Kurt Semm

(1927�2003)

A pioneer of minimally invasive surgery, Kurt Karl Stephan Semm, died this July at the age of 76. He popularized his novel techniques in the face of extraordinary opposition.

He was once shouted down at a symposium after demonstrating a new surgical method called laparoscopy, which, to the assembled surgeons, beggared belief: using a remotely held device threaded through an abdominal incision no bigger than a keyhole, he performed surgery without opening the body cavity. Another time, while he was presenting slides of an ovarian cyst being removed using the same technique, the projector was suddenly unplugged, and his host declared the show to be over.

His lectures were greeted with laughter, suspicion, and derision. His associates at the University of Kiel in Germany asked him to undergo a brain scan because only a madman, they said, would propose using such surgical procedures. He was forbidden to publish papers describing his new techniques, and when he was finally allowed to submit a manuscript to the American Journal of Obstetrics and Gynecology, it was rejected on the grounds that the procedure was unethical. The president of the German Surgical Society even demanded that he be disbarred from medical practice. Dr. Semm endured all of this, not as an wild-eyed young doctor on the fringes of medicine, but as a seasoned obstetrician and chairman of his own clinic, at a time when he had the most to lose professionally.

He invented 80 surgical devices, and improved hundreds more, many while he was in his 70s. He published more than 1,000 papers on minimally invasive surgical methods, among other subjects. He was the first physician to use remote cameras regularly during surgery. So great was his technical flair that he was nicknamed the Magician of Kiel.

Some called him pompous and distant; at times, his ambition led him to embellish his successes unnecessarily. And as a teacher and mentor, he was exacting. Nevertheless, apprentices flocked to the sorcerer�s side. Ronald Levine, M.D., head of gynecological endoscopy at the University of Louisville, first saw Dr. Semm demonstrate his technique in Mexico more than 20 years ago. “It was mind-blowing stuff,” he recounts. “I never would have imagined that laparoscopy could be used this way. It completely changed the field.” Dr. Levine flew to Germany, learned the technique, and while presenting his results at a meeting back in the United States, he, too, was booed off the stage. Camran Nezhat, M.D., clinical professor of gynecology, obstetrics, and surgery at Stanford University School of Medicine, also learned at Dr. Semm�s side and went on to invent video-assisted laparoscopic surgery.

At the end of his life, Dr. Semm�s contributions became more-highly recognized. Surgeons who had mocked him openly now recanted and struck up friendships, inviting him to dozens of training courses and seminars. He became an honorary member of many professional societies. Last year in New York, he received the Pioneer in Endoscopy award from a conclave of surgeons who, decades before, might well have drummed him out of the auditorium. Duncan Turner, M.D., a gynecological surgeon who spoke at Dr. Semm�s memorial, said, “Every domain of modern surgery owes him a debt. Our present ability to cauterize, to sew, to stitch, and to cut—even arthroscopy—all came from Kurt Semm. As a surgeon, he changed my life.”

Patients can be grateful, too.

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