Georg Kelling

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Georg Kelling

Georg Kelling (born July 7, 1866 in Dresden ; † February 14, 1945 there ) was a German internist and gastroenterologist . He is considered to be the inventor of laparoscopy .

Life

Childhood and youth

Georg Kelling was born on July 7, 1866 in Dresden-Friedrichstadt as the eldest son of the engineer Emil Kelling and his wife Margarethe. After attending the Bürgererschule, the Kreuzschule and the Vitzthumschen Gymnasium in Dresden , Kelling left his hometown in 1885 with the school leaving certificate and studied human medicine in Leipzig and Berlin .

Studied in Leipzig and Berlin

Kelling began his medical studies on April 21, 1885 at the University of Leipzig . In the summer of 1887 the future physician served as a volunteer in Grenadier Regiment 101 in Dresden and continued his studies in the winter semester, from October 19, 1887 to March 7, 1888, at the Friedrich-Wilhelms-Universität Berlin (today Humboldt University ) . Here Kelling could give lectures a. a. Listen to Emil Heinrich Du Bois-Reymond ( physiology ), Carl Anton Ewald ( internal medicine ), Robert Michaelis von Olshausen ( gynecology ), Ernst von Bergmann ( surgery ) and Rudolf Virchow ( pathology ). On April 17, 1888, Kelling enrolled at the Medical Faculty of Leipzig University and attended lectures by Felix Victor Birch-Hirschfeld (pathology), Ernst Adolf Coccius ( ophthalmology ), Albert Döderlein and Paul Zweifel ( gynecology ), Paul Flechsig ( psychiatry ), among others. and his later doctoral supervisor Hoffmann (internal medicine). During his studies he became a member of the Association of German Students Berlin and the VDSt Leipzig .

He passed the "Medical State Exam" in June 1890 and received his doctorate in medicine on July 15, 1890 with the subject "About determining the size of the stomach". The successful doctorate had a major influence on his further professional development, because he decided to begin his further training in the field of gastrointestinal diseases. In the summer of 1891 he went to Berlin to continue his education for five years .

Training in Berlin

In addition to Adolf Kussmaul's (1822–1902) clinic in Strasbourg , Berlin was the Mecca of gastroenterology in Germany at the turn of the century. Well-known gastroenterologists and physiologists worked here during this time. Kelling worked and interned with Ismar Boas (1858–1938) in the Polyclinic for Gastrointestinal Diseases in Friedrichstrasse, with Carl Anton Ewald in the internal department of the Kaiserin-Augusta-Hospital and under Emil Du Bois-Reymond (1818–1896) in the Physiological Institute of the Charité .

Kelling's teacher Boas founded the first outpatient clinic for stomach and intestinal diseases in Berlin's Friedrichstrasse in 1886, against the resistance of the Berlin medical community. Until 1906 he conducted private medical courses on stomach and intestinal diseases, which were very popular and were also attended by Kelling.

With the establishment of the Kaiserin-Augusta-Hospital in north-west Berlin in 1869, an efficient department for internal medicine was created there, which Ewald headed with great medical and scientific success from 1888 to 1915 and which Kelling also sat in on.

In addition to the practical training with Boas and Ewald, Kelling continued his theoretical training at the Physiological Institute of the Charité, which opened in Dorotheenstrasse in 1877. His first work came from the experimental-physiological department under the direction of Johannes Gad (1842-1926) and from the chemical-physiological department under the direction of the later Nobel Prize winner Albrecht Kossel (1853-1927).

Kelling evidently sought the scientific closeness to the most important gastroenterologists and physiologists of his time and, as his clinical and animal experiments show, also used it with great success.

Work in Dresden

Georg Kellings' house in Dresden, Christianstrasse No. 30

In 1896 Kelling established himself as a doctor for gastrointestinal diseases in Dresden. In addition to setting up his practice, he initially dealt intensively with endoscopic issues at the Dresden-Friedrichstadt City Hospital and at the Royal University of Veterinary Medicine in Dresden. In the summer of 1898 he went to see the well-known surgeon Johann von Mikulicz-Radecki at the Royal Surgical Clinic in Breslau to do his internship there. In 1898, Kelling wrote about this visit in Part II of the work “Endoscopy for the esophagus and stomach”

"... During my stay ... thanks to the kindness of the privy councilor Professor Dr. von Mikulicz had several opportunities to perform esophagoscopy and gastroscopy with the founder of the method, who has exceptional skill and criticism in this area . "

