The History of Radical Hysterectomy

Abstract

Carcinoma of the uterine cervix provides one of the few examples in medical history of a method of treatment that was once discarded by most of the medical profession and was later reclaimed. In addition, radical hysterectomy (RH) competed with radical vaginal hysterectomy during the early history of RH. The primitive form of RH was first described by Clark and Reis in 1895. Radical hysterectomy was then described in detail and performed by Wertheim, more than 100 years ago. Afterward, RH was abandoned for the treatment of carcinomas because of the use of radiotherapy; however, RH was then modified and repopularized by Meigs in the 1950s. The surgical principles of this operation have undergone only minor modifications throughout the years and remained the basis of the surgical approach used by gynecologic oncologists today. The history of the treatment of cervical carcinoma and the history of RH are unique in medicine. Because of the efforts of the surgeons and scientists, cervical carcinoma has become rarer, and its mortality rate has decreased, although it is still common in undeveloped countries. The history of the treatment of cervical carcinoma includes 3 Nobel Prize winners and 1 Nobel Prize nominee. We therefore think that knowledge of the historical development of this filed will inspire and contribute to the education of future generations. In this article, the historical development of the surgical treatment of cervical carcinoma, the contributors to this surgical procedure, and the pioneers of the surgical and medical treatment of cervical carcinoma are summarized; pictures and illustrations are also provided. Our aim was to inform the gynecologic oncology community about the pioneers that devoted their professional lives to develop of these techniques.