The first human laparoscopy and NOTES operation: Dimitrij Oscarovic Ott (1855-1929).

Dimitrij Oscarovic Ott (1855-1929) can undoubtedly be called the true pioneer of laparoscopy, especially of natural orifice transluminal endoscopic surgery. In 1901 already he performed abdominal examinations via a transvaginal access calling this procedure 'ventroscopy'. In 1902 the publication of his first results, as well as a description of the method and the equipment used, were released. In addition to Georg Kelling (1866-1945) and Hans Christian Jacobaeus (1879-1937), he therefore was one of the pioneers of present-day laparoscopy. Whereas Kelling published and presented his first results of merely animal trials in 1901 and Jacobaeus performed his first interventions on humans only in 1910, Ott had already used his new method in clinical practice since 1901. By only one incision in the cul-de-sac and utilizing a head lamp system similar to reflector lamps used by otolaryngologists, he inspected the abdominal cavity making use of a gynecological speculum. The patient was positioned in an extreme head-down position; for better lighting he used an additional light source which was connected to the speculum. Nowadays in Russia Prof. Ott still is a legend, especially in St. Petersburg. He was the director of the National Institute of Obstetrics and the personal physician to Empress Aleksandra Fedorovna (1872-1918). He is regarded as the father of the Russian school of obstetrics and gynecology as well as the founder of endoscopic surgery and laparoscopy in Russia.