May 24th Happy Birthday Dr. Trendelenburg

Your gynecologist may have stood you on your head before for a better peek at the cervix at the time of a pap smear or at your pelvic organs at the time of abdominal gynecologic surgery, but did you know that tilt-table-head-down position had a name? The name is Trundelenburg Position. Originally described as "Elevated Pelvic Position" it was published as an insightful breakthrough in 1890. He realized quickly that in vaginal surgery or bladder surgery this position also provided wide views that were very beneficial. In gynecology we only know him for the famous table position, in fact us gynos call out all the time, " more trundelenburg please" to get the nurses or assistants to tip the table in that direction, but just a bit steeper, and so forth. It is a very useful position, although recent gyno surgeons have cautioned that too steep a Trendelenburg position can be quite difficult for the patient leading to various complications such as sliding and damage to the eyes.  Trundelenburg table position is the only eponymic we know. Trendelenburg was such an influential name, it is still the label on many medical symptoms and devices! The Trendelenburg canula is used by anesthesiologists to prevent reflux from vomit if a patient is tubed, the Trendelenburg sign is a specific sign on one side of the body that diagnoses a congenital dislocation of the hip on the other, and the Trundelenburg symptom which is a waddle due to paralyzed gluteal muscles, and finally the Trendelenburg test which helps determine the competency of the venous valves in patients with varicose veins. Then he had actually 4 operations named for him as well, my favorite was that of the insertion of an ivory peg into the knee joint for the correction of a slipping patella. He may have gotten the ivory idea from the ancient Indian medical texts he loved to pour over and that he used to write his first medical thesis in 1867. Dr. Trundelenburg was quite the guy to gab about!

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