Berish Strauch, trailblazer in reconstructive medicine, dies at age 90

Berish Strauch, a plastic surgeon whose groundbreaking procedures and devices to reattach or replace vital body parts include one of the first toe-to-thumb transplants, a device to reverse vasectomies and, perhaps most notably, the first inflatable penile prosthesis, died December 24 in Greenwich, Conn. He was 90.

His daughter, Laurie Strauch Weiss, said the cause of his death at a hospital was respiratory failure.

From the late 1960s, Dr. Strauch is spearheading a revolution in plastic surgery, especially microsurgery, in which doctors use microscopes and precision instruments to sew together tiny blood vessels, nerves and ligaments, some of which are thinner than a human hair. said dr. June K. Wu, associate professor of surgery at Columbia University, who completed her residency under Dr. Strauch completed.

As the longtime chief of reconstructive surgery at Montefiore Medical Center in the Bronx, Dr. Strauch invented many of the surgical procedures and technologies that are now considered commonplace. Among other achievements, he pioneered techniques to remove excess skin from patients who had lost significant amounts of weight through bariatric surgery – a kind of extreme tummy tuck.

After a New York City firefighter lost his thumb in 1976, Dr. Strauch to reattach it. When that proved impossible, he proposed something more radical: taking one of the man's big toes and sewing it in place of the severed finger.

Not only did the operation work, but within a few months the firefighter was back on the job.

“I don't recommend a transplant for someone who has lost a finger,” he told Midnight newspaper in 1976. “A thumb, yes, because the opposable thumb is what distinguishes us from animals.”

Dr. Strauch was one of the first modern surgeons to use leeches to control blood flow after surgery and remove necrotic tissue – a seemingly medieval technique that, he said, could not be improved upon by human innovation.

“If you had to design an instrument to remove blood,” he told The New York Times in 1987, “you couldn't design one more suitable than the Biblical leech.”

He left a particularly deep mark on the field of urology. He created the so-called Strauch clamp, a device used to reverse vasectomies. And perhaps his most notable but no less important innovation: he invented the first inflatable penile prosthesis.

Artificial penises have been used for centuries, either as a replacement for detached members, as a treatment for erectile dysfunction or for use in sex reassignment surgery. But in most cases they were either permanently limp or permanently erect – neither of which was a particularly satisfying arrangement for anyone involved.

Dr. Strauch designed a prosthetic penis that was connected via a tube to a fluid reservoir that was implanted in the body. When the patient wanted an erection, he could activate a pump to fill the prosthesis (although to reverse it, he would have to manually work the fluid back into the reservoir).

He received a patent for his invention in 1973, after which he sold it to a company called American Medical Systems. One of the company's founders, F. Brantley Scott, subsequently developed the product further and has since received the most honor in the annals of medical history.

Berish Strauch was born on September 19, 1933 in the Bronx, the son of Herman and Anna (Weiss) Strauch. His father cut men's suits in Manhattan's garment district; his mother was a milliner.

As a child, Berish, who went by Bob in informal situations, accompanied his parents to work. He later said that watching them for hours with scissors and knives sparked his interest in surgery.

He attended the Bronx High School of Science and graduated from Columbia, where he studied pre-med, in 1955 and from medical school in 1959. After fellowships at Roosevelt Hospital in New York and Stanford Hospital in Palo Alto, California , he returned to the Bronx to join Montefiore's staff. In 1978 he became head of plastic surgery there.

Dr. Strauch married Rena Feuerstein in 1955. She died just eight weeks before he did. Together with their daughter, he is survived by their son Robert, himself a renowned hand surgeon; seven grandchildren; and his sister, Renee Freed. The Strauchs lived in Rye, NY

Although he never sought attention, Dr. Strauch played a small but important role in one of the biggest tabloid stories of the 1990s.

In 1992, Amy Fisher, a Long Island teenager, shot a woman named Mary Jo Buttafuoco in the side of the head after confronting her about Ms. Fisher's affair with Ms. Buttafuoco's husband, Joey.

Ms Buttafuoco survived, but she suffered extensive damage to her face, including partial paralysis. When Dr. Strauch heard about her case, he contacted her attorney and offered to help.

“This is one of the most fertile areas of medicine,” he told Newsday in 1992. “A whole new level of knowledge has emerged in the past twenty years.”

He performed extensive surgery on Ms Buttafuoco in early 1993, returning most of her face to normal – although it was too late to reverse the extensive nerve damage.

“She will still have some elements of the paralysis, especially of the lower lip,” he told Newsday after the operation. “But she is a beautiful lady and she will look great.”