History of Microsurgery

JB Murphy

1897

First vascular anastomosis reported by JB Murphy

Alexis Carrel

1902

Alexis Carrel reports the triangulation technique for end-to-end vascular anastomosis, which will win a Nobel prize in 1912

Jay McLean

1916

A medical student at Johns Hopkins University, Jay McLean, discovers heparin

Bunnell

1948

Bunnell reports repairing upper extremity nerves and using nerve grafts for facial paralysis

Joseph Murray

1954

Joseph Murray performs the first renal transplant among identical twins, which will win a Nobel prize in 1990

Julius Jacobson

1961

Julius Jacobson develops the first two-person binocular microscope with the Carl Zeiss Co and first coins the term “microvascular surgery.” He also works to develop microsurgical instruments

Ronald A. Malt

1962

Ronald Malt and Charles McKhann perform the first upper extremity replantation, Zhongwei Chen successfully replants amputated hand

Robert Goldwyn

1963

Robert Goldwyn and Donald Lamb divide and re-anastamose abdominal island flaps based on the superficial epigastric vessels in dogs, but are unsuccessful due to availability of suture and needle size

Profile 1

1964

Harry Buncke begins experimenting with replanting and transplanting tissues in rabbits and rhesus monkeys

Ty Young

1965

TY Young performs likely first toe-to-thumb transplant, which is not reported until 1973

Susumu Tamai

1965

Shigeo Komatsu and Susumu Tamai report successful replantation of amputated thumb

John Cobbett

1967

John Cobbett performs a toe-to-thumb transplant in a 31 year old woodworker

Berish Strauch

1967

Berish Strauch and Donald Murray perform microvascular groin flaps in rats

Donald McLean

1969

Donald McLean and Harry Buncke perform an omental flap for scalp reconstruction, with patency of the anastomosis demonstrated 3 weeks postoperatively by arteriography. This followed previously failed attempts at scalp flap and groin flap reconstructions.

Bernard O'Brien

1970

Bernard O’Brien starts the microvascular Lab in Melbourne known as the Microsurgery Research Centre

Susumu Tamai

1970

Susumu Tamai reports the first successful neuromuscular transplant in a dog, with one-year follow-up showing normal function

Robert Acland

1971

Robert Acland develops the first microsutures, and will later develop sets of micro instruments

Hanno Millesi

1971

Hanno Millesi reports work on interfasicular nerve grafting, while Jim Smith reports cross-facial nerve grafting

Rollin Daniel

1971

Rollin Daniel and Ian Taylor perform the first groin flap in humans

CR Peters

1971

C.R. Peters, D.M. McKee and B.E. Berry present free jejunal flap for pharyngoesophageal reconstruction using loupes

ISRM

1971

The International Society of Reconstructive Microsurgery is founded, which will later merge with the International Microsurgery Society to form the World Society of Reconstructive Microsurgery in 2001

Ian Taylor

1975

Ian Taylor describes free fibula transplant

Toyomi Fujino

1975

Breast reconstruction with superior gluteal myocutaneous flap described by Toyomi Fujino

Jacques Baudet

1976

Jacques Baudet coins the term “musculocutaneous flap” for use with the latissimus

Kiyonori Harii

1976

Kiyonori Harii uses a gracilis free flap for facial reanimation, using a branch of the masseter muscle

Bernard O’Brien

1977

Bernard O’Brien describes first double toe transplant and split omental flap, and experimental work on microlymphatic surgery

Hans Holmstrom

1979

Hans Holmström performs the first SIEA flap, describing microsurgical transfer of abdominoplasty tissue on the inferior epigastric vessels for breast reconstruction

Stephen Mathes

1980

Stephen Mathes describes vascularized joint transplants in an MCP joint of a three year-old child

Ruyao Song

1982

Ruyao Song introduces the radial forearm flap, called “the Chinese flap”

James Urbaniak

1982

James Urbaniak and Lucinda Fonseca Dos Santos describe the scapular free flap anatomy, and Jacques Baudet describes extending this flap to include lat, serratus, the groin flap, and even tensor fascia lata

Tsu-Min Tsai

1982

Tsu-Min Tsai performs the free vascularized toe PIP joint transfer

Harry Buncke

1982

Harry Buncke performs a scalp transplant between two identical twins

Julia Terzis

1984

Julia Terzis introduces the concept of the “baby-sitter” procedure to coapt ipsilateral hypoglossal nerve to the facial nerve prior to performing cross-facial nerve grafting and begins revolutionizing facial reanimation.

ASRM

1984

American Society for Reconstructive Microsurgery is established

Susan Mackinnon

1984

Susan Mackinnon begins experimenting with pretreated nerve allografts and host immunosuppression, and will use these techniques to successfully reconstruct the sciatic nerve in a child in 1988

James Urbaniak

1985

James Urbaniak performs a vascularized fibula to femoral head transplantation

Marko Godina

1986

Marko Godina presents early coverage of the traumatic extremity coining the term “fix and flap”, revolutionizing the treatment of open lower leg fractures

Ian Taylor

1987

Ian Taylor publishes his landmark injection studies and introduces angiosomes

Isao Koshima

1989

The perforator flap era begins with reporting of a DIEP flap by Isao Koshima and Shugo Soeda

Hung-Chi Chen

1990

Bernard O’Brien and Hung-Chi Chen report experimental work of vascularized lymph node transfers in canines

Scott Levin

1991

Soctt Levin and Chih-Hung Lin report balloon-assisted endoscopic harvest of microsurgical flaps

Robert Allen

1992

Robert Allen begins using muscle sparing perforator flaps of the deep inferior epigastric artery for breast reconstruction

Rodolfo Capanna

1993

Rodolfo Capanna describes reconstructions of large metadiaphyseal bone defects by combining a vascularized fibula flap with an allograft shell.

Julian Pribaz

1994

Julian Pribaz introduces the concept of prelamination to refer to the implantation of tissue or other devices into a flap prior to transfer and suggests that the term prefabrication be restricted to the implantation of vascular pedicles

Iso Koshima

1998

Isao Koshima first uses the term “supermicrosurgery”

Marco Innocenti

2004

Marco Innocenti reports on vascularized proximal fibular epiphyseal transfer for distal radial reconstruction

Anthony Berger

2005

Anthony Berger publishes use of vascularized bone graft from the medial femoral condyle

Jean-Michel Dubernard

2005

First facial allotransplant performed by Jean-Michel Dubernard and Bernard Duvauchelle for woman who had suffered a dog bite injury

Alexander Shin

2006

Allen Bishop and Alexander Shin expand on the use of vascularized rib grafts for complex spinal reconstruction

Hiko Hyakusoku

2007

Hiko Hyakusoku reports technique for pedicled perforator flaps

Edgar Biemer

2008

First Double Arm Transplantation performed by Edgar Biemer

Michel Saint-Cyr

2009

Michel Saint-Cyr defines the perforasome theory of a unique vascular territory for each perforator

Julia Terzas

2009

Julia Terzas describes corneal neurotization to restore corneal sensibility

Pedro Cavadas

2011

Pedro Cavadas performs the first bilateral leg transplant

JP Hong

2013

JP Hong describes elevation of a “super-thin” anterior lateral thigh flap

Jaume Masià

2016

Jaume Masià proposes the mechanism of action of vascularized lymph node transfers

Video

2021

The Future of Microsurgery (Click the picture above to view video message from L. Scott Levin, MD, FACS.)