“A tribute to Prof Gerhard Friederik Buess (1948-2010)”
In 1981, a senior professor was performing a midnight emergency exploratory laparotomy for massive lower gastrointestinal bleeding from an unknown source. A surgical resident who was assisting the professor offered a suggestion. He suggested the use of flexible fiberoptic gastroscope which the hospital had recently purchased to localise the site of bleeding.
This pioneering “intraoperative colonoscopy” led to visualizing the bleeding polyp in the right colon and the performance of an appropriately directed and lifesaving resection. This surgical resident was Dr Gerhard Friederik Buess. Raw curiosity and ingenuity demonstrated by Gerhard Buess as a young surgical resident characterized his personality and forecast the essence of his professional career. He was criticized for misappropriating the hospital’s valuable new gastroscope and he suddenly found that his career was in jeopardy. He was successful, however, in convincing his department chairman that the endoscopic discovery was an enormous benefit to the patient and therefore was a worthwhile application of the instrument. This singular experience undoubtedly brought endoscopy to his spiritual core. Endoscopy then became his passion and career. Gerhard directed his curiosity, ingenuity, industry, and creativity to the field of gastrointestinal endoscopy and to its ultimate expression, the invention of a new endoscopic instrument and a new technique, the transanal endoscopic microscope and transanal endoscopic microsurgery. Gerhard F. Buess was born on April 10, 1948 in Merklingen, Germany. His mother was a school teacher and his father was a technician for Mercedes Benz, and both parents contributed to his career choice of academics and technology. Following graduation from public schools in Merklingen he attended Eberhard Karls University in Tuebingen and the Ludwig Maximilian University in Munich where he received his medical degree in 1972.His thesis was “Tissue Glue in Bone Surgery.” Soon after (1973) he passed the Educational Commission for Foreign Medical Graduates (ECFMG) certification. He had successive surgical residencies in Bavaria and in the university hospital in Koeln-Lindenthal, qualifying as a surgeon in August, 1984.In December 1985he obtained his PhD on research and development of Transanal Endoscopic Microsurgery (TEM).At the age of 38,in 1986, he was appointed Professor of Surgery at the Clinic and Polyclinic forGeneral and Abdominal Surgery of the Johannes-Gutenberg-University in Mainz. He joined as Professor of Surgery at the Department of General Surgery of the Eberhard-Karls-University in Tuebingen in July 1989 where he established a working group for minimally invasive surgery (MIC Tuebingen). He became Professor of Surgery and Director of the Section for Minimally Invasive Surgery in June 1994. In the same year Dr.Buess was also appointed head of the Department of Surgery at the Olympia park Klinik, Munich. While maintaining his academic appointment at the University of Tuebingen, he was appointed head of the Department ofMinimally Invasive Surgery at Helios Kliniken GmbH in Muelheim in June 2001, where he worked until October 2005. He received an honorary professorship of the Shandong Provincial Qianfoshan Hospital Jinan in 2006. Gerhard Buess carried out research throughout his whole working life. He has the credit of development of several techniques and technologies for surgery to his name. Within the fields of minimally invasive surgery and digestive surgery, the following need special mention:
- Development and clinical application of new systems for esophageal dilatation and stent placement (1978–1985)
- Introduction of transanal endoscopic microsurgery into clinical practice, with the procedure being the first endoscopic operation on the gastrointestinal tract (1983)
- Development of training models and a stepwise training system for TEM on an international level and clinical trials on TEM (1983–1989)
- Development of technology for and the technique of endoscopic microsurgical dissection of the esophagus (EMDE) (1986–1989), with clinical introduction of EMDE worldwide and the first endoscopic technique for resection of the esophagus (1989)
- Introduction of laparoscopic colonic and rectal resections into routine clinical practice (1990)
- Development of instruments with multiple degrees of freedom and multifunctional instruments, automatic suturing devices, the first robotic system, camera holding and guiding systems, 3D vision systems, and complex simulation systems (1996)
- Development of technologies for and technique of NOTES transvaginal procedures with a rigid endoscope (2008)
During his professional career, Gerhard Buess has been a member of various surgical organisations including the
- German Society of Surgery
- German Association of Surgical Endoscopy(CAE)
- Steering Committee of the German Association of Endoscopy and Visualisation Techniques (DGE-BV)
- Steering Committee of the Society for MinimallyInvasive Therapy (SMIT)and President in 1996
- European Association forEndoscopic Surgery and other interventional techniques(EAES) and President from 2005 to 2007
- President of the 10th World Congress of Endoscopic Surgery
- President of the Annual Congress of the EAES, Berlin, 2006.
