The French Contribution to the Evolution of the Procedure and the Instrumentation for Lithotripsy

Abstract

Lithotomy is one of the oldest recorded surgical techniques, although an early mention in the Hippocratic Oath states: “I will not cut, even for the stone, but I will leave such procedures to the practitioners of the craft.” 1 Oath. in: Chadwick J. Mann W.N. Hippocratic Writings. Penguin Classics, London1983 Google Scholar , 2 Modlin M. A history of urinary stone. S Afr Med J. 1980; 58: 652-655 PubMed Google Scholar A possible interpretation of the prohibition may recommend that only skillful lithotomists must involve with this delicate and dangerous surgical procedure. 3 Master V.A. Meng M.V. Stoller M.L. Stone nomenclature and history of instrumentation for urinary stone disease. in: Stoller M.L. Meng M.V. Current Clinical Urology, Urinary Stone Disease: A Practical Guide to Medical and Surgical Management. Humana Press Inc, Totowa, NJ2007 Crossref Google Scholar Two approach routes were in use: the median perineal (Apparatus Minor) and the vertical (Apparatus Maior or Marian operation), both resulting at severe side-effects such as hemorrhage, pain, incontinence, impotence, and fistula. The latter was adopted by the famous family of lithotomists Collot in France, Jean Baseilhac (Frère Cosme), and Jacques Beaulieu (Frère Jacques) who was the inventor of the lateral lithotomy. Great lithotomists who followed the lateral procedure were Rau, Cheselden, and the majority of the pioneers in lithotripsy. Finally, Pierre Franco attempted a suprapubic approach (Apparatus Altus) in a 2-year-old child. 4 Riches E. The history of lithotomy and lithotrity. Ann R Coll Surg Engl. 1968; 43: 185-199 PubMed Google Scholar The difficulties of lithotomy led to the development of stone destruction into the bladder and extraction of the fragments through the physical way, baptized lithotrity, or lithotripsy (from the Greek noun “lithos” meaning stone and the verb “trivein” meaning to rub). The first effective for lithotripsy instruments were designed by 2 French surgeons, Jean Civiale (1796-1867), and Jean-Jacques-Joseph Leroy d’Étiolles (1798-1860), and made by the French Joseph Frédéric Benoît Charrière (1803-1876).