History of Mayo Clinic Rochester

History of the Department of Urology Mayo Clinic Rochester Why in the world Rochester, Minnesota? The vision of Urology (Drs Millet and Braasch) The inception of Post Graduate Punch (Braasch-Bumpus) Resectoscope Controversy regarding urologists Division of Urology becomes and Post graduate Medical Education Medical Education (Fellowships) becoming open surgeons at the Mayo Clinic Department of Urology in 1970 The father of Mayo Clinic, Dr. William Worrall Mayo, was born in at the Mayo Clinic Dr. Hermon Bumpus modifi ed the Braasch resectoscope by adding Eccles, England, and studied medicine at Manchester, Glasgow At the turn of the 20th century, the practice of urology was Dr. Leo Burger, who had modifi ed the cystoscopic lens to both a Bugbee electrode to the resectoscope to control bleeding and by The debate on the defi nition of what constitutes a urologist that began in 1939 Dr. Ormond Culp (chair of the division-department from 1962-1972) and London before immigrating to the United States in 1845. He limited to the treatment and complications of gonorrhea, improve visualization and Drs. Hugh Hampton Young and the development of a closed loop fl uid irrigation system that combined in the British Medical Journal came to a head in 1947, when the American Board pushed for and received separation of the Division of Urology from initially worked as a pharmacist at Bellevue Hospital in New York syphilis, genitourinary tuberculosis, bladder calculi, urinary JT Geraghty of Johns Hopkins to gain expertise in treating Dr. Will and Charlie Mayo were among the fi rst physicians to recognize temperature control of the irrigating fl uid with maintenance of water of Urology denied two graduates of the Mayo Urology Residency to sit for board the Department of General Surgery in 1970. The separation from and as a tailor in Lafayette, Indiana, prior to completing his medical incontinence and urinary retention. The Mayo Brothers however prostatic and urogenital lesions. He learned the technique of the need for post-graduate medical education, encouraged by their pressure by a circulating pump. The later modifi cations, a entirely new certifi cation “due to failure from being trained to do open urologic surgery”. At the Department of General Surgery was cleared by the Mayo Board degree at Indiana Medical College in 1850. Upon graduation he was had a different vision. As dedicated general surgeons, they retrograde cystography and pyelography using a silver solution, father to routinely take sabbaticals for educational purposes. Although concept at that time, were adapted to improve aseptic technique and that time all members of the Department of Urology, Drs. Thompson, Emmett, of Governors and was based upon the unique endoscopic skills of employed at the University of Missouri, medical department where he knew that the surgical techniques employed were based upon a process developed by German surgeons Drs. Lichtenberg and they early on encouraged the staff to do likewise, they soon realized reduce postoperative complications during prostatic resection. The Cook, Pool and Greene were world renown for their expertise in transurethral the urologist, the prestige of the division, and the concept that a contracted malaria. His goal upon leaving Missouri was to “drive until accurate diagnosis and that the diagnosis of urologic conditions Volecker and currently employed at Hopkins. this would not be practical in the long term and sought to enhance development of the Braasch-Bumpus punch resectoscope in 1927 surgery; indeed, they had developed or enhanced techniques for transurethral department would allow recognition of the increased national and I get healthy, die, or see no one with malaria”. Rochester, Minnesota, were in their infancy. post-graduate medical education on regional levels. With this in (Further modifi ed by Dr. Gershom Thompson in 1935) was however removal of ureteral and bladder stones, treatment of bladder tumors and benign international stature of the urologic practice. Following his educational journey, he returned to Rochester became his home town based upon job opportunity as a military mind, Dr. Will took several of his sabbaticals to observe post-graduate directly competing with the “hot loop” resectoscope developed in prostate disease but were blocked by the Mayo General Surgery Department It was the vision of Dr. William Mayo, who in 1898, asked Dr. where he developed a diagnostic and operative cystoscope surgeon for the regional US Army draft board and the only county in medical training throughout the US and Europe during the 1907-1914 1920 by Dr. John Caulk of St Louis. Although the two methodologies from performing open surgery. With the recognition that the Board of Urology Melvin Millet, (a graduate of the University of Minnesota, 1895 that perfected the ability to introduce ureteral catheters Minnesota without a natural lake (no malaria). time period. During these visits he observed that interns and resident competed against each other for