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Colorectal Channel
Colorectal Quiz Episode 37: The Yancey-Soave story of the original surgical descriptions for Hirschsprung disease
With Dr. Marc Levitt & Dr. Erika Newman & Dr. Jason Frischer & Dr. Carolyn Yancey · hosted by Dr. Rod Gerardo & Dr. Mimi Denning
Chapter 1 of 6 · Fundamentals
Introduction
Introduction and episode framing
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Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Dr. Henri Ford's 2018 APSA presidential address revealed that Dr. A.C. Yancey had described the submucosal dissection technique 12 years before Suave.
Dr. Yancey published his submucosal dissection technique in the Journal of the National Medical Association in 1952.
Dr. Suave published his submucosal dissection technique in the journal Surgery in 1964.
Dr. Yancey's and Dr. Suave's articles demonstrate essentially an identical submucosal dissection technique.
In 1951-1952, Black academics could not publish their work in mainstream surgical journals.
Dr. Yancey did not express anger about Dr. Suave's later publication of the same technique, instead emphasizing the value and purpose of the National Medical Association.
Dr. Yancey completed his surgical training under Dr. Charles Drew at Friedman's Hospital.
Dr. Yancey established the first postgraduate academic training program in the state of Alabama for Black surgeons at the Tuskegee VA.
Dr. Yancey conducted preliminary preclinical work for the pull-through technique at the veterinarian hospital in Tuskegee.
Three of Dr. Yancey's four children went into medicine.
Dr. Newman brought Dr. Yancey's story to the attention of the Hirschsprung interest group at APSA.
The Hirschsprung interest group members write papers, review manuscripts for journals, write board questions, and influence CPT coding.
When reviewing articles for journals, Dr. Newman now sends back revisions to ensure correct references to Dr. Yancey's work are included.
A fellow at Children's National wrote an operative note describing a patient as status post a 'Yancey-Suave procedure,' indicating the terminology has become part of standard practice.
The National Medical Association was created in the basement of First Congregational Church in Atlanta because Black doctors had no other place to publish their work during segregation.
Dr. Yancey's only career options after training were the military or the VA system due to segregation.
Dr. Yancey worked at Hughes Fawley Pavilion Hospital, which was the hospital for colored patients, and traveled back and forth to Grady Memorial Hospital.
Around 1964, Dr. Yancey gained privileges to see colored patients at Emory University Hospital on the main campus.
The original Swenson operation for Hirschsprung disease was a full-thickness rectal dissection performed transabdominally.
Surgeons performing wide rectal dissection for Hirschsprung disease were injuring the nervi erigentes, leading to fecal incontinence, bladder dysfunction, and sexual dysfunction.
Dr. Douamel in France developed a technique leaving the original rectum in place and pulling ganglionated bowel through.
Dr. Suave in Italy developed a submucosal dissection technique staying within the rectal wall to avoid nerve injury, eventually breaking through full thickness for the pull-through.