(Assistant Professor, Department of Obstetrics and Gynecology, Seth GS Medical College and KEM Hopsital, Mumbai)
The surgical revolution which consisted of introduction of laparoscopy for pelvic procedures was pioneered by Raoul Palmer (1906-86). His exceptional stature has been revered by many and well documented. He was a Frenchman with an international influence. He was a surgical gynecologist, and did most of his work along with his wife, Elisabeth Palmer. He is believed to be one of the first to use the colposcope routinely for all his patients, and also started using the Papnicolaou smear regularly. However, the highlight of his pioneering career was the advancement in laparoscopy. Initially, it was called as “celioscopy”.
Pneumoperitoneum creation was investigated extensively by Palmer. The use of carbon-dioxide, the quantity of gas to be insufflated and the speed of insufflation were looked into in detail, and published by him in the late 1940s. Though his initial experience was with local anesthesia, he had come to the conclusion that general anesthesia should be preferred for laparoscopy procedures.
He designed many instruments for use in laparoscopic surgeries. Most of his work was from Hospital Broca, Paris. The resilience with which he and his supportive wife continued their pioneering medical work, despite the difficulties of German occupation of Paris during the second world war, is described well by Litynski. He is credited with making the first motion picture of laparoscopy, soon after the introduction of an efficient lighting system in 1952. His visionary ideas included the belief of usage of the newly introduced techniques in reproductive enhancement.
He authored many texts and mentored many pupils. Notable gynecologists who were tutored by him include Patrick Steptoe and Melvin Cohen. The modern operative laparoscopy doyen Semm, has also acknowledged Palmer as a founding father in gynecological laparoscopy. He had famously stated that the Paris clinic of Palmer was considered to be a “temple of laparoscopy.
Operative endoscopic gynecology, which is now standard of care, owes a lot to this great individual.
- Bruhat MA. [Operative laparoscopy: genuine surgical advance or simple temptation by the feasible?].[Article in French] Bull Acad Natl Med. 1994 Feb;178(2):199-208.
- Cohen J. Raoul Palmer: a maker of fate. Reprod Biomed Online. 2007 Jan;14(1):125-6.
- Schlogel G. [Raoul Palmer and the coelio-surgical adventure from 1940 to 1995]. [Article in French]. Hist Sci Med. 1996;30(2):281-7.
- Litynski GS. Raoul Palmer, World War II, and transabdominal coelioscopy. Laparoscopy extends into gynecology. JSLS. 1997 Jul-Sep;1(3):289-92.
- Biographies. In O’Dowd MJ, Philipp EE, editors. The History of Obstetrics and Gynecology. 1st ed. Lancs: Parthenon Publishing Group 2000; pp. 640.
Prasad M. Remembering Past Greats: Raoul Palmer. JPGO 2018. Volume 5 No.11. Available from:https://www.jpgo.org/2018/11/remembering-past-greats-raoul-palmer.html