The Life of Rudolf Nissen: Advancing Surgery Through Science and Principle

Abstract

Rudolf Nissen (1896-1981) was a surgeon whose career began in Germany during the first third of the 20th century, a period of rapid progress in biomedical technology, during which neurosurgery, anesthesiology, and other specialties emerged. A protégé and later close colleague of thoracic surgery pioneer Ferdinand Sauerbruch (1875-1951), Nissen resigned from the Berlin Charité Clinic and left Germany in 1933, in response to the rise of Nazi fascism. Throughout his subsequent career in Istanbul, Turkey, the American cities of Boston and New York, and finally Basel, Switzerland, Nissen developed innovative surgical techniques, advocated for patient-centered medical education, and promoted surgical subspecialization. A lifelong proponent of clear scientific writing, Nissen expressed, in extensively published work, his philosophy that progress in surgery depends critically on rigorously applying the scientific method, upholding professional integrity, and respecting human dignity.

Risk Factors for Adverse Outcome for Elderly Patients undergoing Curative Oncological Resection for Gastrointestinal Malignancies

“…The decision to operate at all or adopt a palliative approach is particularly complex in these acute circumstances. Rudolf Nissen, one of the fathers of modern surgery, is quoted in saying at the end of his career in the 1950s: 'I believe that more misfortune arises through omission or hesitation in … surgery than through operative complications' [42]. Nissen's statement highlights the importance of the surgeon's role in an honest and sensible communication with the patient and the family who will more often than less follow his or her advice as long as they developed trust and respect for their doctor.…”

Reinforcing the aneurysmal aorta by additional layering: old and new strategies to prevent rupture

“…Upon examination by the attending surgeon, Rudolph Nissen, a large AAA was detected. Nissen, himself a prominent surgeon known for pioneering achievements in gastroesophageal surgery [37,38], decided to apply "cellophane" wrapping [36,39,40]. The anterior two-thirds of the aneurysm were wrapped with a film that very likely was polyethylene, not true cellophane.…”

Pioneering orthopaedic trauma surgery in Turkey: Burhaneddin Toker (1890–1951), the stormy 1930s, and refugees running from Nazism

“…Although the Law for the Restoration of the Professional Civil Service exempted Nissen because he was a World War I veteran who had served at the front, foreseeing the approaching troubles he resigned and emigrated to Switzerland in May 1933. 4,28 Already famous before he came to Turkey, Nissen was especially known for his innovations in thoracic surgery. He achieved international scientific acclaim when he performed the first-ever successful total pneumonectomy in 1931.…”

“…4,27 During his Istanbul years, he devised a new operative technic in 1936 for the treatment of gastroesophageal reflux and later this technique, which is still practiced widely, was dubbed the Nissen fundoplication. 28,29 During World War I, Nissen was shot by a gun in his lung at the front which led to lifelong problems. An abscess formed in his lung around the retained bullet in 1939 and he left for the United States after five and a half years in Istanbul to undergo surgery and never came back.…”

“…An honorary doctoral degree from Hacettepe University, Ankara was awarded to Nissen posthumously in 1983. 28 Nissen was six years junior to Burhaneddin Toker, but this did not pose a problem between them. (Figure 3) Toker's speaking fluent German and familiarity with the German culture also should have eased communication.…”