Mark Ravitch
Mark Mitchell Ravitch (1910–1989) was an American surgeon
Ravitch was one of the most influential American surgeons of the twentieth century, remembered as an innovator, teacher, and historian – A Surgeon’s Surgeon. A product of Johns Hopkins under Alfred Blalock, he combined technical brilliance with a restless drive to improve surgical practice, leaving lasting legacies in chest wall reconstruction, gastrointestinal surgery, and operative instrumentation.
His name endures through the Ravitch procedure for pectus deformities, and his role in introducing surgical stapling to the United States during the Cold War marked a decisive step toward modern minimally invasive techniques.
Ravitch was a pioneer of non-operative management of intussusception, demonstrating in a landmark 1948 study that barium enema reduction could safely obviate laparotomy in infants and children. At a time when paediatric surgical mortality was unacceptably high, his experimental and clinical work challenged entrenched dogma and redefined standards of care. In parallel, his collaboration with James R. Cantrell and Jacob A. Haller in 1958 produced the first description of the rare congenital anomaly complex now known as Cantrell’s sequence, another enduring eponym in paediatric surgery.
Ravitch’s influence extended beyond his technical contributions. A prolific author, with over 450 papers and 22 books, he was an exacting but inspiring mentor who demanded intellectual rigour from his students, and continuing to teach from his hospital bed in his final year. He combined surgical innovation with historical scholarship, most notably in his two-volume A Century of Surgery, 1880–1980, preserving the lineage of modern surgical thought.
Biographical Timeline
- 1910 – Born September 12 in New York City to Russian immigrant parents.
- 1930 – Graduated Phi Beta Kappa with a degree in zoology from the University of Oklahoma.
- 1934 – Received M.D. from Johns Hopkins University School of Medicine. Began surgical internship and later pediatrics residency at Johns Hopkins.
- 1942–1943 – Completed surgical residency under Alfred Blalock (1899–1964).
- 1943–1946 – Served as Major in the U.S. Army Medical Corps, 56th General Hospital, Europe; operated continuously during the Battle of the Bulge.
- 1946 – Returned to Johns Hopkins as professor of surgery and director of the blood bank.
- Late 1940s – Developed non-operative management of intussusception using barium enema.
- 1949 – Published early work on surgical correction of chest wall deformities (pectus excavatum/pectus carinatum) – later known as the Ravitch procedure.
- 1952 – Appointed professor of surgery at Columbia University College of Physicians and Surgeons and first full-time chief of surgery at Mount Sinai Hospital, New York.
- 1955 – Resigned from Mount Sinai after departmental disputes; returned to Baltimore.
- 1956 – Became surgeon-in-chief, Baltimore City Hospitals.
- 1958 – On a National Research Council mission to the USSR, observed surgical stapling techniques with Nikolai Amosov; subsequently introduced modern stapling to the United States.
- 1966–1969 – Head of Pediatric Surgery, University of Chicago.
- 1969–1986 – Professor of Surgery and Surgeon-in-Chief, Montefiore Hospital, University of Pittsburgh.
- 1981 – Published A Century of Surgery, 1880–1980 (landmark two-volume surgical history).
- 1983–1984 – President of the American Surgical Association.
- 1985 – Johns Hopkins University established the Mark M. Ravitch, M.D. Endowed Professorship in Surgery.
- 1989 – Died March 1 in Pittsburgh from carcinoma of the colon and prostate, aged 78. Famously continued teaching students from his hospital bed in his final year.
Medical Eponyms
The Ravitch Procedure (Chest Wall Deformities) (1949)
In The Operative Treatment of Pectus Excavatum, Ravitch published his definitive technique for surgical correction of funnel chest. He argued for early intervention on cosmetic, orthopaedic, and physiologic grounds:
The younger the patient at the time of correction, the more favorable are his chances for attaining a normal appearance with subsequent growth of the thoracic cage.
This operation, involving resection of deformed costal cartilages and transverse sternal osteotomy, became known as the Ravitch procedure and remains in use, with modifications, for severe pectus deformities.
Key Medical Contributions
Non-Operative Management of Intussusception
1948 – Ravitch and Robert M. McCune established the hydrostatic reduction of intussusception by barium enema as a safe alternative to immediate surgery.
The cumulative experience of 75 years in the treatment of intussusception shows reduction by hydrostatic pressure to be a safer primary approach than operation. In 27 patients treated primarily by barium enema there were no deaths. The morbidity and length of hospital stay were much reduced when compared with those of patients treated primarily by operation during the same period. The use of hydrostatic pressure under fluoroscopic control in the treatment of intussusception is auxiliary to surgery and not in opposition to it.
Ravitch, McCune 1949
This technique, once controversial, became the standard of care worldwide
Surgical Stapling Innovations
Ravitch was instrumental in introducing mechanical stapling to Western surgery. On a 1958 mission to the Soviet Union, he observed pulmonary surgeons, including Nikolai Amosov, employing stapling devices to improve efficiency and safety. Using his fluency in Russian, Ravitch obtained prototype staplers, which he and Félicien Steichen (1926–2011) refined in U.S. laboratories.
We were astonished to find the use of mechanical sutures to be routine, safe, and efficient… a technology that held great promise for Western surgery.
Ravitch, 1959
His advocacy, combined with later engineering refinements by Steichen and commercial development by Leon Hirsch, led directly to the modern autosuture stapling revolution in the 1960s.
Cantrell’s Sequence (1958)
In 1958, J. R. Cantrell, Jacob A. Haller, and Mark M. Ravitch jointly described a constellation of thoraco-abdominal congenital malformations: abdominal wall defects, sternal anomalies, pericardial and diaphragmatic deficiencies, and cardiac abnormalities.
