Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

You are welcome to submit questions and suggestions using our "Contact Us" form. The information on this blog follows the terms on our "Privacy and Security Statement" and cannot be construed as medical guidance or instructions for treatment.

We have 199 guests online

A Moment in History

Andreas Vesalius Bruxellensis (1514- 1564)

A Flemish anatomist and surgeon, Andreas Vesalius was born on December 31, 1514 in Brussels, Belgium. He is considered to be the father of the science of Anatomy. Up until his studies and publications human anatomy studies consisted only on the confirmation of the old doctrines of Galen of Pergamon (129AD - 200AD). Anatomy professors would read to the students from Galen's work and a demonstrator would point in a body to the area being described, if a body was used at all. The reasoning was that there was no need to dissect since all that was needed to know was already written in Galen's books. Vesalius, Fallopius, and others started the change by describing what they actually saw in a dissection as opposed to what was supposed to be there. 

Vesalius had a notorious career, both as an anatomist and as a surgeon. His revolutionary book "De Humani Corporis Fabrica: Libri Septem" was published in May 26, 1543. One of the most famous anatomical images is his plate 22 of the book, called sometimes "The Hamlet". You can see this image if you hover over Vesalius' only known portrait which accompanies this article. Sir William Osler said of this book "... it is the greatest book ever printed, from which modern medicine dates" 

After the original 1543 printing, the Fabrica was reprinted in 1555. It was re-reprinted and translated in many languages, although many of these printings were low-quality copies with no respect for copyright or authorship.

The story of the wood blocks with the carved images used for the original printing extends into the 20th century. In 1934 these original wood blocks were used to print 617 copies of the book "Iconaes Anatomica". This book is rare and no more can be printed because, sadly, during a 1943 WWII bombing raid over Munich all the wood blocks were burnt.

One interesting aspect of the book was the landscape panorama in some of his most famous woodcuts which was only "discovered" until 1903.

Vesalius was controversial in life and he still is in death. We know that he died on his way back from a pilgrimage to Jerusalem, but how he died, and exactly where he died is lost in controversy. We do know he was alive when he set foot on the port of Zakynthos in the island of the same name in Greece. He is said to have suddenly collapsed and die at the gates of the city, presumably as a consequence of scurvy. Records show that he was interred in the cemetery of the Church of Santa Maria delle Grazie, but the city and the church were destroyed by an earthquake and Vesalius' grave lost to history. Modern researchers are looking into finding the lost grave and have identified the location of the cemetery. This story has not ended yet.

For a detailed biography of Andreas Vesalius CLICK HERE.

Personal note: To commemorate Andrea Vesalius' 500th birthday in 2014, there were many scientific meetings throughout the world, one of them was the "Vesalius Continuum" anatomical meeting on the island of Zakynthos, Greece on September 4-8, 2014. This is the island where Vesalius died in 1564. I had the opportunity to attend and there are several articles in this website on the presence of Andreas Vesalius on Zakynthos island. During 2015 I also attended a symposium on "Vesalius and the Invention of the Modern Body" at the St. Louis University. At this symposium I had the honor of meeting of Drs. Garrison and Hast, authors of the "New Fabrica". Dr. Miranda

Follow MTD:

Rare & Collectible Books at AbeBooks.com 

bookplateink.com

Leon Hirsch and the founding of the United States Surgical Corporation

Published: Thursday, January 02, 2025 07:00 | Written by: Efrain A. Miranda, Ph.D. | Hits: 119

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Leon C. Hirsch
Leon C. Hirsch


Leon C. Hirsch (1927 – 2023). The story of the development of surgical staplers in America cannot be told without the presence and vision of Leon Hirsch, an American business executive and entrepreneur... 

After his 1958 trip to the USSR with two other surgeons, Dr. Mark Ravitch tried to have his colleagues take interest in the surgical stapling technology. Dr. Ravitch and Dr. Felicien Steichen stated in one of their books “Interestingly enough, a number of American manufacturers, knowing of our interest, visited our laboratories and operating rooms to see how the staplers performed, but for one reason or another decided that there was no future in stapling – to their later expressed regret! (1)”

There have been several apocryphal stories, including one where L. Hirsch was a down-on-his luck shoe salesman (not true) that met with his friend Ravitch as they both lived close to each other (not true either). So, what is the real story of how Leon Hirsch met Mark Ravitch and founded the United States Surgical Corporation (USSC).?

The original story, as told by Leon Hirsch, can be found in the May 1990 edition of the medical journal “Surgical Rounds” (2), an edition entirely dedicated as a “Festschrift (commemorative publication) to Mark Ravitch, MD”, after his death.

