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Dr Lambert van Kleef and the first 63a successful stomach operation. WCalvariënberg hospital, he found a large but rather left the hospital on 12 March having gained considerableexist at the time. For eleven days she was given nutritiousenemas, consisting of eggs. Eventually, she recovered and shehen Dr Lambert van Kleef was appointed as thefirst surgeon-physician at the Maastricht 160 run-down hospital. Both the operating theatre and the laboratory weight. The Limburger Koerier, a daily newspaper, reported on were in bad shape, the wards were crammed full with wooden 4 February, 1882 that ‘Doctor van Kleef, barber-surgeon in the beds. Nursing was done by the sisters of mercy of the holy Calvariënberg hospital’ had performed a stomach operation Carolus Borromeus. At that time the sisters had barely any ‘that will cause quite a stir in the scientific community.’ Years medical knowledge and saw it more as their task to provide after the operation, in 1891, Van Kleef indicated during a spiritual care to the patients. demonstration of another patient that the patient of his first Nevertheless Van Kleef managed to successfully operation was doing well. perform a pylorus resection (excision of the sphincter of the In 1883, Emile Schreinemacher of Maastricht received stomach) in this hospital on 27 January, 1882. The patient, who his doctorate from the University of Leiden for his dissertation was a woman from Van Kleef’s former town Venlo, survived the De resection pylori, in which he described the specimen from daring operation. She suffered from a stomach ulcer, which the pylorus resection of this patient as follows: ‘the pylorus is after being cured had resulted in scar formation and atrophying severely malformed and only accessible with a thin quill’. He of the exit of the stomach, a process that can lead to almost also pointed out that the procedure performed by Van Kleef was complete blockage of the stomach. She had been troubled for remarkable because the first operation of a stenosing stomach fifteen years by this relatively common disorder, which can ulcer had been performed in Paris only two years earlier. When cause chronic complaints and severe emaciation due to the Van Kleef dared to undertake the surgery, only 23 similar impossibility to absorb sufficient amounts of food. The patient procedures had been performed, including one by Dr Anton had been treated with stomach lavage for many years, but to no Berns in Amsterdam. So far all patients but one had died. Van avail. Due to stomach bleeds she was in critical condition, and Kleef’s operation was the first successful stomach operation in the operation was the ultimum refugium for survival. the Netherlands and the second successful one of its kind in The surgery lasted two hours. According to Lister’s the world. During the next six years, Van Kleef performed procedure, the air in the operating theatre was first saturated another four stomach procedures but all patients died within a with carbolic fumes and the patient was wrapped in warm few days. Undoubtedly, he had his share of luck, but his blankets to keep body temperature at an acceptable level. reputation was firmly established! Anaesthesia consisted of a morphine injection and some chloroform, only during the inception and end of the anaesthesia. During the procedure the patient was half awake. After the operation the patient collapsed after which ether injections were administered. The technique of infusion did not


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