This condition became known as Cantrell’s sequence (or pentalogy of Cantrell), and their original paper in Surgery, Gynecology and Obstetrics remains the seminal description of this rare but severe malformation complex.
Stigler’s Law of Eponymy
Ravitch pre-empted Stigler’s publication in 1980, publishes “Dupuytren’s invention of the Mikulicz enterotome with a note on eponyms” and delivers a nuanced critique:
In 1979, a year before Stephen Stigler formally articulated his Law of Eponymy, Ravitch published “Dupuytren’s invention of the Mikulicz enterotome with a note on eponyms,” offering a nuanced critique of misplaced attribution in surgical history. His essay pre-empted (and justified) Stigler’s observation that ‘no scientific discovery is named after its original discoverer…’
My own feeling is that whatever their fallibility, eponyms illuminate the lineage of surgery and bring to it the color of old times, distinguished figures, ancient sieges, and pestilences, and continually remind us of the international nature of science.
Fallible eponyms certainly may be. Given an eponym one may be sure (1) that the man so honored was not the first to describe the disease, the operation, or the instrument, or (2) that he misunderstood the situation, or (3) that he is generally misquoted, or (4) that (1), (2), and (3) are all simultaneously true …
Priority, in the award of an eponym, is not necessarily purely temporal: … in terms of importance to medicine and to the sick, the physician who convinces his colleagues of the value of a new procedure, which they then adopt, exceeds in significance his hapless fellow who devised the same procedure earlier but failed to gain its adoption. And by the same token, the individual who first clearly establishes the nature of a condition is usually more deserving of the eponym than the forgotten author of a mere description unearthed by diligent scholasticism or pure serendipity.
Ravitch 1979
Surgical Historian and Bibliophile
Ravitch was a prolific historian of surgery. His two-volume A Century of Surgery 1880-1980 remains a definitive reference on the evolution of modern surgical practice. As historian of the American Surgical Association, he preserved and contextualized surgical milestones.
A dedicated bibliophile, he amassed a rare collection of over 300 volumes spanning the 16th to 20th centuries, later donated to the Falk Library of the Health Sciences, University of Pittsburgh.
Major Publications
- Ravitch MM, Sabiston DC Jr. Anal ileostomy with preservation of the sphincter; a proposed operation in patients requiring total colectomy for benign lesions. Surg Gynecol Obstet. 1947 Jun;84(6):1095-9. [Dis Colon Rectum. 1990 Jun;33(6):529-38.]
- Ravitch MM, McCune RM Jr. Reduction of Intussusception by Barium Enema : A Clinical and Experimental Study. Ann Surg. 1948 Nov;128(5):904-17.
- Ravitch MM. The Operative Treatment of Pectus Excavatum. Ann Surg. 1949 Apr;129(4):429-44. [Ravitch procedure]
- Gordon AJ, Braunwald E, Ravitch MM. Simultaneous pressure pulses in the human left atrium, ventricle and aorta; preliminary communication. Circ Res. 1954 Sep;2(5):432-3.
- Cantrell JR, Haller JA, Ravitch MM. A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart. Surg Gynecol Obstet. 1958 Nov;107(5):602-14. [Cantrell’s sequence]
- Ravitch MM, Brown IW, Daviglus GF. Experimental and clinical use of the Soviet bronchus stapling instrument. Surgery. 1959 Jul;46(1):97-108.
- Ravitch MM. Intussusception In Infants And Children. 1959
- Ravitch MM, Matzen RN. Pulmonary insufficiency in pectus excavatum associated with left pulmonary agenesis, congenital clubbed feet and ectromelia. Improvement following operation. Dis Chest. 1968 Jul;54(1):58-62.
- Ravitch MM. Dupuytren’s invention of the Mikulicz enterotome with a note on eponyms. Perspect Biol Med. 1979; 22(2 Pt 1): 170-184.
- Ravitch MM. The American Surgical Association. The peaks of excitement. Ann Surg. 1980 Sep;192(3):282-7.
- Ravitch MM. A Century of Surgery 1880-1980. Volumes I & II. 1981
- Steichen FM, Ravitch MM. Stapling in surgery. 1984
- Ravitch MM. Second thoughts of a surgical curmudgeon. 1987
- Ravitch MM, Steichen FM. Atlas of general thoracic surgery. 1988
References
Biography
- Fingeret AL, Fingeret AE, Hardy MA. Mark M. Ravitch: historian and innovator. J Surg Educ. 2011 Mar-Apr;68(2):155-8.
- Labosier J, Rees J. Mark M. Ravitch: A surgeon’s surgeon Circulating Now 2016
- Ramenofsky ML, Raffensperger J. Mark M. Ravitch MD: Surgeon, author, teacher, soldier. J Pediatr Surg. 2020 Oct;55(10):2243-2245.
- Mark M. Ravitch Papers. NLM
Eponymous terms
- Steichen FM. Naissance des sutures mécaniques modernes en chirurgie: petites et grandes histories, en hommage à Mark Ravitch [The origin of modern mechanical sutures in surgery: short and long stories, in hommage to Mark Ravitch]. Chirurgie. 1998 Dec;123(6):616-23.
- Abeshouse M, Goldstein S, Phillips B. Mark M. Ravitch: A Staple in Surgical History and Innovation. Am Surg. 2020 Feb 1;86(2):79-82.
- Mark M. Ravitch, M.D. Endowed Professorship in Surgery. Johns Hopkins University
Eponym
the person behind the name