Leon Hirsch says: “In 1963, I was engaged in a discussion with a patent broker in New York City when I noticed a strange-looking metal object on his desk, which he described to be a Russian surgical stapler. Further inquiry led to the disclosure that this patent broker had been retained by the Russian government to try to market Soviet-made surgical staplers in America”. This patent broker had tried to garner the attention of at least five companies (Ethicon, Davis & Geck, American Hospital Supply, Aloe Corp., and Ipco, Inc) with no success.

This statement by Leon Hirsch goes against everything I knew, that is, that Dr. Ravitch was the one trying to bring the patents from the then USSR to the USA. In another version of this story Dr. Ravitch bought the patents and tried to sell them to USA medical companies! None of these are true.

Mark M. Ravitch, MD

Mark M. Ravitch, MD 

Felicien Steichen, MD

Felicien Steichen, MD

Leon Hirsch continues “The patent broker offered to lend me his information book on Russian stapling… the package disclosed that recently, three American surgeons had been to Moscow to study Russian surgical techniques, including the technique of surgical stapling”. This statement by the Soviet government is not correct, as Dr. Ravitch and two other surgeons had been to Moscow, yes, but to study Russian transfusion and resuscitation techniques, and the fact that they ended observing surgery (and seeing surgical staplers at work) was serendipitous. That in itself is another story.

Leon Hirsch phoned Dr. Ravitch who at the time was working at John Hopkins. They planned to meet for 15 minutes, which stretched into lunch, then back to Dr. Ravitch’s office for a demo of the staplers. The discussion veered into the difficulty of loading the staples one by one in this large, cumbersome device. “Intrigued, I asked Dr. Ravitch to borrow the instrument, took it back to my home workshop, and realized that the answer to the loading problem was to separate the instrument from the staples. I made a model of a cartridge (in balsa wood) that could be preloaded with staples and easily slipped into the instrument. Dr. Ravitch was elated”. The idea of the interchangeable cartridge was Hirsch's!

With this idea, and financial support that he pursued, Leon Hirsch proceeded to form the United States Surgical Corporation, with four initial employees. It took three years (1964-1967) to develop a stainless steel surgical stapler that had interchangeable preloaded stapler cartridges that were up to American standards. Since then, thousands of patients have benefited from these devices.

An interesting side note is that Leon Hirsch wanted Mark Ravitch to play a part in this new company, but Ravitch declined. Hirsch states: "Dr. Ravitch said that he had no commercial interest in pursuing such a project but he would be willing and happy tp evaluate, first in the laboratory and if successful clinically, such new devices. In typical Ravitch fashion he added that he planned to report exactly what he found, good or bad". 

The story of USSC continued through acquisitions, so USSC became Tyco, then Tyco Healthcare, Covidien, and today is the Stapling Division of Medtronic.

Leon Hirsch and USSC confronted the conundrum of training surgeons in the use of the new staplers. To this end he initially hired eight nurses, but eventually created a six-week extremely difficult grueling training program that took sales representative from basic medical terminology to being able to direct the surgeon through the steps on the use of the surgical staplers in the procedure. By doing this, he changed the way medical devices surgical representatives operate in the medical arena. Some of the readers of this article probably went through this challenging training program! In fact, some medical companies started trying to hire people that had been trough this training.

Drs. Ravitch and Steichen continued their quest training surgeons on the benefits of surgical stapling, while at the same time testing and improving the newer devices that Leon Hirsch and USSC developed.

In 2018, The Mullings Group interviewed Leon Hirsch (then 91 years old) and published a video of this interview, where he covers these topics and more. This video now forms part of the History of Surgical Stapling.

My personal thanks to Joe Mullings, Chairman & CEO of the Mullings Group Companies for his permission to share this video and some video captures for this article.

Sources:
1.  “Current Practice of Surgical Stapling” Ravitch, M; Steichen, F; Welter, R. 1991 Lea & Febiger Publishers, USA.
2. “Festschrift to Mark Ravitch, MD” Surg Rounds J. May 1990. Romaine Pierson Publication.
3. "Stapling in Surgery" Ravitch, MM; Steichen, FM.1984 Yearbook Medical Publishers USA.
4. The Origin of Medical Terms" Skinner 1970
5. "Notes by Dr. Mark Ravitch on Trip to Russia - September 1958" Personal notes.
6.“Leon Hirsch: Opportunity is Everywhere” YouTube video by the Mullings Group. Oct 2018
7.  “Tribute to Felicien Steichen” SAGES Minimally Invasive Surgery Videos. April 2012 
All images are in the public domain, or. have been authorized for use.