Introduction: Eugène-Louis Doyen studied medicine at Reims and Paris. He explored the German school of surgery by in Heidelberg, Wurzburg, and Vienna, which contributed to developing his daring and inquisitive surgical persona, becoming a dominant leader in French surgery. Known for his contributions to thoracic, abdominal, and gynecologic surgeries, he innovated instruments and novel techniques for intraoperative hemostasis, by introducing the concept of angiotripsy and designing special vascular clamps. However, his seminal work in the emergent 19th century field of neurosurgery, particularly in the treatment of trigeminal neuralgia, has yet to be fully appreciated. Doyen was a pioneer of trigeminal ganglionectomy. Combining the Hartley-Krause subtemporal approach and Rose’s sphenoidal route, he devised an approach towards improving surgical effectiveness for relief of trigeminal neuralgia. He improved the efficiency of a craniotomy by developing an electric craniotome, created instruments for detaching the dura from the inner skull, and fashioned special devices to expose and remove the ganglion en bloc. Perhaps his most genius neurosurgical concept was the “endoscopy” of the cerebellopontine angle for a retrogasserian neurectomy, likely stemming from his gynecologic experience and the many specula he designed. He conceptualized the idea of a small window retrosigmoid craniotomy by inserting a speculum in the cerebellopontine gutter with a specially designed neurotome to cut the sensory trigeminal root, thus eliminating the need for the invasive, more extensive gasserectomy procedure. Known for his unconventional methods and being a “chirurgien célèbre,” Doyen was often in conflict with the medical staff. His intimidating, eccentric personality and insistence on pushing the boundaries of surgical practice, such as in filming operations (including a craniectomy), although attracting popularity and notoriety, further fueled these controversies. His spirit of innovation, inquiry, and excellence are part of the intriguing progress in technical development of neurosurgery at the end of the 19th century.
.jpg)