the next 40 years, the hot loop had changed their criteria for membership in 1947 and that they were not going with an additional year of training in urology in London) to through separate ports that were within the cystoscope, thus Innovation in the assistants were treated like “fl unkies” to the staff physician performing resectoscope would eventually win out. to recognize any physician who trained at Mayo Clinic to be eligible for board join their staff. Dr. Millet was to be the third associate outside enabling canalization of the ureteral orifi ces under direct the “scut work” with little formal education or the opportunity to learn certifi cation in urology, an intense concern arose that Mayo Clinic would lose of the brothers. Dr. Will requested that Dr. Millet dedicate vision. With minor modifi cations, the Braasch cystoscope Treatment of Urinary Calculi surgical techniques with “hands on experience” surgery usually being national and international prestige. Although the Department of General Surgery his practice to diagnosis and treatment of the diseases of the that he developed and failed to patent was the predominant taught by observation alone. In 1915 Dr. Will Mayo developed several adamantly fought against urologists becoming open surgeons, the Mayo Board of Out of the rubble comes a gem urinary tract. As the habit of the brothers they sent Dr. Millet to cystoscopic instrument used from 1910 to 1970. During this 3-year formalized fellowships (post internship and residency) at Mayo Governors bypassed their veto in 1950 and personally hired Dr. Ormond Culp on Beginning in 1967 the Departments of Urology and Nephrology Germany to evaluate the cystoscope that was then being used time span, Dr. Braasch recognized that the colloidal silver Defending the TURP, Defi ning the TUR Clinic in the various specialties. The fellowships developed followed staff. Dr. Culp had completed his residency at Johns Hopkins Hospital under Drs. became world famous with arguably one of the fi rst metabolic stone by Dr. Maximilian Nitze and to review another new technology, solution used for retrograde pyelography was associated with Mayo Clinic emerged from the rubble of a tornado that struck a formalized educational plan, with all of the “fellows” having to syndrome and the Division of Mayo Hugh Hampton Young, Hugh Jewett and William Scott, had practiced endoscopic clinics in the world that combined the efforts of the two departments the X-ray machine by Dr. William Roentegen. Their purpose sterile abscess formations in the renal cortex if the solution Rochester, Minnesota, in August of 1883. The twister killed more spend time in the areas of clinical diagnosis, research +/- surgery, and and open urologic techniques in the US Army Medical Corp during WWII and had in the management of stone disease. Dr. Lynwood Smith for decades was to see if the combination of these two methodologies had had infi ltrated into the renal parenchyma. He subsequently than 24 individuals and injured another 40. This incident prompted +/- endoscopy (depending on specialty). Weekly didactic and patient Urology helping establishment of Urology been on the urology staff at Henry Ford Hospital in Detroit. Urology subsequently led the efforts from nephrology, and although a variety of urologists applicability to a urologic practice. became a major advocate to pursue the development of better the Head Mother, Sister Alfred Moes from a local convent to approach management conferences were mandatory and built into the schedule. became the third recognized surgical sub-specialty at Mayo Clinic allowed to do worked with Dr. Smith, it was Dr. Joseph Segura that eventually led techniques and different solutions for use in the radiographic as a separate fi eld from General Surgery Dr. William W. Mayo to establish a hospital for Rochester. Dr. WW Dr. Millet returned to Mayo Clinic with the concept of how to The fi rst fellowships at the clinic were offered in the 1915-1916 open surgical procedures following orthopedic and plastic surgery. the Department of Urology in this fi eld. In 1981 Dr. Segura attended assessment of the genitourinary tract. He published the fi rst Mayo then 63 years of age, envisioned that his sons Dr. William combine these two modalities for the diagnosis of genitourinary school year and became an instant success. a urological conference in England and reviewed a case presentation comprehensive collection of genitourinary radiographic studies on how a group of German physicians had inserted a guide wire from J. Mayo (University of Michigan, 1883) and Dr. Charles H. Mayo problems. Dr. Millet was the fi rst physician to develop a From 1932-1947 urologists at Mayo Clinic performed between 800- entitled “Pyelography” that became a instant classic in 1915. the back into the kidney and sequentially dilated up the tract 2 mm (Northwestern University, 1888) would take over his practice. His technique to use water instead of air as the medium for 1000 TURP’s per year.

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