The College's Committee on Trauma (COT) launched its inaugural Advanced Trauma Life Support (ATLS^®) course to address management of the trauma patient immediately upon arrival at a hospital.¹⁴⁹ Based on the premise that the greatest threat to life should be treated first, the goal of ATLS is to teach a simplified and standardized approach to caring for trauma patients. The idea for ATLS got its start in 1978 after the tragic crash of a private airplane piloted by James K. Styner, MD, FACS, killed his wife and injured his children.^150,151 "When I can provide better care in the field with limited resources than my children and I received at the primary facility, there is something wrong with the system, and the system has to be changed … simply put, you have to train them before you can blame them," Dr. Styner said.¹⁵² A trial course was given to a small group of Nebraska physicians, and when news of the "Nebraska course" spread, the College began to train instructors and conduct its own courses in 1980. More than one million physicians in 60 countries have taken the ATLS course, which is now widely accepted as the standard of care for initial assessment and treatment in trauma centers.¹⁵³
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Michael R. Harrison, MD, FACS, and colleagues at the University of California, San Francisco, performed the first open fetal operation. Dr. Harrison and his team corrected a dangerously blocked urinary tract in a fetus by sewing into place a bladder shunt, a little tube about the size of dry spaghetti.^154-156 Dr. Harrison said that at the time "everyone was a skeptic and that's not surprising because the idea of fetal surgery was sort of shocking."¹⁵⁷ Although fetal intervention started with crude surgical tools used to cut and sew during open operations, it quickly evolved through minimally invasive techniques and endoscopic and image-guided manipulation.¹⁵⁸ Dr. Harrison was the recipient of the College's 2002 Jacobson Innovation Award.¹⁵⁹
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For the first time, artificial skin was successfully used to treat a burn patient by John F. Burke, MD, FACS. In 1969, Dr. Burke, a Harvard University medical professor and general vascular surgeon at Massachusetts General Hospital in Boston, had made a request of Ioannis Yannas, PhD, a professor of fibers and polymers in Massachusetts Institute of Technology's department of mechanical engineering: using ordinary substances, develop a flexible material to protect against infection and dehydration that looks like normal skin and will not be rejected by a patient's immune system. Consisting of a top layer of thin plastic sheet and a bottom layer of cow tendons and shark cartilage, the artificial skin acted as a seed bed for healthy skin cells taken from the patient's body. The two men said neither could have created the product on his own since it required a command of two different spheres of knowledge: the biology of the skin and the engineering of polymers.¹⁶⁰ The synthetic human skin, now called "Integra," would save the lives of innumerable severely burned people worldwide.¹⁶¹ Dr. Burke was the recipient of the College's 1999 Jacobson Innovation Award.¹⁶²
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During the 1980s a trio of French surgeons—Prof. Philippe Mouret (Lyon), Prof. Francois Dubois (Paris), and Prof. Jacques Perrisat (Bordeaux), borrowed laparoscopic equipment from gynecologists and somewhat independently began refining an approach to perform laparoscopic general surgical
procedures—particularly cholecystectomy (surgical removal of the gall bladder).¹⁶⁶ By autumn 1989, this "French Technique" quickly gained worldwide attention among surgeons following presentation reports of its successful use in patients by Profs. Perrisat and Dubois at surgical meetings in the United States. In January 1990, Prof. Dubois published preliminary results of the technique in 36 patients for an American medical audience in the Annals of Surgery.¹⁶⁷ Professor Dubois would later receive the inaugural Jacobson Innovation Award of the American College of Surgeons (1994)¹⁶⁸ for his accomplishments in this field and Professor Perrisat was named the 2011 recipient of the SAGES George Berci Lifetime Achievement Award in Endoscopic Surgery.¹⁶⁹ Based on the initial work of these three French surgeons, a laparoscopic surgical approach is now a regular part of the general surgeon's armamentarium, and patients who are qualified candidates for the procedures are routinely offered a minimally invasive approach to selected abdominal operations, which results in less scarring and pain, and quicker recovery times.
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