Erich Mühe and the rejection of laparoscopic cholecystectomy (1985): a surgeon ahead of his time

Abstract

During the early 1980s, news of Semm's laparoscopic appendectomy was rippling through German medical circles. Erich Mühe, fascinated by Semm's technique and spurred by successes of the Erlangen endoscopists, came up with the idea of laparoscopic removal of gallstones. In 1984, Mühe had already worked out the details of an operative laparoscope, the "Galloscope," and on September 12, 1985, he carried out the first laparoscopic cholecystectomy. Later, he modified his technique and operated through a trocar sleeve. Finally, he designed an "open laparoscope" with a circular light. By March 1987, Mühe had conducted 97 endoscopic gallbladder removals. He published information about his technique at the Congress of the German Surgical Society (April 1986) and at other surgical meetings in Germany. His concept, however, was ignored. In the middle of the 1980s, the surgical community was still not prepared for the era of "minimally invasive therapy." Erich Mühe was a surgeon ahead of his time.

Figure 1.

Erich Mühe. (1986) Fig. 12-14 in Highlights.

Figure 2.

The “Galloscope” of Mühe had side-view optics, an instrumentation channel with valves, light conductor, and duct for creating pneumoperitoneum. Fig. C-9 in Highlights.

Figure 3.

Mühe followed each step of the surgical laparoscopy established by Semm; he first used lower abdominal access for the “Galloscope.” Later, Mühe introduced the laparoscope under the right costal arch. Fig. 12-7 in Highlights.

Figure 4.

“Open Laparoscope” according to Mühe (1986) was manufactured out of aluminum and vastly improved the light source by attaching a circular illumination to the distal end. Only once did Mühe present his “open tube with circular light,” at a CAES symposium held in October 1987. Fig. 12-10 in Highlights.

Figure 5.

Mühe had to watch from the sidelines as others received credit for the laparoscopic “revolution.” First, on April 21, 1992, Mühe received official honors for pioneering work in endoscopic surgery. From right to left: Wittmoser, Mühe, Buess, Pier, and Götz at a opening ceremony of the 1992 Congress of the German Surgical Society. Fig. C-11 in Highlights.

Figure 6.

“Biking gives me an intensive sense of life.” Erich Mühe is the 1985 German and the 1987 World Champion in a bike race for physicians. Fig. 12-17 in Highlights.