Félicien M. Steichen

Félicien M. Steichen (October 13, 1926 – June 27, 2011) was a Luxembourgish-born American surgeon and Professor of Surgery. He was a pioneer in the development and use of surgical staples. He and Mark M. Ravitch are considered the fathers of modern surgical stapling. Steichen was also noted for his contributions to the development of minimally-invasive surgery.

Early life Born the second son and third of five children of Joseph Steichen, a civil servant, and Anne Gonner, a Homemaker, Steichen grew up at 11 rue de la Semois, in the Péitruss (Pétrusse) Valley neighborhood of Luxembourg City, in the Grand Duchy of Luxembourg. In 1946, he graduated from the Athénée.

Medical and surgical training Steichen studied medicine at the University of Lausanne Medical School, from which he graduated first in his class in 1953. Shortly thereafter, he was offered

From 1954 to 1959, Steichen was surgical resident at Baltimore City Hospital ("BCH," now Bayview Medical Center), led by Director of Surgery Mark M. Ravitch. He was Chief Resident from 1959 to 1961, and then appointed fellow in surgery at the Johns Hopkins School of Medicine. At BCH, Steichen and Ravitch also developed a trusting, collegial relationship that extended beyond the hospital ward and lasted for 35 years.

Developing modern surgical stapling

Baltimore City Hospital In late 1958, Steichen, Ravitch, and Ravitch's then-current chief resident, Peter Weil, began laboratory experiments with stapling instruments. The staplers they used had been procured by Mark Ravitch in Moscow during a medical experts' visit to the Soviet Union earlier in 1958 that was unrelated to stapling. In early 1959, the BCH team began to use the staplers clinically. In 139 pulmonary lobectomies and segmentectomies for tuberculosis through 1961, the BCH team showed a significant reduction in life-threatening complication of bronchial fistula, from 14% using manual closures to 4.6% using staplers. This work was published in the Journal of Thoracic and Cardiovascular Surgery, Steichen's first appearance as a major author of a scientific paper.

In May, 1961, Steichen finished his residency

Lincoln Hospital: establishing the viability of surgical stapling In 1963, after two years in Luxembourg and at the U.S. Air Force Hospital in Wiesbaden, Germany, he was recruited to Lincoln Hospital and the Albert Einstein College of Medicine, in New York City, by Peter Weil, his friend, colleague and fellow former chief resident at Baltimore City Hospital. Shortly after returning to the United States, he became an American citizen.

Steichen and Ravitch were the first to understand the importance of the modern instruments, and the first to develop many of the procedures in which the instruments could be applied. In that sense, they can legitimately be called the Fathers of Modern Stapling, not just American Stapling. Ravitch and Steichen were always scrupulous about crediting their predecessors in the development of mechanical sutures; indeed, if the names Hultl and von Petz survive, it is largely because Ravitch and Steichen habitually cited their elegant and brilliant work in all their major monographs. Yet large-scale applicability of mechanical suturing did not come about until Ravitch and Steichen began developing techniques for modern instruments and popularizing them in the surgical community through their writings, films and teaching seminars. As the Surgeon and Historian, A.P. Naef, has stated: "[in 1963,] extended clinical use and potential industrial production [of surgical staplers] were far from obvious."

Two events served to catalyze the development of modern surgical stapling: at Lincoln Hospital, Weil gave Steichen full freedom to use the hospital's surgical laboratory to focus on testing and developing surgical stapling. In Baltimore, Mark Ravitch met with an Entrepreneur named Leon Hirsch (later Founder of the United States Surgical Corporation) about whether surgical stapling could be commercially viable. The result was an informal group, comprising Ravitch, Steichen, Hirsch and eventual Executive Vice President of U.S. Surgical Turi Josefsen. Hirsch has called this group "a model of the way in which the private sector and Academia can work together." Ravitch and Hirsch focused on de-constructing the Soviet instruments and creating American prototypes. Steichen's priority became to test the new instruments, adapt them to surgical procedures, and develop new operations for their use. Initial prototypes for the workhorses of surgical stapling, the TA and GIA staplers, were created by 1964.

