History of neurosurgery in Turkey



Turkish Neurosurgical Society

 

Inherited Tradition to New Horizons

The Turkish Neurosurgical Society (TNS) is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical management and care in Turkey and beyond the borders.
The history of neurosurgery as a practice may be somewhat brief when compared to all other medical practices.  During recent excavations in Aşıklı Höyük, 35 skulls - which had undergone a surgical procedure called “trepanation” - were found. However, it is difficult to tell whether these procedures were performed because of medical reasons or religious purposes such as to exorcise demons.  Although modern history of neurosurgery began in Turkey in the 20th century, in Anatolia thousands of different neurosurgical touchstones form modern procedures.


Brief History of Pre-TNS Era

This era starts with Dr. Cemil Topuzlu (1868-1958) who should be considered the founder of modern surgery in Turkey. Dr. Topuzlu operated on many surgical cases for Pott’s disease, spinal and cranial injuries and brain abscesses. One of his cranial abscess cases was presented to the French Surgical Societies, which had most likely been the first international neurosurgical presentation from Turkey.
In the years that followed, Dr. Alexander Kamburoğlu (?-1913), Dr. Garabe Yahoub (1865-1936), and Dr. Mim Kemal Öke (1884-1955) performed brain and spinal surgeries. Dr. Öke wrote the first neurosurgery book in Turkish called “Dimağ ve Cümcüme Afetleri ve Tedavileri (Disasters of the Mind and Skull and Their Treatment)”. Dr. Abdulkadir Cahit Tuner went to Germany for formal studies, and became the first neurosurgeon in Turkey in 1923.  Until then all the neurosurgical procedures were performed by general surgeons.
In 1949, Dr. Hami Dilek founded the first clinic with a specialization program in neurosurgery. Later on, Dr. Feyyaz Berkay, who received his education in the USA, established the first neurosurgery clinic in Cerrahpaşa Medical School. Similarly, Dr. Bülent Tarcan, who was trained in the United Kingdom, returned to Turkey to establish the first neurosurgery clinic in Çapa Medical School. These were followed by the establishment neurosurgery clinics in Hacettepe University in 1960, in Ankara University in 1965, and Ege University in 1967.  Neurosurgery clinics were sprung and spread all over Anatolia, while Dr. Berkay was a trailblazer in the foundation of the first Turkish Neurosurgical Society (TNS). The first Neurosurgery Congress convened in 1971, but due to the political atmosphere of the time, there were limitations and it could not be carried out as expected or planned. Unfortunately, in 1980 the Turkish military coup closed down almost all independent societies such as the Turkish Neurosurgical Society.


Turkish Neurosurgical Society (TNS)

