Curriculum Vitae Hans Troidl Emeritus Prof. Dr. med Dr. h. c. (University Bordeaux, France) Honorary Fellow of the Association Francaise de Chirurgie Honorary Fellow of the Royal College of Surgeons of England Hans Troidl was born on July 5 1938 in Schwarzenfeld, Bavaria, Germany. He studied medicine at Munich University, where he graduated in 1964. He started his surgical career as a surgical resident and private assistant of Prof Rudolf Zenker at the Munich University Clinic. In 1969 he followed Prof. Hamelmann to Marburg University and wrote his habilitation to achieve the next step in his academic surgical career (Sir Jim Black, Nobel prize winner, was his mentor). In 1979 Hamelmann and Troidl went to Kiel University, where Hans Troidl was appointed Professor of Surgery. At Kiel University Hans Troidl had close contact with the world leading gynecologist at this time: Kurt Semm. In 1981 Hans Troidl was elected to become the Chairman and Chief of the Second Department of Surgery at Cologne University, Clinic Merheim. During this time (1981-2003) as a Professor of Surgery and Chief Surgeon at Cologne Merheim Hans Troidl worked intensely to fulfill the multiple roles as scientist, surgical educator, compassionate surgeon and caretaker for his patients. The most important teachers of Hans Troidl Benno Stampfl- Pathology Peter Kiefhaber Internal Medicine Horst Hamelmann - Surgery John Goligher Surgery (most important)
2 and Sir Karl Popper Philosophy ( The Black Swan ) His main interests in basic science and clinical research: - Etiology of peptic ulcer - Postoperative nutrition - Establishment of the systematic follow-up clinic - Outcome - quality of life as surgical endpoint - Surgical oncology - Trauma and Intensive Care Medicine - Nutrition and acute pain therapy - Ultrasound and flexible endoscopy - Risk management, failure analysis and safety in surgery - Mental Training for surgical education Scientific Publications: More than 400 Presentations, more than 200 scientific papers as lead author, books (include The `Blue Bible: Surgical Research Basic Pinciples and Clinical Practice) (Co) Editor: Surgical Endoscopy, Endoscopy, European Journal of Surgery, Minimal Invasive Chirurgie) Editor of the medical journal Minimal Invasive Chirurgie (MIC) Honours and Awards among others: Honorary Fellow of the Trauma Society oft he American College of Surgeons Honorary Fellow of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA) Honorary Fellow of the Association Francaise de Chirurgie Honorary Fellow of the Royal College of Surgeons of England Docteur honoris causa Université Segalen Bordeaux Erich Lexer Preis Deutsche Gesellschaft für Chirurgie
3 Hans Troidl, Endoscopic Surgery and the origin of EAES In Hans Troidl s mind endoscopic surgery is the generic term, which includes flexible endoscopy on the one hand and what nowadays is called minimal invasive surgery (Wickham) or minimal access surgery (Cushieri) on the other hand. Hans Troidl prefers the term Endoscopic Surgery, because it characterizes flexible endoscopy and endoscopic surgery as innovative patient- friendly diagnostic and therapeutic methods, meaning increased comfort and less trauma for the patients. During his early years at the Munich University Clinic Hans Troidl was strongly influenced by Professor Kiefhaber, who was a pioneer of flexible endoscopy and who introduced the laser technology to stop gastrointestinal bleeding. In Kiefhaber s Department of Internal Medicine at Munich University Hans Troidl had his first contact with the innovative endoscopic technology, including laparoscopy of the liver and flexible endoscopy. Later, working at the University of Kiel, Hans Troidl was associated with Kurt Semm, a world famous gynecologist who has truely pioneered pelviscopy and laparoscopy. Prof. Semm had built new laparoscopic instruments, established photo documentation and developed new therapeutic concepts based on laparoscopy. On a Sunday morning in 1981 it was Prof Semm, the gynecologist, who demonstrated Hans Troidl, the general surgeon, by laparoscopy, that a young female patient with acute right-sided abdominal pain was suffering from adnexitis and not from assumed appendicitis. However neither Hans Troidl nor his colleagues from the Surgical Department could value this new and promising approach at this time. The general surgeons simply failed to recognize that a new era had begun. A few years later at Clinic Merheim, Cologne University, Hans Troidl and a few other surgeons like Hans Groitl from Erlangen University, who were interested in flexible endoscopy, promoted that surgeons should use this powerful new tool in the field of general surgery. They were engaged in the Surgical Study Group on Endoscopy and Ultrasound, a task force of the German Society of Surgery (Arbeitsgemeinschaft Endoskopie der Deutschen Gesellschaft für Chirurgie -CAES). Leading members of this task force (Prof.Troidl, Prof. Groitl, Prof. Manegold and Prof. Götze - Chairman Executive Board Scientific Publisher Springer Heidelberg-New York) had the idea to establish a new scientific journal, which should be a worldwide platform for surgeons with interest