Exhibit of the Month: The Civiale Set

05 April 2018 By Friedrich Moll

Every month, an EAU History Office member chooses an item of particular interest from the European Museum of Urology. This instrument was chosen by Dr. Friedrich Moll, urologist and medical historian of Düsseldorf, Germany. Its historical importance lies in the fact that it heralded the true beginnings of endoscopic surgery.

The big Civiale Set introduced a new era of urology: from “cutting on the stones” to blind lithotripsy.

In 1824, Jean Civiale (1792–1867), a French proto-urologist, designed, described and used his lithotrite to perform “blind” transurethral lithotripsy, which was later called the first minimally invasive procedure. Civiale reported on his first lithotripsies during the session of the Academy of Sciences in Paris on 22 March 1824. The date given for the first operation by him was 23 January 1823. The Academy proclaimed that Civiale was the first surgeon to create and instrument and procedure that truly could remove bladder stones without resorting to the ancient method of perineal lithotomy.

This also led to a discussion within the Paris Academy of Medicine of the usefulness of statistics to outline the results of operations: an important marker of the development of scientific urology in the 19th century, which is now a base of evidence based medicine in general.

This set was manufactured by the famous French cutler and instrument maker, Joseph Charriere (1803-1876). Charriere was responsible for several “inventions” of new instruments within operative medicine and was a teacher of several protagonists in this handcraft including Josef Leiter of Vienna.

The mid 19th century saw further professional disagreement in urology on the techniques and instruments for lithotripsy, for example,  “trilabe” versus “split brake” and a discussion about priority darkens this invention. Find out more about this topic in the European Museum of Urology.

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