- Steering Committee of the Società Italiana di Chirurgia Endoscopica (SICE)
- New EuropeanSurgical Academy (NESA)
Furthermore, he was awarded an honorary fellowship of the Royal College of Surgeons of Edinburgh (FRCS Ed) in1991, Socio Corrispondente of the Societa` Italiana di Chirurgia in 1992, honorary member of the Serbian Society forEndoscopic Surgery (JUEH) in 2000, honorary member of the Asociacion Espanola de Coloproctologia in 2007, honorary member of the Cuban Society of Endoscopic Surgery in 2010, and honorary member of Italian Society for EndoscopicSurgery (SICE) in 2010. He was a member of the Pool of Reviewers at the European Science Foundation, Strasbourg, France, and the Pool of Reviewers at the Italian Ministry of Research and University. The enormity of Professor Gerhard Buess’s achievements can be judged by the several awards he received during his working life. His honours include the Jubilee prize of theGerman Association for Surgery in 1992, the Adalbert-Seifriz-Prize 1993 from the ‘‘VereinTechnologie-Transfer-Handwerke.V.,’’ the Rudolf-Schindler-Prize for the best video, ‘‘Jahrestagung der DGEBV’’ in 1994, the Rick Satava Award in San Diego, USA, in 1998 and the Inaugural Distinguished Recognition Award from the International Federation Societies of Endoscopic Surgeons(IFSES), Athens, Greece, 2007. However, he was especially proud of the award and recognition received from the German Society of Surgery (Deutsches Gesselschaft fur Chirurgie) in 1992 together with Dr. Muhe, as the two German surgeons who first developed minimally invasive procedures (Buess, TEM, 1983) and laparoscopic cholecystectomy (Muhe 1985). This prize came after years of criticism of and controversy over the clinical applications of such techniques. Dr Gerhard Buess was founding and chief editor of the Journal of Minimally Invasive Therapy and Allied Technologies. Furthermore, he was co-editor or member of the editorial board of Surgical Laparoscopy & Endoscopy, Endoskopie heute, Minimal Invasive Chirurgie, Rivista Italiana di Videochirurgia e Chirurgia Mini-invasiva, Langenbeck’s Archives of Surgery, Surgical Endoscopy,The International Journal of Medical Robotics and Computer Assisted Surgery, and Management & Krankenhaus. During his working life, Prof. Gerhard Buess wrote or edited 7 textbooks that focused on endoscopic and minimally invasive surgery; and as first author or co-author he wrote over 72 book chapters and 265 original articles and editorials; and he gave over 950 lectures in surgical and other medical conferences worldwide. He was one of the few living surgeons whose name has been included in all surgery textbooks for a surgical procedure he developed and first introduced into the clinical practice: transanal endoscopic microsurgery. He contributed much to the development of new technologies and their application to surgery. He built a center for minimally invasive surgery renowned throughout the world: Sektion fur MIC (Minimale Invasive Chirurgie) Tuebingen. Spinoffs from this center can be found worldwide: from Germany to Italy, from Japan to India, from China to Cuba. Hundreds of surgeons visited this center from all over the world and most of them attended the training courses at MIC Tuebingen.
I had the pleasure to meet Prof Gerhard Buess in Genova in 1996, at a local event on minimally invasive surgery, where he was invited as international guest. I will never forget his friendly attitude. Despite the huge importance of the man, it was not at all difficult to talk to him in a truly friendly fashion. Gerhard Buess will not be remembered as one of the top skilled surgeons of his age, which would have been a premium quality of many. He will always be remembered as a real genius, a true innovator, with the capacity to foresee decades in advance the true needs of surgeons, which made him unique. Most of concepts he first described during his life will probably see the light only in the next years, while today we routinely use devices derived from his ideas without even knowing. There are several things I think I learned from him during the years of my stay in Tuebingen, in the late 90ies. The first is that to influence the way to treat a disease, it is much more effective to design an easier new method of cure, rather that perfecting an existing one and teaching it. And this is done easily with the appropriate use of technology. The art of surgery is hand-crafted, even today, while it has to move quickly into something more standardised and consequently scientific. I would also like to remember the man, enjoying life everyday, a man of positive thinking till the very end, a man who always aimed to share his joys with all his many friends. Gerhard Buess died in Herrsching following a protracted illness on October 30, 2010. The surgical community lost one of the surgical scientist, great innovator who boosted technical progress in surgery and pioneered the revolution of minimally invasive surgery. The world’s surgical scientific community will miss this man and his extraordinary visionary approach to medicine, surgery, and innovative technologies.