Evolution of endovascular surgery
Medical science has advanced significantly since 1507, when Leonardo da Vinci drew this diagram of the internal organs and vascular systems of a woman.
The specialty continues to be based on operative arterial and venous surgery but since the early 1990s has evolved greatly. There is now considerable emphasis on minimally invasive alternatives to surgery. The field was originally pioneered by interventional radiologists, chiefly Dr. Charles Dotter, who invented angioplasty. Further development of the field has occurred via joint efforts between interventional radiology, vascular surgery, and interventional cardiology. This area of vascular surgery is called Endovascular Surgery or Interventional Vascular Radiology, a term that some in the specialty append to their primary qualification as Vascular Surgeon. Endovascular and endovenous procedures can now form the bulk of a vascular surgeon's practice.
The development of endovascular surgery has been accompanied by a gradual separation of vascular surgery from its origin in general surgery. Most vascular surgeons would now confine their practice to vascular surgery and similarly general surgeons would not be trained or practice the larger vascular surgery operations or most endovascular procedures. More recently, professional vascular surgery societies and their training program have formally separated "Vascular Surgery" into a separate specialty with its own training program, meetings, accreditation. Notable societies are Society of Vascular Surgery (SVS), USA; Australia and New Zealand Society of Vascular Surgeons (ANZ SVS). Local societies also exist e.g. New South Wales Vascular and Melbourne Society of Vascular Surgeons (MVSA). Larger societies of surgery actively separate and encourage specialty surgical societies under their umbrella e.g. Royal Australasian College of Surgeons (RACS).
SIR (Society of Interventional Radiology) remains intimately involved with the practice of endovascular therapy. Many of its members form part of a multi-disciplinary team treating vascular disorders alongside vascular surgeons. Although in many parts of the world vascular surgeons have evolved to now work alone.
Dr Elmi Muller is a General Surgeon specialized in Transplant Surgery and Vascular access surgery. She has an active interest in promoting organ donation and transplantation and is currently the intenational Transplantation Society’s councillor for the region Middle East/Africa as well as the president of the Southern African Transplantation Society. She has been involved in many transplant-related outreach and educational programmes for the public and medical profession through the Organ Donor Foundation of South Africa, of which she is the Medical Director. She initiated a Donation after Cardiac Death programme as well as a transplant programme for HIV positive patients utilizing HIV positive donors at Groote Schuur Hospital.