Roscoe R. Graham: An Enduring Legacy in the 21st Century.

Background: Modern advancements in surgery have led to a climate in which many classical techniques are becoming obsolete. However, the Graham patch technique for duodenal repair continues to be widely employed as originally described in Dr Roscoe Reid Graham's 1937 article: an omental graft held in position over a duodenal perforation by three interrupted sutures. Methods: Primary documents including original newspaper articles and war documentation were retrieved from the University of Toronto Archives and Records. Contemporary case reports and journal publications were analyzed. A review of current literature on applications and modifications of the Graham patch was undertaken. Discussion: Roscoe Graham received his education at the University of Toronto. Following his surgical training, he joined the No. 10 General Hospital as a Captain in World War I. Upon returning from duty, his surgical contributions were extensive. His achievements include the development of a procedure for rectal prolapse repair, the first insulinoma resection, and the pioneering of an omental patch technique for the treatment of perforated duodenal ulcers. He was an integral member of the Toronto medical community and reputed to be among North America's best surgeons. Conclusions: While many surgical techniques described in the twentieth century have been discarded in favour of new technological applications, Graham's original omental patch is still used across the world. In addition to providing an effective solution to perforated ulcer repair in both open and laparoscopic procedures, it has been adapted for use in traumatic solid organ injury. This paper describes the life and career of Roscoe Reid Graham, highlights his medical contributions, and explores how his omental patch technique continues to be indispensable on the modern surgical stage. Level of Evidence: N/A (C) 2016 Lippincott Williams & Wilkins, Inc.

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