Nikolai Ivanovich Pirogov (1810–1881), the founder of thyroid surgery in Russia. Towards the 215 th anniversary of Russian genius

Nikolai Ivanovich Pirogov (1810–1881) was a genius of Russian surgery. In 1831 at the age of 20, at a written test todefend his Doctor of Medicine degree, he presented his understanding of the structure and function of the thyroidand the major checkpoints of thyroidectomy. He was pretty accurate in describing thyroid morphology and clinicalfeatures of thyroid disease, and also drew important conclusions about ways to prevent dangerous complicationsduring thyroid surgery. Pirogov described approaches to the thyroid (“elliptic, longitudinal, cruciform neck cuts”), andstages of thyroidectomy (“bilateral ligation of the superior thyroid arteries…exposure of the thyroid…ligation of theinferior thyroid artery”) in detail. Pirogov wrote: “Prior to extirpation, ligation of the superior thyroid artery should beperformed and preferably on both sides. Regarding the inferior thyroid artery, due to its deep location under the gland,it has to be ligated after the lower end of the thyroid is lifted…”. In May 1847 in St. Petersburg he performed a number ofexperiments with ether anesthesia in animals and on himself, and was the first in the world to perform thyroid resectionunder general anesthesia, less than a year after the beginning of clinical use of ether by Dr. John Warren (USA). Similaroperations were performed in 1852-1853, again, using 30-40 ligatures, which was unusual in European surgical practiceat that time. In 1847, in Vladikavkaz, Russia, Nikolai Pirogov was the first surgeon to use general anesthesia duringa thyroidectomy.2 The patient was a 17-year-old girl with a goiter causing compression of the trachea.15 The surgerywas quite difficult since the “tumor was of a size of an apple” and “more than 30 ligatures were required.” The woundhealing was complicated “with pus.” The outcome of surgery was nevertheless a success. Soon Pirogov performedthree more thyroid surgeries in St. Petersburg.
Keywords: Pirogov, history of surgery, history of thyroid surgery
Conflict of interest. The authors have no conflicts of interest.
Funding. Absent.