- The Nobel Prize in Physiology or Medicine 1909 was awarded to Theodor Kocher “for his work on the physiology, pathology and surgery of the thyroid gland”.
- Along with Lister and Hallsted, Kocher introduced aseptic technique to surgical operations greatly reducing mortality rates.
- Performed over 5,000 thyroid excisions with a reduction in mortality from 14% in 1884 to 0.18% in 1898
“The surgeon is a doctor who can operate and knows when he should not do it.“
- Born August 25, 1841, Bern, Switzerland
- 1860-1865 – Medical studies Universität Bern
- 1909 – Nobel Prize in Physiology or Medicine for work on then thyroid gland
- 1909 – Theodor Kocher Institute (TKI) in Bern was established
- 1911 – Retired
- Died July 27, 1917, Bern, Switzerland
Key Medical Attributions:
- Thyroid Surgery: Extensive work on the thyroid gland. Based on his 1883 work on the thyroid gland’s function in metabolism and demonstration that thyroid surgery should be ‘hygienic’; associated with minimal blood loss and that a viable part of the gland needs to be left intact following the operation.
- Aseptic Surgery: Recognized the importance of aseptic techniques and introduced aseptic techniques of Lister whilst evolving his own. Careful evaluation of post-operative wound complication led him to ban visitors form the operating theatre…
- Neurosurgery: research was pioneering and covered the areas of concussion, neurosurgery and intracranial pressure (ICP) found that decompressive craniectomy was an effective method to lower ICP. Worked with Harvey Cushing in 1900 first encountering the Cushing reflex during decompressive surgery
- Surgical instruments: A craniometer; surgical clamp; arterial tweezers and forceps
- Research Statistics: (“arithmetical observations”) were introduced to prove the beneficial effect of “radical surgical techniques” and to control their quality. Death rates, incidence of infections, follow-ups etc were assessed and reported. Kocher recorded all operations in notebooks and later published e.g. 119 inguinal hernia operations (1892); 1513 appendectomies (1913) and 2712 with goitres treated with iodine injections (1873)
- Kocher’s arc incision – oblique incision for opening the knee joint
- Kocher’s incision – ubcostal incision performed on the right side exposes the gallbladder and common bile duct, and on the left side gives access to splenectomy or splenorenal venous anastomosis.
- Kocher’s manoeuvre – Operative mobilization of the duodenum to expose the retroduodenal, intrapancreatic and intraduodenal portions of the common bile duct
- Kocher’s Operation – relates to a few operations…
- Method of excision of the ankle joint
- Method to reduce the subcoracoid dislocation of the humerus (1870)
- Procedure of removal of the tongue
- procedure of pilorectomy
- Kocher’s sign – in patients with Basedow-Graves disease – dissinergism between eyeballs and frontal muscles movements when patient is looking upward
- Kocher’s craniometer
- Kocher’s Surgical Clamp – used to prevent blood loss during surgery (1882)
- Kocher Reflection (Kocher’s reflex) – contraction of the abdominal muscles subsequent to the exploratory compression of the testicle.
- Kocher T. Eine neue Reductionsmethode für Schulterverrenkung, Berliner Klinische Wochenschrift (Berlin Weekly Clinics), vol 7, issue 9, 28 Feb 1870, 101-105. [Full text translation]
- Kocher T. Chirurgische Operationslehre (Text-Book of Operative Surgery). Jena, Fischer, 1892. [Archive Text]
- Kocher T. ‘Die antiseptische Wundbehandlung’ (Antiseptic wound treatment)(1881)
- Kocher T. ‘Vorlesungen über chirurgische Infektionskrankheiten’ (Lectures on surgical infectious diseases) Basel-Leipzig, C. Sallmann, 1895.
- Kocher T. Zur Pathologie und Therapie des Kropfes. Deutsche Zeitschrift für Chirurgie, Leipzig, 1874, 4: 417-440.
- “Theodor Kocher – Facts”. Nobelprize.org. Nobel Media AB 2014. [Source]
- Aguirre CP. Biography: Emil Theodor Kocher (1841-1917). University of Valencia – CSIC 2002. [Full text]
- Choong C, Kaye AH. Emil theodor kocher (1841-1917).J Clin Neurosci. 2009 Dec;16(12):1552-4. Epub 2009 Oct 7. [PMID 19815415]
- Schültke E. Theodor Kocher’s craniometer. Neurosurgery. 2009 May;64(5):1001-4; discussion 1004-5. doi: 10.1227/01.NEU.0000344003.72056.7F. [PMID 19404160]
- Gemsenjäger E. Theodor Kocher (1841-1917). Milestones in European Thyroidology (MET) [Full text]
- Tröhler U. Der Nobelpreisträger Theodor Kocher 1841-1917. Birkhäuser publisher Basel 1984
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