The Turkish Neurosurgical Society (TNS) is the main society of the neurosurgical specialty in Turkey. TNS was established in October, 1985. There are at present almost 1800 neurosurgeons in Turkey. Today, with its 1200 members, the TNS is the main organization for neurosurgeons in our country. Neurosurgery in Turkey has been improving every year: today, many neurosurgical departments perform state of the art surgical and medical procedures.
In 1959, Dr. Türkmen, who completed training at Philadelphia Medical Center, founded the Neurosurgery Department in Hacettepe University School of Medicine and left Turkey in 1960. Dr Nurhan Avman (1928-1968) directed this department until 1965. After leaving Hacettepe University, Dr Avman founded the Neurosurgery Department in Ankara University. Later on, Dr. Avman would be the person who initiated the Turkish neurosurgery journey. During this period, in Europe, a Turkish genius, M.Gazi Yaşargil M.D., made a great breakthrough in neurosurgery and developed the concept of microneurosurgery technique.
The first neurosurgical society of Turkey was founded in Istanbul by 11 neurosurgeons in 1968; however, this society was closed as a result of the 1980 military coup. The Turkish Neurosurgical Society (TNS) was later founded in Ankara by Nurhan Avman, Ertekin Erasıl, Hamit Ziya Gökalp, Aykut Erbengi, Vural Bertan, Süleyman Sağlam, Özdemir Gürçay, Yücel Kanpolat, and Tunçalp Özgen in 1985, and with unanimous vote, Dr. Avman was elected the first president of TNS. Subsequent presidents were Dr. Aykut Erbengi, Dr. Özdemir Gürçay, Dr. Tunçalp Özgen, Dr. Yücel Kanpolat, Dr. Osman Ekin Özcan, Dr. Ertekin Arasıl, Dr. Yamaç Taşkın, Dr. M. Nur Altınörs, Dr. M. Kemali Baykaner, Dr. Kaya Aksoy, Dr. M. Necmettin Pamir, Dr. Nurcan Özdamar, Dr. Ö. Selçuk Palaoğlu, Dr. Mehmet Zileli, Dr. Ethem Beşkonaklı, Dr. Murat Bavbek, Dr. Uğur Türe, DR. Zeki Şekerci, Dr. Talat Kırış and Dr. Şükrü Çağlar.
This non-governmental society arose to this day from the day it became active, and it accelerated the publishing of scientific studies. TNS is the most prominent scientific and professional organization in its field of activity. This society provides support for neurosurgeons all over the country and also encourages research activities among young trainees as well as funding scientific projects. Nowadays, at least twelve scholarships for international courses are provided. The society also contributes to the specialty by merits awards for select scientific studies, thereby enabling scientific progress.
Under TNS, there are six education and training groups: (1) pediatric neurosurgery, (2) spinal and peripheral nerve surgery, (3) neuro-oncology surgery, (4) stereotactic, functional, pain and epilepsy surgery, (5) neurovascular surgery, and (6) neurotrauma.  There are also 24 different boards under TNS such as social rights of membership, external relations, social responsibility projects, R&D activities, training of trainers, professional and personnel rights, and insurance system. They all together form a big structure, rapidly growing and becoming one of the most popular scientific organizations of Europe and West Asia.
TNS is also an active member of the European Association of Neurosurgical Societies (EANS) and the World Federation of Neurosurgical Societies (WFNS). Therefore, TNS cooperates with these organizations in scholarship programs and establishing educational standards in the practice of neurosurgery. TNS is one of the best-organized national societies in Turkey. It has so far held 31 national congresses as well as numerous courses and hands-on workshops.
TNS organizes its annual national congress in April of every year. This year, the 31th National Neurosurgery Congress was organized in Antalya with at least 1400 participants.  In addition, both national and International Basic Neurosurgery Courses are designed for residents in training and junior neurosurgeons. These consist of four annual courses, covering the key topics of Vascular Neurosurgery, Tumor, Neurotrauma/Functional Neurosurgery, and Spine/Peripheral Nerves. Hence, the course cycle takes four years to complete. Specific course features include up to 10 hours of daily lectures, nearly 100 topics in each course. This year, as well as the TNS Congress, IBNC (Term II Course II, Neuro-oncology) was performed prior to congress sessions in Antalya. Today, these courses constitute some real success stories for TNS, with an increasing number of participants from all over the world.
TNS has 2 scientific peer-review journals, both of which have been continuously in publication since 1989. The Turkish journal is called “Türk Nöroşirürji Dergisi” and the international journal “Turkish Neurosurgery”. Besides journals, TNS publishes a bulletin each year and publishes all the oral and poster presentations of the national congress.
To increase the quality of education, a Neurosurgical Board has been introduced by TNS. Members who pass the oral and written board examination are given a certificate.  Although there is not any official sub specialization for neurosurgery, several internal TNS organizations focus on certain aspects of neurosurgical care. Several meetings and symposiums are performed by these subgroups all year round.


Conclusion

The evolution of Turkish Neurosurgery may reflect a deep inherited tradition toward innovation and development. This makes us proud of what we hace accomplished and shared in such a short time period. Turkish Neurosurgery is thankful to Gazi Yaşargil, “Neurosurgery's man of the century” and all other masters who contributed to - and totally changed - the perspective of Neurosurgery toward lesser “No Man’s Land”.
On behalf of the Turkish Neurosurgical Society, we are delighted and really excited to host you in Istanbul for the WFNS XVI World Congress of Neurosurgery. I hope that this event will promote the highest quality of neurosurgical practice all over the world.

Y. Şükrü Çağlar, M.D.
Professor of Neurosurgery
President of the Turkish Neurosurgical Society

August 2019
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