Human Plastic Anatomy

Historical Background and the Renaissance

The Renaissance marked a fundamental turning point in the study of human body structure. Religion relaxed its strict prohibitions, and human anatomy became a central focus of scientific attention. Anatomists finally gained official permission to openly perform autopsies. Prior to this, such research was strictly forbidden by the church: anatomists had to work underground or limit themselves to animal studies, which inevitably led to gross misconceptions.

A massive contribution to the discipline was made by Andreas Vesalius. By actively using autopsy methods, he was able to study the true arrangement of internal organs in detail. This allowed him to discover and scientifically disprove numerous errors of Galen — an ancient physician whose unquestionable authority was based on the dissection of over five hundred animals rather than humans. Vesalius's work opened a completely new era in the morphological sciences.

Plastic Anatomy and Modern Preparations

Leonardo da Vinci is rightfully considered the founder of plastic anatomy, a field focused on creating anatomical preparations for practicing surgical procedures. Even before official permission from the church, he secretly dissected the bodies of deceased pregnant women to study fetal development at various gestational ages and created highly accurate sketches of embryos.

His main innovation was that he was the first to describe organs with maximum accuracy and in strict relation to neighboring structures. Before him, researchers often worked with decomposed or isolated body fragments.

Today, da Vinci's ideas live on in modern anatomy labs. During practical classes, students work not only with artificial plastic models, but also with plastinates — real cadaveric material. Through a complex processing technique, biological fluids in tissues are replaced with silicone using various polymer agents.

Features of Plastinates:

• They look like silicone copies while maintaining absolute anatomical accuracy.
• They are odorless and immune to degradation.
• They can be safely stored at normal room temperature.

Important Ethical Rule: Since plastinates are made from the bodies of people who were once alive, students are only permitted to photograph them for personal study. Publishing such images online is strictly prohibited.

Plastic and reconstructive surgery

Knowledge of plastic anatomy serves as the foundation for plastic (reconstructive) surgery. This extensive field of medicine deals with restoring lost forms and functions of tissues and organs. Surgeons correct both congenital and acquired defects resulting from severe trauma, illnesses, or previous surgical interventions. The primary goal of such operations is the precise correction of anatomical and functional alterations.

It is important to remember a key rule: by default, absolutely any surgical operation contains elements of plastic surgery, as it always includes a final stage — restoring the integrity of incised tissues.

Complex reconstructive interventions require coordinated teamwork by a specially trained medical team. The surgical team typically includes an oncologist, a plastic surgeon, an anesthesiologist-intensivist, and a pathologist, whose presence is necessary for urgent intraoperative pathomorphological tissue examination.

Reconstructive Interventions on Internal Organs

Methods of reconstructive surgery are widely used in treating metastatic lesions and neoplasms of internal organs.

1. Lung Interventions: Surgeons perform various types of resections. These include lobectomy (removal of a lung lobe, including extended or video-assisted thoracoscopic procedures), segmentectomy, and atypical (sublobar, robot-assisted) resection. In severe cases, pneumonectomy is performed — the complete removal of the lung, which may be accompanied by complex resection and reconstruction of the tracheal bifurcation. Simultaneous bilateral operations and reconstructive-plastic interventions on the chest wall and diaphragm are also practiced.
2. Liver Interventions: For liver tumors, the spectrum of operations includes removal of an entire lobe (hemihepatectomy), marginal atypical resections, and removal of specific segments (e.g., specific segmentectomies S1, S7, S8). Complex combined procedures are performed: left-sided caval lobectomy (S2 + S3), laparoscopic bisegmentectomy, and trisegmentectomy (removal of three segments, e.g., S5+S6+S4 or S5+S6+S7). Operations are often supplemented with angioplasty and a reconstructive-plastic component. In addition to the scalpel, local destruction methods are used to destroy tumors: radiofrequency ablation, thermal ablation, and cryoablation.

Eponymous Anatomical Structures

Many anatomical structures traditionally bear the names of the great scientists who first described their functions and structure:

• Fallopian tubes (uterine tubes) are named after the Italian anatomist Gabriele Falloppio. Their main function is to capture the released egg during ovulation and ensure its safe transport into the uterine cavity, where subsequent implantation occurs.
• The Eustachian tube is named after the works of Bartolomeo Eustachio. It is a narrow channel connecting the pharyngeal cavity to the isolated middle ear cavity. The middle ear itself houses the smallest auditory ossicles: the malleus, incus, and stapes. The main task of the Eustachian tube is to equalize pressure between the middle ear cavity and the external environment. This is why passengers are advised to yawn, swallow, or open their mouths during airplane flights when pressure changes occur. The essence of this simple maneuver is that swallowing opens the Eustachian tube, pressure instantly equalizes, and unpleasant sensations or pain in the ears disappear.

Class and exam questions

What else to study on this topic

• Technique for producing silicone plastinates
• Types of liver resections: from segmentectomy to hemihepatectomy
• Tumor ablation methods: radiofrequency, thermal, and cryoablation
• Reconstruction of the tracheal bifurcation during pneumonectomy
• Galen's errors and Andreas Vesalius's anatomical discoveries

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.