ABSTRACT
The first successful nephrectomy was performed by the German surgeon Gustav Simon on August 2, 1869 in Heidelberg. An account of the events leading up to the operation and this most extraordinary surgeon is provided by Moll and Rathert. The patient was a 46-year-old washerwoman who had undergone a hysterooophorectomy for an ovarian cyst. Due to adhesions, she had suffered damage to the ureter and following multiple failed attempts to stem the flow of urine from the wound, Simon decided that the only remaining option would be to remove the kidney. In animal experiments, he proved that one healthy kidney could be sufficient for urine excretion. The operation was performed through a flank incision using the retroperitoneal approach. The operation was completed in 40 minutes, with only 50 mL blood loss. On August 8, Simon performed a second nephrectomy, this time for urolithiasis, which was also successful. Simon pioneered scientifically orientated thinking in urology and paved the way for future developments in reconstructive procedures.
