keil : Aperçus on the history of vascular surgery. Lecture. In: Martin Sperling (1991), pp. 13-21 and 171 f.
  4. Ernst Kern : Seeing - Thinking - Acting of a surgeon in the 20th century. ecomed, Landsberg am Lech 2000, ISBN 3-609-20149-5 , pp. 161 and 191.
  5. Christoph Weißer: Vascular surgery. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin, New York 2005, ISBN 3-11-015714-4 , p. 465.
  6. Peter Stierli, Lorenz Gürke, Jürg Schmidli : Hybrid in vascular surgery. In: Hubert Steinke , Eberhard Wolff, Ralph Alexander Schmid (eds.): Cuts, knots and networks. 100 years of the Swiss Society for Surgery. Chronos, Zurich 2013, ISBN 978-3-0340-1167-9 , pp. 181–186.
  7. Ernst Kern : Seeing - Thinking - Acting of a surgeon in the 20th century. ecomed, Landsberg am Lech 2000, ISBN 3-609-20149-5 , pp. 160 f., 191 and 247.