Anton Wolfler - forgotten genius of surgery

Abstract

Nowadays, when surgery as a science was so rapidly developed, the names of many scientists who stood at its origins are forgotten or rarely mentioned, and their contribution remains underestimated. One of them is the innovator of surgery of the XIX century. Czech scientist Anton Welfler, whose bold ideas have spread far beyond the boundaries of abdominal surgery. Unfortunately, for many he is known only as the author of the methodology for the formation of gastroenteroanastomosis and as a student of Theodore Billroth. However, in reality, A. Welfler made an incomparably greater contribution not only to gastric surgery, but also to herniology, thyroid surgery. The result of his study of embryogenesis, the histological structure of the thyroid gland, his own clinical experience gained two monographs, subsequently recognized as fundamental in this section of surgery. He developed a histological classification of thyroid cancer, for the first time described both solid and cystic forms of papillary cancer. He also suggested the possible mechanisms of carcinogenesis. Together with Theodore Billroth A. Welfler introduced the technique of total thyroidectomy into clinical practice. Widely used in modern surgical practice, gastroenteroanastomosis with the loop of the small intestine turned off and the U-shaped inter-intestinal anastomosis, named after Caesar Roux, was in fact, developed by A. Welfler in the experiment. Caesar Roux himself noted A. Welfler’s priority in the invention of this design. In 1897, Caesar Roux modified the method of A. Welfler, forming a posterior-free version of this operation.