Jean Civiale was a French

France

The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

 surgeon

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 and urologist, who, in 1832, invented a surgical instrument (the lithotrite

Lithotrite

The lithotrite was an early medical device, invented by Jean Civiale, which was used to perform transurethral lithotripsy, the first known minimally invasive surgery, to crush stones inside the bladder without having to open the abdomen . To remove a calculus the instrument was inserted through...

) and performed transurethral lithotripsy, the first known minimally invasive surgery

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, to crush stones inside the bladder

Urinary bladder

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

 without having to open the abdomen

Abdomen

In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

 (lithotomy

Lithotomy

Lithotomy from Greek for "lithos" and "tomos" , is a surgical method for removal of calculi, stones formed inside certain hollow organs, such as the kidneys , bladder , and gallbladder , that cannot exit naturally through the urinary system or biliary tract...

). To remove a calculus, Civiale inserted his instrument through the urethra

Urethra

In anatomy, the urethra is a tube that connects the urinary bladder to the genitals for the removal of fluids out of the body. In males, the urethra travels through the penis, and carries semen as well as urine...

 and bored holes in the stone. Afterwards, he crushed it with the same instrument and aspired the resulting fragments or let them flow normally with urine

Urine

Urine is a typically sterile liquid by-product of the body that is secreted by the kidneys through a process called urination and excreted through the urethra. Cellular metabolism generates numerous by-products, many rich in nitrogen, that require elimination from the bloodstream...

.

Civiale founded the first urology service in the world, at the Necker Hospital in Paris.

Civiale has been also recently recognized as a pioneer of evidence-based medicine

Evidence-based medicine

Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...

. In 1835, the Académie des Sciences in Paris

Paris

Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...

 commissioned a report on the statistical research

Statistics

Statistics is the study of the collection, organization, analysis, and interpretation of data. It deals with all aspects of this, including the planning of data collection in terms of the design of surveys and experiments....

 that had been conducted by him on a wider scale throughout Europe

Europe

Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

, with the aim of proving that bladder lithotripsy was superior to lithotomy. Civiale used for the first time the method of comparing the relative mortality

Mortality rate

Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...

 rates between both groups of patients, and found that the new lithotripsy method had had 7 deaths in 307 operations (2.2%), while the old lithotomy method had 1,024 deaths in 5,443 operations (18.8%). For this study, he received in 1836 the Montyon Prize

Montyon Prizes

Montyon Prizes are a series of prizes awarded annually by the Académie Française. They were endowed by the French benefactor Baron de Montyon....

 from the Academy, and one of the members of the committee was none other than famous mathematician Simeon Poisson. As a consequence, the Academy recommended that the medical uses of probability

Probability

Probability is ordinarily used to describe an attitude of mind towards some proposition of whose truth we arenot certain. The proposition of interest is usually of the form "Will a specific event occur?" The attitude of mind is of the form "How certain are we that the event will occur?" The...

 should be better studied.

Among the many students of Civiale, Sir Henry Thompson

Sir Henry Thompson, 1st Baronet

Sir Henry Thompson, 1st Baronet FRCS , British surgeon and polymath, was born at Framlingham, Suffolk.-Medical career:...

, a British surgeon and urologist, took the instrument and the technique to Great Britain

Great Britain

Great Britain or Britain is an island situated to the northwest of Continental Europe. It is the ninth largest island in the world, and the largest European island, as well as the largest of the British Isles...

 and became quite famous with it, after operating King Léopold I of Belgium

Leopold I of Belgium

Leopold I was from 21 July 1831 the first King of the Belgians, following Belgium's independence from the Netherlands. He was the founder of the Belgian line of the House of Saxe-Coburg-Gotha...

.

In 1840, he was elected a foreign member of the Royal Swedish Academy of Sciences

Royal Swedish Academy of Sciences

The Royal Swedish Academy of Sciences or Kungliga Vetenskapsakademien is one of the Royal Academies of Sweden. The Academy is an independent, non-governmental scientific organization which acts to promote the sciences, primarily the natural sciences and mathematics.The Academy was founded on 2...

.

Principal publications

• De la Lithotritie, ou brolement de la pierre, (Paris), 1827)
• Lettres sur la Lithotritie, &c. (1827)
• Traite pratique et historique de la Lithotritie (1847)
• Resultats Cliniques de la Lithotritie pendent les Annes 1860-64 (1865)