Robert Battey (November 26, 1828 - November 8, 1895) was an American physician who is known for pioneering a surgical procedure then called Battey's Operation and now termed radical oophorectomy (or removal of a woman's ovaries). [1]
Robert Battey (November 26, 1828 - November 8, 1895) was an American physician who is known for pioneering a surgical procedure then called Battey's Operation and now termed radical oophorectomy (or removal of a woman's ovaries). [1]
Robert Battey was born in Augusta, Georgia to Cephas and Mary Agnes Magruder Battey. He was educated in Augusta and at Phillips Academy, Andover, Massachusetts. He graduated from Philadelphia College of Pharmacy in 1856. He went on to take courses at Jefferson Medical College, graduating in 1857. In the same year he studied at the Obstetrical Institute of Philadelphia gaining a diploma from the University of Pennsylvania. In 1859 he toured Ireland and also Great Britain, where he was introduced to the ovariotomist Thomas Spencer Wells. [2]
Battey served four years as a surgeon in the Nineteenth Georgia Volunteer Regiment during the American Civil War. After the Confederate surrender in April 1865, Battey resumed his practice in Rome, Georgia. His field of study was gynecology, and he became well known for a procedure he pioneered to remove a woman's ovaries. Initially referred to as ovariotomy, and named "Battey's Operation" in his honor, it is what today is termed a radical oophorectomy. He performed the first successful oophorectomy in May 1869 when he successfully removed a large dermoid cyst from a physician's wife. On August 27, 1872 he performed his first 'normal' oophorectomy. The patient, Julie Omberg, had diseased ovaries and lived to be 80 years old. There was a lynch mob waiting for Dr. Battey if he failed the operation.
He was instrumental in establishing the Gynecological Infirmary in Rome, Georgia, later enlarged and renamed the Martha Battey Hospital in honor of his wife.
In 1873, Battey became a professor of obstetrics at the Atlanta Medical College, where he stayed until 1875. He co-founded the American Gynecological Society in 1876, and was elected president in 1888. Hecontinued to practice medicine until his death on November 8, 1895.
During the second half of the 19th century many women were treated using bilateral oophorectomy for conditions recognised today such as amenorrhoea, dysmenorrhoea, menometrorrhagia, and various conditions that were variously referred to at the time as pelvic neurosis, oophoromania, oophoralgia, menstrual molimina (premenstrual syndrome), ovarian epilepsy and sexuologic (nymphomania) disorders. [2] [3] Battey himself is credited by E.P. Becton in 1888 with performing several hundred oophorectomies (cited in [3] ), and by 1906, following its widespread practice, Van De Warker estimated that 150,000 women had undergone this procedure (cited in [3] ).
However, mortality following the procedure remained high, even into the late 1870s, and of 35 cases described by Alexander Russell Simpson, 12 women died. [4] Furthermore, debate on the efficacy of oophorectomy remained controversial until the end of the 19th century, when J Whitridge Williams maintained that many of the ovaries he had examined after removal were normal, and that many operations had not been justified. [5] Even Battey himself in 1887 conceded that his more favorable results (9/9) were for ovarian epilepsy, whereas cure rates were only 13/20 and 1/7 for oophoralgia and oophoromania respectively (cited in [2] ).
Ironically, Thomas Spencer Wells, the ovariotomist Battey had first met in 1859, went on (at a Symposium attended by Battey and Alfred Hagar in 1886) to condemn the practice of surgical castration for mental or nervous diseases, [6] saying "That in nearly all cases of nervous excitement and madness it [oophorectomy] is inadmissible" and "That in nymphomania and mental diseases it [oophorectomy] is, to say the least, unjustifiable". Finally, just 3 years after Battey's own presidency of the society, A Reeves Jackson, the 1891 president of the American Gynecological Society, in a retrospective examination of the first 15 years of the Society's activities "..made a ruthless self-examination of its Fellow's past practices, and a scathing condemnation of their irrational surgical procedures, including Battey's operation...". [7]
The value of the experimental surgery championed by Battey is less that it contributed to an improvement of women's physical, emotional and mental well being, and more that it incidentally helped in the perfection of pelvic surgery and provided clear evidence for the concept that there was an unambiguous relationship between ovarian function and menstruation. [3]
Obstetrics and Gynaecology is the medical specialty that encompasses the two subspecialties of obstetrics and gynecology.
Gynaecology or gynecology is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area of obstetrics and gynecology (OB-GYN).
Tubal ligation is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus the implantation of a fertilized egg. Tubal ligation is considered a permanent method of sterilization and birth control.
Hysterectomy is the partial or total surgical removal of the uterus. It may also involve removal of the cervix, ovaries (oophorectomy), Fallopian tubes (salpingectomy), and other surrounding structures. Partial hysterectomies allow for hormone regulation while total hysterectomies do not.
Oophorectomy, historically also called ovariotomy is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term is mostly used in reference to animals, e.g. the surgical removal of ovaries from laboratory animals. Removal of the ovaries of females is the biological equivalent of castration of males; the term castration is only occasionally used in the medical literature to refer to oophorectomy of women. In veterinary medicine, the removal of ovaries and uterus is called ovariohysterectomy (spaying) and is a form of sterilization.
Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different cell types including epithelial cells, germ cells, and stromal cells. When these cells become abnormal, they have the ability to divide and form tumors. These cells can also invade or spread to other parts of the body. When this process begins, there may be no or only vague symptoms. Symptoms become more noticeable as the cancer progresses. These symptoms may include bloating, vaginal bleeding, pelvic pain, abdominal swelling, constipation, and loss of appetite, among others. Common areas to which the cancer may spread include the lining of the abdomen, lymph nodes, lungs, and liver.
Lawson Tait, born Robert Lawson Tait was a pioneer in pelvic and abdominal surgery and developed new techniques and procedures. He emphasized asepsis and introduced and advocated for surgical techniques that significantly reduced mortality. He is well known for introducing salpingectomy in 1883 as the treatment for ectopic pregnancy, a procedure that has saved countless lives since then. Tait and J. Marion Sims are considered the fathers of gynecology.
Salpingectomy refers to the surgical removal of a Fallopian tube. This may be done to treat an ectopic pregnancy or cancer, to prevent cancer, or as a form of contraception.
In medicine, Meigs's syndrome, also Meigs syndrome or Demons–Meigs syndrome, is the triad of ascites, pleural effusion, and benign ovarian tumor. Meigs syndrome resolves after the resection of the tumor. Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The causes of the ascites and pleural effusion are poorly understood. Atypical Meigs syndrome, characterized by a benign pelvic mass with right-sided pleural effusion but without ascites, can also occur. As in typical Meigs syndrome, pleural effusion resolves after removal of the pelvic mass.
Vaginectomy is a surgery to remove all or part of the vagina. It is one form of treatment for individuals with vaginal cancer or rectal cancer that is used to remove tissue with cancerous cells. It can also be used in gender affirmation surgery. Some people born with a vagina who identify as trans men or as nonbinary may choose vaginectomy in conjunction with other surgeries to make the clitoris more penis-like (metoidioplasty), construct of a full-size penis (phalloplasty), or create a relatively smooth, featureless genital area.
Gynecologic oncology is a specialized field of medicine that focuses on cancers of the female reproductive system, including ovarian cancer, uterine cancer, vaginal cancer, cervical cancer, and vulvar cancer. As specialists, they have extensive training in the diagnosis and treatment of these cancers.
A fellowship is the period of medical training, in the United States and Canada, that a physician, dentist, or veterinarian may undertake after completing a specialty training program (residency). During this time, the physician is known as a fellow. Fellows are capable of acting as an attending physician or a consultant physician in the specialist field in which they were trained, such as internal medicine or pediatrics. After completing a fellowship in the relevant sub-specialty, the physician is permitted to practice without direct supervision by other physicians in that sub-specialty, such as cardiology or oncology.
An immature teratoma is a teratoma that contains anaplastic immature elements, and is often synonymous with malignant teratoma. A teratoma is a tumor of germ cell origin, containing tissues from more than one germ cell line, It can be ovarian or testicular in its origin. and are almost always benign. An immature teratoma is thus a very rare tumor, representing 1% of all teratomas, 1% of all ovarian cancers, and 35.6% of malignant ovarian germ cell tumors. It displays a specific age of incidence, occurring most frequently in the first two decades of life and almost never after menopause. Unlike a mature cystic teratoma, an immature teratoma contains immature or embryonic structures. It can coexist with mature cystic teratomas and can constitute of a combination of both adult and embryonic tissue. The most common symptoms noted are abdominal distension and masses. Prognosis and treatment options vary and largely depend on grade, stage and karyotype of the tumor itself.
Primary fallopian tube cancer (PFTC), often just tubal cancer, is a malignant neoplasm that originates from the fallopian tube.
William Goodell was an eminent American gynecologist from Philadelphia, best remembered for first describing what is now referred to as Goodell's sign.
A borderline tumor, sometimes called low malignant potential (LMP) tumor, is a distinct but yet heterogeneous group of tumors defined by their histopathology as atypical epithelial proliferation without stromal invasion. It generally refers to such tumors in the ovary but borderline tumors may rarely occur at other locations as well.
Ovarian pregnancy refers to an ectopic pregnancy that is located in the ovary. Typically the egg cell is not released or picked up at ovulation, but fertilized within the ovary where the pregnancy implants. Such a pregnancy usually does not proceed past the first four weeks of pregnancy. An untreated ovarian pregnancy causes potentially fatal intra-abdominal bleeding and thus may become a medical emergency.
Theca lutein cyst is a type of bilateral functional ovarian cyst filled with clear, straw-colored fluid. These cysts result from exaggerated physiological stimulation due to elevated levels of beta-human chorionic gonadotropin (beta-hCG) or hypersensitivity to beta-hCG. On ultrasound and MRI, theca lutein cysts appear in multiples on ovaries that are enlarged.
Ovarian remnant syndrome is a condition that occurs when ovarian tissue is left behind following oophorectomy, causing development of a pelvic mass, pelvic pain, and occasionally dyspareunia. Ovarian remnant syndrome (ORS) is characterized by the presence of residual ovarian tissue after a woman has had surgery to remove one ovary or both ovaries (oophorectomy).
Prophylactic salpingectomy is a preventative surgical technique performed on patients who are at higher risk of having ovarian cancer, such as individuals who may have pathogenic variants of the BRCA1 or BRCA2 gene. Originally salpingectomy was used in cases of ectopic pregnancies. As a preventative surgery however, it involves the removal of the fallopian tubes. By not removing the ovaries this procedure is advantageous to individuals who are still of child bearing age. It also reduces risks such as cardiovascular disease and osteoporosis which are associated with removal of the ovaries.
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