At Lincoln, from 1963 to 1969, Steichen was the first to study, then apply clinically, many of the surgical stapling techniques that are in routine use today. These include the first:

clinical functional end-to-end anastomosis; clinical gastrectomy using a stapling instrument; clinical pulmonary lobectomy using the GIA stapling instrument;

The functional end-to-end anastomosis, in particular, is credited to Steichen.

The team also: studied use of the GIA stapling instrument inserted from above and below to avoid any cul-de-sac at all in the Duhamel Procedure; of surgery at the University of Pittsburgh School of Medicine and associate surgeon-in-chief at Montefiore Hospital of Pittsburgh, University of Pittsburgh Medical Center. He focused particularly on the esophagus, as well as gastric (stomach) reconstructions, intestinal pouches, and operations in the lowest parts of the pelvis. When U.S. Surgical Corporation's EEA circular stapler came on line in 1979, surgeons now possessed an instrument that could accomplish – in hard-to-access places – what hand suturing (for all but the most skilled surgeons) could not. Steichen and Ravitch were the first to describe its use in many operations on the esophagus, the stomach and the junction of the intestine and rectum.

Workshops From 1973 to 1986, Steichen and Ravitch organized post-graduate workshops in surgical stapling in Pittsburgh. Each of the 26 workshops trained 40 surgeons and 20 operating room nurses, or more than 1,000 surgeons and 500 nurses in total.

New York Medical College and Lenox Hill Hospital In 1978, Steichen became professor of surgery He was Director of Surgery at Lenox Hill Hospital until 1987, Stapling in Surgery has been called the "original monograph describing the application of mechanical stapling devices to gastrointestinal surgery." It marks the definitive exposition of stapling technique in most general and thoracic surgery. Principles and Practice of Surgical Stapling compiles the contributions of "approximately 40 participants in the International Symposium [that Steichen and Ravitch had organized in Pittsburgh in] 1986, and covers the use of staples in esophageal, gastric, colorectal and thoracic surgery." The third book, Current Practice of Surgical Stapling is a history of, and compilation of the state of the art in, surgical stapling.

Influence

Steichen was the first to bring surgical stapling to Europe, in Geneva from 1969 to 1970. He invited students and surgeons from Europe and North Africa to come to Pittsburgh or NYMC to learn about surgical stapling.

Steichen travelled to Europe to demonstrate surgical stapling technique and to share his knowledge. In 1978, he and Mark Ravitch travelled to Taipei, Kuala Lumpur, and Tokyo to spread stapling technique in Asia. In 1982, Steichen travelled to El Salvador to work with surgeons there on stapling techniques. By 1984, he was a principal participant in international symposia devoted exclusively to stapling, as at the University of Amsterdam or the University of Düsseldorf, and later, at Brive-la-Gaillarde, and Biarritz, France.

The Pitt Workshops were eventually transformed into the international symposia on stapling. The second such international symposium (and First European Congress on Surgical Stapling), organized ("...the 'Second Symposium and First European Congress on Stapling' [was] organized in 1988 in Luxembourg by [Ravitch] and Felicien M.) Steichen." This was a personal triumph for Steichen, but also a coming of age for surgical stapling. Over 500 surgeons since it attracted attendees from Eastern and Western Europe, China, Japan, Australia, and North and South America, and offered them both scientific and laboratory sessions on stapling. and the French Academy of Surgery.

Minimally-invasive surgery

Steichen contributed to the newly emerging field of minimally invasive surgery (MIS) in three ways: In 1993, Steichen became the first director of the new Institute for Minimally-Invasive Surgery at St. Agnes Hospital, in White Plains, New York. blend of laparoscopic techniques and three-dimensional drawings explaining these techniques.