in endoscopy. This journal should be a counterpart of the already existing journal `Endoscopy` which was dominated by interventional gastroenterologists and internists. The new journal was named `Surgical Endoscopy Ultrasound and Interventional Techniques` and appeared in 1987. In order to promote the new journal the First World Congress/International Congress on Surgical Endoscopy, Ultrasound and Interventional Technique was organized in 1988 in Berlin. As Congress President Hans Troidl remarked at the opening ceremony: `At this crossroads in surgery...surgeons must accept and test these modern methods (flexible endoscopy and laparoscopy)... to ensure that surgery...becomes safer, more comfortable and more versatile. In Berlin Hans Troidl for the first time met Jacques Perissat and for both a deep and true friendship emerged. In 1989 Troidl received a telephone call from Bordeaux. Perissat invited him to France with the intention to demonstrate his method of laparoscopic cholecystectomy
4 using intracorporal lithotripsy. In Bordeaux Troidl could perform his first laparoscopic cholecycstectomy under guidance of Perissat. Back in Cologne, on October 23 rd 1989 Hans Troidl established his own modified technique of laparoscopic cholecystectomy and initiated a program of endoscopic surgery at Clinic Cologne-Merheim. Hans Troidl, the Scientific Concept of Endoscopic Surgery and the development of EAES The idea of founding a European society of endoscopic surgery was born in a bar in Louisville, Kentucky during the annual meeting of SAGES in 1989. The generator of this idea was Jacques Perissat and in the present Hans Troidl, he found a strong energetic and enthusiastic friend and colleague, who supported this vision. Hans Troidl`s contributions and perceptions on the new society were invaluable to the founding process of EAES. His mantra was that a new European society must above all serve one goal: The scientific evaluation of the new revolutionary endoscopic surgery. Hans Troidl was strongly influenced by his teacher, the world famous philosopher Sir Karl Popper. Following Popper s pathway he formulated the central scientific hypothesis of endoscopic surgery: Endoscopic Surgery results in less trauma, less pain, increased comfort with equal patient safety and produces a better patient outcome. Hans Troidl therefore preferred the term patient-friendly surgery. To his mind the new society was obliged to test this hypothesis in rigorous scientific investigations. Although an enthusiastic promoter of Endoscopic Surgery Hans Troidl was deeply concerned that patient safety was at danger in the early days of the minimal invasive technology. He feared the socalled event surgeons, who would perform any operative procedures by key hole surgery in order to gain personal prestige and fame. He reminded his colleagues that open surgery has already set the standards and bounderies of patient safety and that Endoscopic Surgery as an alternative method must be performed at the same saftey level. Knowing that all inventors and explorers in history had been risk takers, he struggled to find the right balance between the risk of the new path and the safety of the tradiotional. Hans Troidl realized what kind of paradigm shift (Thomas Kuhn) had taken place in surgery. Endoscopic surgery had fundamentally changed the attitude and discussions among the surgical community. Scientific debates on traditional endpoints of patient outcome like survival and complication rate had still their justification, but new outcome measures, socalled soft data, describing patient s quality of life after surgery like comfort, fatigue and pain came into focus and served as strong arguments to establish endoscopic surgery. During the founding process of EAES Hans Troidl, as one of the founding presidents, was involved in numerous discussions on the by-laws of the new society. Difficult decisions had to be made. Where should the headquarter of EAES be located? Where and how often should EAES-meetings be organized? Who should be eligible for the Presidency of EAES. He also introduced the concept of Consensus Conferences, but he preferred the term Clearing Conferences because he is deeply convinced that in science there is no voting (more right or more wrong). In all these topics the opinion of Hans Troidl was heard and often heavily discussed. Following his strong conviction for scientific evaluation of endoscopic surgery Hans Troidl together with his surgical team from Cologne established the Scientific Committee of EAES. In June 1993 the 1 st EAES Annual Congress took place at Cologne, Germany, and Hans
5 Troidl as the Congress President had chosen as topic: Endoscopic Surgery on trial to underline his scientific view on the new technology. Due to his contributions to EAES Hans Troidl became the second President of EAES for a two years term (1993 1995), following Jacques Perissat (1990-93), organizing meetings not only in Germany or France but also in Spain and Norway and Turkey. Authored by Stefano Saad, MD, Professor of Surgery Head of the Department Visceral/Vascular/Thoracic Surgery Academic Hospital University of Cologne, Clinic Gummersbach