Angelo L. Soresi

Biographical Timeline

• Born on June 19, 1877 in Italy [confirmed with WWII registration card]
• 1900 – Medical degree, University of Rome.
• 1903 – Regia Universita di Napoli Facolta di Medicina e Chirurgia
• 1906 – Began medical practice in the United States (New York).
• World War I (1914–1918) – Served four years as a surgeon with the Italian Army.
• 1919 – Published landmark surgical paper on diaphragmatic/hiatal hernia, later cited as the first elective repair treatise.
• 1920-1939 – Attending surgeon at the Greenpoint Hospital, Brooklyn
• Professor of the principles of surgery at the New York Homeopathic Medical College
• Fellow of the International College of Surgeons (FICS), Fellow of the International College of Anesthetists (FICA)
• 1932 – Published Peridural Anesthesia (preliminary report)
• 1939 – Honorary consultant in surgery, Greenpoint Hospital
• Died on December 11, 1951 at Greenpoint Hospital, Brooklyn

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Key Medical Contributions

Peridural anaesthesia and the “hanging drop” endpoint (1932)

In his preliminary report (February 17, 1932), Soresi described peridural (epidural) anaesthesia as deposition of local anaesthetic outside the dura in the loose connective tissue of the epidural space, contrasting it with spinal anaesthesia where the drug is deposited within the dura and mixed with CSF.

A method of anesthesia is described by which the anesthetic fluid is injected in the peridural space, thus obtaining the same anesthetic results of spinal anesthesia without its unpleasant features.

Soresi 1932

Soresi’s core claim was that peridural injection could achieve spinal-like anaesthetic effects without typical spinal sequelae, introducing what later authors recognised as an early description of the hanging drop concept.

Soresi technique (1932)

• Premedication: caffeine by hypodermic injection 15 minutes before block (given as ⅓ grain).
• Needle and “finder” injection: a very fine 6 cm needle; inject 1% novocaine while advancing toward the spine, then remove syringe near the target depth.
• Placement confirmation (visual endpoint): after syringe removal, he watched the column of solution in the needle shank; on further slow advancement, the fluid suddenly disappeared, which he interpreted as entry into the epidural space.
• Dose: once the sign occurred, inject 30–50 cc of 1.5–2% solution very slowly.

I call the attention of the reader to a phenomenon which, to my knowledge, has not been described…The surgeon watches care­fully the fluid in the shank of the needle while push­ing very slowly the needle toward the spine. Suddenly it will be noticed that the fluid disappears from the shank, as if it had been sucked away. This phenomenon indicates that the needle has entered the epidural space.

Soresi 1932

Priority note: Soresi vs Gutiérrez (hanging drop)

Both Soresi (1932) and Alberto Gutiérrez (1933) independently developed their technique for using internal pressure differences to identify the epidural space. Though priority rests with Soresi’s 1932 paper.

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Major Publications

• Soresi AL. A new method of intestinal anastomosis. New instrument for direct transfusion of blood and temporary anastomosis between blood vessels. Ether anesthesia by compressed air. International Medical Congress (16th: 1909, Budapest)
• Soresi AL. Diaphragmatic hernia: its unsuspected frequency: its diagnosis: technic for radical cure. Ann Surg. 1919 Mar;69(3):254-70.
• Soresi AL. Retractors made with hairpins. JAMA 1919;72;(19):1364.
• Soresi AL. Artificial pneumothorax with fractures ribs. 1921;76;(6):379.
• Soresi AL. A new diaphragm for the complete elimination of secondary radiation. Radiology 1931; 16(4): 486-491
• Soresi AL. Peridural anesthesia; a preliminary report. Medical journal and record 1932; 135: 165-166.
• Soresi AL. Anaesthetic Effects of Alcohol. 1935
• Soresi AL. Episubdural Anesthesia. Anesthesia & Analgesia 1937; 16(6): 306-310
• Soresi AL. Continuous drop feeding for the treatment of ulcers of stomach and duodenum.  American Journal of Digestive Diseases 1938; 5: 39–40

Patents

• Soresi AL. Operating-table. US1166018A. 1914
• Soresi AL. Instrument for the transfusion of blood. US1151300. 1915
• Soresi AL. Rotary cutting and drilling instrument. US1377288A. 1919
• Soresi AL. Collar. US1378142A 1919
• Soresi AL. Surgical catgut thread. US1564983A 1921
• Soresi AL. Apparatus for surgical uses. US1564146A 1924

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References

Biography

• DR. ANGELO SORESI, SURGEON 51 YEARS; Ex-Professor at Homeopathic College Dies–Advocated Filming of Operations. New York Times December 12, 1951, Page 3
• Angelo L Soresi. New York State Journal of Medicine. January 15, 1952
• Dr. Angelo L. Soresi. Journal of the International College of Surgeons 1952; 17(1): 131
• Soresi, Angelo Luigi. JAMA. 1952; 148(13):1138

Eponymous terms

• Stylopoulos N, Rattner DW. The history of hiatal hernia surgery: from Bowditch to laparoscopy. Ann Surg. 2005 Jan;241(1):185-93
• Neruda B, Schmitz-Franken A. 475. Angelo Luigi Soresi (1877-1951), Inaugurator of Combined Spinal Epidural Anaesthesia (CSE) and the Hanging Drop Technique. Regional Anesthesia & Pain Medicine 2008; 33: e258.
• Schmitz-Franken A. Das wissenschaftliche Werk des Angelo Luigi Maria Soresi (1877-1951): ein Erstbeschreiber und Wegbereiter der kombinierten Spinal-Peridural-Anästhesie. Düsseldorf, 2008.
• Neruda B. The search for the originator of the hanging drop technique. Reg Anesth Pain Med. 2008 May-Jun;33(3):276-7; author reply 277-8.
• Dumanian GA, Janes LE, Dumanian ZP. Northwestern and Other Historical Vignettes regarding the Vascular Anastomotic Coupling Device. Plast Reconstr Surg Glob Open. 2019 May 16;7(5):e2194.