Books Steichen authored or co-authored 18 books, 50 book chapters, and 3 monographs. Kremer, Karl, Werner Platzer, Hans Wilhelm Schreiber and Félicien M. Steichen, Minimally Invasive Abdominal Surgery, Thieme New York, New York, 2001. (GTV) and 0-86577-639-3 (TNY). (Authorized translation of the German edition of Minimal-invasive Chirurgie, vol. 7/2 of Kremer, Lierse, Platzer & Schreiber, Eds., Chirurgische Operationslehre, Georg Thieme Verlag, Stuttgart, 2001. Ravitch, Mark M. and Félicien M. Steichen, Atlas of General Thoracic Surgery, W.B. Saunders Company, Philadelphia, 1988. . Ravitch, Mark M. and Félicien M. Steichen, Current Practice of Surgical Stapling, Lea & Febiger, Philadelphia, 1991. . Ravitch, Mark M. and Félicien M. Steichen, Principles and Practice of Surgical Stapling, Year Book Medical Publishers, Chicago, 1987. . Steichen, Félicien M. and Mark M. Ravitch, Stapling in Surgery, Year Book Medical Publishers, Inc., Chicago, 1984. . Steichen, Félicien M. and Roger Welter, eds., Minimally Invasive Surgery and New Technology, Quality Medical Publishing, Inc., St. Louis, 1994. . Steichen, Félicien M. and Ruth A. Wolsch, Mechanical Sutures in Operations on the Small & Large Intestine and Rectum, Cine-Med, Inc., Woodbury, Connecticut, 2004. . Steichen, Félicien M. and Ruth A. Wolsch, Mechanical Sutures in Operations on the Lung, Cine-Med, Inc., Woodbury, Connecticut, 2008. . Steichen, Félicien M. and Ruth A. Wolsch, Mechanical Sutures in Operations on the Esophagus and Gastroesophageal Junction, Cine-Med, Inc., Woodbury, Connecticut, 2008. . Steichen, Félicien M. and Ruth A. Wolsch, Mechanical Sutures in Operations on the Stomach, Biliary Tree & Pancreas, Cine-Med, Inc., Woodbury, Connecticut, 2008. . Steichen, Félicien M. and Ruth A. Wolsch, History of Mechanical Sutures in Surgery, Cine-Med, Inc., Woodbury, Connecticut, 2008. . The Surgical Clinics of North America, Symposium on Stapling Techniques, Vol. 64, No. 3, June 1984. W.B. Saunders Company, Philadelphia. .

Papers Steichen also authored or co-authored over 125 articles during his career. 10 of which were later converted into video by the Ciné-Med Corporation, and are now in the library of the American College of Surgeons. Some of these were combined and given new names when re-issued between 1989 and 1991: Stapling in the Gastrointestinal Tract with the Use of Historical Stapling Instruments Colo-Sigmoidectomy and Circular End-To-End Stapled Colo-Rectal Anastomosis Paulino Jejunal Pouch, Gastric Replacement Eversion, Crossing, and Variations in Design of Linear Staple Lines Thoracoscopic Modified Belsey Fundoplication The Effect of Surgical Stapling on Technical Concepts in Thoracic and Abdominal Surgery Sequential Anastomosis Resection (Anastomosis-Resection Integree) Intersecting Linear and Circular Staple Lines Everting Stapled Closure of the Bronchus Pulmonary Vessels and Parenchyma in Pulmonary Lobectomies and Parenchymal Resections Creation of Substitute Autologous Organs

Personal life Steichen married Michèle Queinnec on July 2, 1961, in Brignogan-Plages, Finistère, France. She is an Art Historian who worked as a Docent at the Metropolitan Museum of Art and the Cloisters for over 20 years. They were married for 50 years. The Félicien M. Steichen Prize for Technical Research in General Surgery is given by the Deutsche Gesellschaft für Chirurgie (German Surgical Association) each year to a deserving surgical researcher from among papers submitted to the Association for the prize. Fellow of the American Surgical Association Fellow of the Halsted Society Fellow of the American College of Surgeons Honorary Member of the Deutsche Gesellschaft für Chirurgie (German Society for Surgery) Commander of the Order of the Oak Crown of the Grand Duchy of Luxembourg Officer of the Order of the Oak Crown of the Grand Duchy of Luxembourg