Development of Microsurgery

Swedish otolaryngologist Carl-Olof Nylen built the first surgical operating microscope in 1921 by modifying a monocular Brinell-Leitz microscope, testing it first on animals before using it on a patient with chronic ear infection later that year, work that has led historians to call him the father of microsurgery; his colleague Gunnar Holmgren produced an improved binocular version the following year. The technique remained largely confined to ear surgery for decades until neurosurgeon Gazi Yasargil brought it into neurosurgery in the late 1950s, vascular surgeon Julius Jacobson performed the first microvascular surgery, joining blood vessels under microscope magnification, in 1960, and plastic surgeon Harold Buncke achieved notable breakthroughs in reattaching severed tissue using microsurgical technique during the 1960s. By making it possible to join blood vessels and nerves as small as a single millimeter across, microsurgery enabled procedures that had previously been impossible, including reattachment of severed limbs and digits and free tissue transfer in reconstructive surgery, transforming ophthalmology, neurosurgery and plastic surgery alike.