Obviously, Kelling also had the opportunity to study abdominal surgery with von Mikulicz in Wroclaw and to operate with him, because he formulated 1900

in his article "Studies on stomach surgery" gratefully

"... Thanks to the kindness of the privy councilor Prof. Dr. von Mikulicz was lucky to have been introduced to abdominal surgery by the hand of this master . "

In retrospect, this working visit was extremely beneficial to his later experimental, endoscopic and surgical activities and established his reputation as a gastroenterologist and specialist in gastrointestinal diseases. Kelling's other work is to be seen against the background of the activities of the Society for Nature and Medicine in Dresden and Dresden Medicine for the exploration and endoscopy of open and closed body cavities in the late 19th century.

In 1894, Kelling joined the “Society for Nature and Medicine in Dresden” and was confronted with the research of Alfred Fiedler , Justus Schramm-Vogelsang , Maximilian Nitze and Felix Martin Oberländer .

Death in Dresden

Grave slab of the family grave in Dresden's Annenfriedhof

Georg Kelling and his second wife Johanna are on 13./14. February 1945 killed in heavy air raids on Dresden . The total destruction of her house at No. 30 Christianstrasse is connected with the loss of her personal documents. There are no mortal remains of Georg Kelling and his wife. The presumed date of death is documented on a simple grave slab from the family grave in the Old Annenfriedhof in Dresden.

From oral to abdominal insufflation

In his article on September 17, 1901, "The tamponade of the abdominal cavity with air to stop life-threatening bleeding", Kelling dealt with the previously known and obviously insufficient methods of hemostasis for intestinal bleeding and then presented his considerations with an abdominal air insufflation intra-abdominal vascular compression (air tamponade) at pressures of 50 to 80 mm Hg. He wrote:

"... To determine this, I created a method of endoscopy of the unopened abdominal cavity (celioscopy) ... "

On September 23, 1901, Kelling gave the memorable lecture “About Visiting the Esophagus and Stomach with Flexible Instruments” at the 73rd Meeting of German Naturalists and Doctors in Hamburg.

After discussing esophagoscopy and gastroscopy, he finally explained the principle of his new method, celioscopy, and explained:

“… It is based on the fact that the anterior abdominal wall is extremely flexible. If we empty the stomach and intestines and fill the abdominal cavity by blowing in air, which is filtered through cotton wool, we get a large dome space in which we can orientate ourselves comfortably. The air is blown in through a Fiedler trocar, which is known to be designed in such a way that the end can be blunted after piercing the abdominal wall. This blunt instrument can also be used for palpation. The inspection is done by puncturing a second trocar through which a finest Nitze cystoscope is inserted. I close, m. H, with the wish that the endoscopic methods for the digestive tract will find more application than has hitherto been the case, because they are actually called to replace the laparotomy in many cases. "

At the 47th meeting of the German Society for Surgery in 1923, Kelling took up the topic of "endoscopy" again. In his lecture "On celioscopy and gastroscopy" he reported that he recently turned back to inspecting the abdominal cavity and formulated:

"... ... mainly for economic reasons, because the high price increases the need to spare the patient board days, bandages, medication and, in particular, possibly avoidable operations such as trial laparotomies .... "

Priority dispute

In the years 1910, 1921 and 1932 Kelling had to deal with unpleasant priority claims, which, however, did not affect his creative power. The internist Egmont Wildhirt , who worked for Heinrich Otto Kalk for many years , described Kelling's priority as follows in 1964:

“... But he came up with the concept of filling the abdominal cavity with air and thus creating a field of vision in order to be able to inspect the abdominal organs ... Kelling must therefore be regarded as the real inventor of laparoscopy, even if his pioneering work was forgotten again. "

The first human laparoscopy, however, was carried out by Hans Christian Jacobaeus in Stockholm in 1910, before Kelling was able to transfer his laparoscopy experiments on dogs to humans .

Appreciation

Portrait on the medal "Johannes von Mikulicz-Radecki – Georg Kelling - Endoscopic Surgery Award"

Kelling's extensive bibliography documents the diverse scientific work of the Dresden internist and gastroenterologist. His work is reflected in several examination methods and surgical procedures named after him, even if these are no longer common today or have been overtaken by developments.

