Dr. Keith Lillemoe, the chairman of the surgery department at the Indiana University School of Medicine and former program coordinator for surgical residencies at Johns Hopkins, lectured Tuesday on the past, present and future of surgery. The presentation was the fifth in the 10th annual "Mini Medical School Lecture Series," hosted by the South Bend Center for Medical Education and sponsored by the Medical Education Foundation.
The Indiana University School of Medicine has been at the forefront of many advances in surgery, even before the school graduated its first class of 25 students in 1907, Lillemoe said. On June 15, 1867, for example, Dr. John Bobbs performed the first cholecystotomy or draining of an infected gall bladder in his office in Indianapolis.
From 1912-46, Dr. Willis Gatch served as the chairman of the surgery department and later dean of the medical school. Gatch pioneered the adjustable hospital bed and conducted research in NO2 and O2 anesthesia.
"It was at this point that IU really made its trajectory upwards," Lillemoe said.
Dr. Harris Shumacker served as surgery chairman at IU from 1948-68 and made cardiac surgery a priority. While World War II introduced challenges to the academic medical community, it also led to advances in treating patients.
"It was at the end of World War II and in the 50s that really saw the rejuvenation of surgery," Lillemoe said.
Dr. John Jesseph succeeded Shumacker as chairman of the surgery department and reoriented the focus toward general surgery.
In more recent times, Indiana University School of Medicine has experienced a period of increased growth, progress and expansion with regard to surgery, Lillemoe said. In the late 1990s, Indiana University's hospital consolidated with the Riley Children's Hospital and Methodist Hospital. The three facilities have completed several expansions in recent years and are linked via a monorail system.
"We now have the best of both worlds," Lillemoe said.
Indiana University's Center for Advanced Technology has also allowed medical students and residents to receive top quality training using virtual reality, endoscopic techniques, microsurgery and laser technology.
"Surgery can no longer be 'see one, do one, teach one,'" Lillemoe said. "I'm happy to say that IU is at the forefront of this [new technology]."
Currently, the surgery department at IU's medical school employees 72 faculty members and the institution received over $7 million in research grants for 2002-03.
In the future, surgery will continue to evolve as it faces new challenges and opportunities and as demographics and technology change, Lillemoe said.
Cancer and an aging population are two challenges that surgery currently faces, but increased advances in technology make possible new treatment options, he said. Current genetic testing, for example, allows doctors to identify children who will develop a severe form of thyroid cancer later in life and remove the thyroid to prevent such an outcome. Addition-ally, mechanical heart support systems make it increasingly possible to keep ill patients alive until a suitable heart becomes available for transplantation, he said.
Perhaps just as important, the public availability of data on particular surgeons and facilities makes it possible for patients to research the best options for procedures. Larger education hospitals that perform a high volume of a particular procedure typically have a significantly lower in-hospital mortality rate than smaller community facilities that perform the procedure rarely. Such knowledge can help save patients' lives and reduce costs by minimizing the time the patient spends in the hospital recovering.
"It shows what can happen in regards to saving lives and saving money," Lillemoe said.
Lillemoe received his undergraduate degree from the University of South Dakota and his M.D. from Johns Hopkins University School of Medicine, where he also completed his surgical training. He is president-elect of the Society of Surgery of the Alimentary Tract, vice-president for the Society of Clinical Surgery and director of the American Board of Surgery.
The "Mini Medical School Lecture Series" concludes next Tuesday with a presentation by Dr. Gregory Gramelspacher on Medicare reform.
