In the early 20th century, an established surgical specialty catering to pediatric surgery did not exist, and pediatric surgical ailments were operated on by general surgeons. With his devotion to childhood diseases and his unique thinking in surgical development, William E. Ladd would become a leading figure in America by pioneering the field of pediatric surgery

Cowan, MD, Scott W.

Hicks, MD, Barry A.

Lim, MD, Pei-Wen

Martin, MD, Niels D.

Yeo, MD, Charles J.

English

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsDepartment of Surgery, Gibbon Society HistoricalProfiles Department of Surgery1-1-2013William Edwards Ladd, M.D. (1880-1967): thedescription of his bands.Pei-Wen Lim, MDThomas Jefferson University, peiwen.lim@jefferson.eduNiels D. Martin, MDThomas Jefferson University, Niels.Martin@jefferson.eduBarry A. Hicks, MDThomas Jefferson University, barry.hicks@jefferson.eduCharles J. Yeo, MDThomas Jefferson University, Charles.Yeo@jefferson.eduScott W. Cowan, MDThomas Jefferson University, Scott.Cowan@jefferson.eduLet us know how access to this document benefits youFollow this and additional works at: http://jdc.jefferson.edu/gibbonsocietyprofilesPart of the History of Science, Technology, and Medicine Commons, and the Surgery CommonsThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inDepartment of Surgery, Gibbon Society Historical Profiles by an authorized administrator of the Jefferson Digital Commons. For more information,please contact: JeffersonDigitalCommons@jefferson.edu.Recommended CitationLim, MD, Pei-Wen; Martin, MD, Niels D.; Hicks, MD, Barry A.; Yeo, MD, Charles J.; and Cowan,MD, Scott W., "William Edwards Ladd, M.D. (1880-1967): the description of his bands." (2013).Department of Surgery, Gibbon Society Historical Profiles. Paper 15.http://jdc.jefferson.edu/gibbonsocietyprofiles/15Surgical LeadersWilliam Edwards Ladd, M.D. (1880–1967):The Description of His BandsPEI-WEN LIM, M.D., NIELS D. MARTIN, M.D., BARRY A. HICKS, M.D., CHARLES J. YEO, M.D.,SCOTT W. COWAN, M.D.From the Department of Surgery, Thomas Jefferson University, Jefferson Medical College,Philadelphia, PennsylvaniaI N THE EARLY 20th century, an established surgicalspecialty catering to pediatric surgery did not exist,and pediatric surgical ailments were operated on bygeneral surgeons. With his devotion to childhood dis-eases and his unique thinking in surgical development,William E. Ladd would become a leading figure inAmerica by pioneering the field of pediatric surgery.William Edwards Ladd was born on September 8,1880, to William Jones Ladd and his wife, Anna RussellWatson, in Milton, Massachusetts, and he was the sixthof seven children. Following in his father’s footsteps, heattended Harvard University, graduating with a B.A. atthe age of 22 years in 1902, and subsequently an M.D.in 1906 from Harvard Medical School.1 After medicalschool he trained in general surgery at MassachusettsGeneral Hospital. After training he was appointed as-sistant professor in surgery at Harvard. He rose to fullprofessor (Fig. 1) not just as a result of wisdom and lovefor children, but because he was an academic, talented,well-known surgeon. In 1940, the William E. LaddProfessor of Child Surgery Chair at Harvard MedicalSchool was established in his honor.1Many believed that the most powerful nonnuclearexplosion in the history of mankind to that date occurredin Halifax, Nova Scoria, Canada, on December 6, 1917,and had a major impact on Ladd and his life as a pedi-atric surgeon. Approximately 4 per cent of Halifax’spopulation died from a catastrophe involving two ships,the S.S Mont Blanc, a French munitions ship, and theS.S. Imo, a Norwegian relief steamship, when theycollided in the Halifax harbor. More than 500 childrenand infants were killed, and approximately 300 childrenwere left without one or both parents alive.2 Relief ef-forts were initiated immediately from the United States,dispatching trains of medical supplies, trained doctors,and nurses. Dr. William E. Ladd led a team of physi-cians and nurses to Nova Scotia and participated in thecare of the injured.2 That catastrophic experiencemovedLadd tremendously, particularly the plight of burnedand injured children, and inspired him to devote histime, skills, and energy to the surgical care of children.Ladd had established an interest in pediatric surgeryeven before the Halifax incident. He, together withmany other prominent surgeons, founded pediatricsurgery at Boston Children’s Hospital in 1910.1 In 1937,FIG. 1. Father of pediatric surgery, William E. Ladd, M.D.Reprinted from European Journal of Pediatrics. Available at:www.springerlink.com/content/m641772466k4j4n4/. AccessedSeptember 26, 2011.Address correspondence and reprint requests to Scott W. Cowan,M.D., Department of Surgery, Thomas Jefferson University, 1100Walnut Street, 5th Floor, Philadelphia, PA 19107. E-mail: Scott.Cowan@jefferson.edu.11Ladd gave up his surgical practice in adult medicine indowntown