Kelling's work received a late but very valuable honor in October 1992 from the Presidium of the German Society for Surgery. Under the name “Johannes von Mikulicz-Radecki – Georg Kelling - Endoscopic Surgery Award”, the German Society for Surgery honors special scientific and practical achievements in the field of endoscopic surgery every year. In honor of Georg Kelling's services, the “Verein Oschatzer Frauenärzte e. V. "with the support of the Collm Klinik Oschatz held a" Georg Kelling Symposium "on September 22, 2001 and published the book" Georg Kelling and the Saxon roots of laparoscopy - 100 years of laparoscopy "on the occasion of the 100th birthday of laparoscopy. .

meaning

  • Contrary to the zeitgeist, Kelling favored endoscopic procedures over trial laparotomy at an early stage (1898).
  • A stage-appropriate surgical treatment of malignant diseases was farsightedly called for by Kelling and the primary use of endoscopic procedures was recommended for this purpose (1898).
  • For the first time, Kelling compiled the necessary basic instruments with insufflation needle (Fiedlerscher trocar), insufflation apparatus (Politzer air pump), optic trocar and optics (Nitze cystoscope) for the laparoscopy and described the method (1901).
  • The first indications and contraindications to celioscopy and laparoscopy were formulated by Kelling (1901).
  • For the first time, Kelling demonstrated the possibilities of intra-abdominal diagnostics with endoscopic inspection and palpation (1901).
  • Kelling, obviously anticipating the problems of training young doctors, recommended that endoscopic procedures be practiced on the cadaver (1901).
  • Kelling had almost visionarily predicted the outpatient performance of endoscopic interventions, especially the laparoscopy (1901).
  • Far ahead of his time, Kelling recognized the advantageous economic aspects of endoscopic treatment methods (1923).

literature

Individual evidence

  1. ↑ Louis Lange (Ed.): Kyffhäuser Association of German Student Associations. Address book 1931. Berlin 1931, p. 109.
  2. ↑ G. Kelling: About the determination of the stomach size. Medical dissertation. Leipzig, 1890.
  3. ^ E. Küster: History of the Augusta Hospital and the Berlin Women's Lazarett Association. Urban & Schwarzenberg, Berlin 1911.
  4. ↑ a b M. Schollmeyer, Th. Schollmeyer: Georg Kelling and the Saxon roots of laparoscopy - 100 years of laparoscopy (1901–2001). Druckerei Wagner, Verlag und Werbung, Siebenlehn 2001, ISBN 3-00-008382-0 .
  5. ^ CP Heidel: On the founding history of the Society for Natural and Medicinal Science in Dresden. Lecture at the conference "Learned Societies in Central Germany (1650-1820) - Part II" of the Saxon Academy of Sciences in Leipzig, Leipzig 1999.
  6. ↑ CP Heidel, A. Scholz: Dresden traditions in the field of endoscopy in the second half of the 19th century. In: Würzburg medical history reports. Volume 19, 2000.
  7. ↑ A. Fiedler: About the puncture of the pleural cavity and the pericardium. In: Annual report "Society for Nature and Medicine in Dresden". GA Kaufmanns Assortment Bookstore, Dresden 1881, p. 137.
  8. ↑ M. Nitze: A new lighting and examination method for the urethra, urinary bladder and rectum. In: Wiener Medical Wochenschrift. Volume 24, 1879, p. 649.
  9. ↑ FM Oberländer: Demonstration of the instruments for endovesical tumor surgery and the ureter-kystoscope by Nitze. Meeting of the "Society for Nature and Medicine in Dresden" on November 14, 1896 in Dresden.
  10. ^ G. Kelling: About the inspection of the esophagus and the stomach with flexible instruments. 73rd "Meeting of the Society of German Natural Scientists and Doctors" on September 22, 1901 in Hamburg.
  11. ^ Günther Seydl: Starting point for endoscopy: The history of endoscopy in the 19th century in Vienna. In: Würzburg medical history reports. 23, 2004, p. 268 f.
  12. ↑ G. Kelling: About the elimination of anesthetic vapors from the operating room. In: Zbl Chir. 5, 1918, pp. 602-606.
  13. ↑ G. Kelling: About the sensitivity in the abdomen and about the Mac Burney pressure point. In: Archives for Digestive Diseases. 11, 1905, pp. 550-573. doi: 10.1159 / 000189435

Web links

personal data
SURNAME Kelling, Georg
BRIEF DESCRIPTION German surgeon and gastroenterologist
DATE OF BIRTH July 7, 1866
PLACE OF BIRTH Dresden
DATE OF DEATH February 14, 1945
Place of death Dresden