Boston to fully contribute to the field ofpediatric surgery (Fig. 2).Ladd’s consistent contributions to clinical researchin children’s diseases led him to publish his first articleentitled ‘‘Treatment of Intussusception in Children’’ in1911. He also focused on pyloric stenosis, a commoncondition that he believed warranted early intervention.In February of 1932, Ladd published an article in theNewEngland Journal of Medicine entitled ‘‘Congenital Ob-struction of the Duodenum in Children.’’3 Although suchcases had been described previously, this condition wasoften overlooked by doctors. In his article, Ladd de-scribed the embryological cause of the disease, attribut-ing it to the incomplete rotation of the intestines, leadingto the attachment of the cecum to the posterior abdominalwall by the ‘‘mesenteric attachments,’’ resulting in duo-denal obstruction. These attachments were later referredto as ‘‘Ladd bands.’’ Because timely and appropriatesurgical intervention offers the only chance for cure inthese patients, Ladd emphasized that early suspicionfor the disease is crucial. In October of 1936, Laddfollowed with another article entitled ‘‘Surgical Dis-eases of the Alimentary Tract in Infants’’ introducinghis method of surgically correcting malrotation thatproved successful during his time at Boston Children’sHospital.4 Before the introduction of his procedure,there were only 15 operative recoveries out of 349 ar-ticles in the literature, and mortality rates of non-operative patients were 100 per cent. Ladd successfullysaved the lives of 16 of 21 patients with the use of hisoperative procedure. The ‘‘Ladd procedure,’’ named inhonor of William E. Ladd, M.D., today involves surgi-cal division of Ladd’s bands, widening of the smallintestine’s mesentery, performing an appendectomy,and placement of the cecum and colon to the left, re-storing an earlier state of embryologic development.Ladd pioneered the repair of cleft palates, bladderexstrophy, and the abdominal approach for removal ofWilms’ tumor. He also left his mark on the surgical repairof tracheoesophageal fistulas, biliary atresia, anorectalabnormalities, and esophageal atresia. In 1941, Laddtogether with Robert E. Gross published the first textbookin pediatric surgery, ‘‘Abdominal Surgery of Infancy andChildhood,’’ defining for the first time this new field oflearning and practice.1 Not just recognized and respectedat Harvard, he also garnered acclaim throughout NorthAmerica. He was a founding member of the AmericanBoard of Surgery, the American Academy of Pediatrics,and the American Association of Plastic Surgeons. Hewas honored by memberships in the highest surgicalgroups, including the New England Surgical Society,the American College of Surgeons, and the AmericanSurgical Association. Ladd was a skillful practitionerand, most importantly, a superb teacher at all levels,from medical students to residents. His greatest suc-cessor, Robert E. Gross, followed in Ladd’s footstepsas an innovator of surgery. Ladd was a major force asrole model, educator, and leader, reflected by the suc-cess of many of his pupils all across the world.FIG. 2. Department of Surgery Boston Children’s Hospital in 1940 when Ladd was Chief. Standing left to right: Charles Ferguson,Donald Mac Collum, Henry Hudson, Thomas Lanman, William Ladd, George Cutler, Augustus Thorndike, Jr., and Robert Gross. Seatedleft to right: Dean Tanner, James Campbell, Harold Hoover, Donald Matson, Marion Connerley, Chilton Crane, Orvar Swenson, JamesBlodgett, Eben Alexnder, Jr., and one not identified. Reprinted from Department of Surgery, Children’s Hospital, 1940. Pediatrics.Available at: http://pediatrics.aappublications.org/content/102/Supplement_2/275/F1.expansion.html. Accessed September 26, 2011.THE AMERICAN SURGEON January 201312 Vol. 79Ladd married his wife, Helen Katherine Barton, onAugust 18, 1910. Together, they had three children.Ladd particularly enjoyed crew and was a member ofthe crew team for Harvard. He continued to row intohis later years. On June 30, 1945, Ladd retired as theWilliam E. Ladd Professor of Children’s Surgery. Ladddied on April 19, 1967, at the age of 86 years after anillustrious and highly productive career.1REFERENCES1. Bill H. William E. Ladd, M.D.: great pioneer of NorthAmerican pediatric surgery. Prog Pediatr Surg 1986;20:52–9.2. Nance ML. The Halifax disaster of 1917 and the birth ofNorth American pediatric surgery. J Pediatr Surg 2001;36:405–8.3. Ladd WE. Congenital obstruction of the duodenum in chil-dren. N Engl J Med 1932;206:277–83.4. Ladd WE. Surgical disease of the alimentary tract in infants.N Engl J Med 1936;215:705–8.No. 1 WILLIAM EDWARDS LADD: THE DESCRIPTION OF HIS BANDS ? Lim et al. 13

William Edwards Ladd, M.D. (1880-1967): the description of his bands.

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William Edwards Ladd, M.D. (1880-1967): the description of his bands.

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