Abstract
Microsurgery is a term used to describe the surgical techniques that require an operating microscope and the necessary specialized instrumentation, the three “Ms” of Microsurgery (microscope, microinstruments and microsutures). Over the years, the crucial factor that transformed the notion of microsurgery itself was the anastomosis of successively smaller blood vessels and nerves that have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Currently, with obtained experience, microsurgical techniques are used by several surgical specialties such as general surgery, ophthalmology, orthopaedics, gynecology, otolaryngology, neurosurgery, oral and maxillofacial surgery, plastic surgery and more. This article highlights the most important innovations and milestones in the history of microsurgery through the ages that allowed the inauguration and establishment of microsurgical techniques in the field of surgery.
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References
Porter R (1999) The greatest benefit to mankind: a medical history of humanity. WW Norton, New York
Kennedy MT (2004) A brief history of disease, science and medicine. Asklepiad Press, Mission Viejo
Neligan PC (2018) Plastic surgery, vol 6. Elsevier, Amsterdam
Soucacos PN, Gartziou-Tatti A, Paschopoulos M (2017) Hybrid and extraordinary beings: deviations from normality in ancient Greek mythology and modern medicine. Konstandaras Medical Publications, Athens
Markatos K, Karamanou M, Saranteas T, Mavrogenis AF (2018) Hallmarks of amputation surgery. Int Orthop. 2018. https://doi.org/10.1007/s00264-018-4024-6
Markatos K, Tzivra A, Tsoutsos S, Tsourouflis G, Karamanou M, Androutsos G (2018) Ambroise Paré (1510–1590) and his innovative work on the treatment of war injuries. Surg Innov 25(2):183–186
Paré A (1840–1841) Oeuvres d’Ambroise Paré. Paris, France: J-B Baillière. Gabriel Buon, Paris (1575)
Markatos K, Androutsos G, Karamanou M, Tzagkarakis G, Kaseta M, Mavrogenis AF (2018) Jean-Louis Petit (1674–1750): a pioneer anatomist and surgeon and his contribution to orthopaedic surgery and trauma surgery. Int Orthop. 2018. https://doi.org/10.1007/s00264-018-3978-8
Uluç K, Kujoth GC, Başkaya MK (2009) Operating microscopes: past, present, and future. Neurosurg Focus 27(3):E4
Tamai S (2009) History of microsurgery. Plast Reconstr Surg 124(6 Suppl):e282–e294
Soucacos PN, Urbaniak JR, Bright DS, Adelaar RS (1975) Replantation of severed digits and hands using microsurgical techniques. In: Proceedings of the IX European Federation Congress, Amsterdam, June 29–July l4 p 249a
Bey E, Brachet M, Lambert F, Cariou JL (2005) Microsurgery: history of instrumental vascular anastomoses, our experience with eversion-stapling using VCS forceps. Ann Chir Plast Esthet 50(1):12–18
Berthiaume F, Maguire TJ, Yarmush ML (2011) Tissue engineering and regenerative medicine: history, progress, and challenges. Annu Rev Chem Biomol Eng 2:403–430
Viola J, Lal B, Grad O (2003) The emergence of tissue engineering as a research field. Arlington, VA: National Science Foundation. https://www.nsf.gov/pubs/2004/nsf0450/. Accessed 9 Nov 2018
Wagner WR (2016) Regenerative medicine from the McGowan Institute. https://web.archive.org/web/20100612200346/http://www.mirm.pitt.edu/news/article.asp?qEmpID=395. Accessed 9 Nov 2018
Maher B (2013) Tissue engineering: how to build a heart. Nat Mag. https://www.scientificamerican.com/article/next-generation-stem-cells-transplanted-in-human-for-the-first-time/. Accessed 9 Nov 2018
Aitken E, Jackson A, Kearns R et al (2016) Effect of regional versus local anaesthesia on outcome after arteriovenous fistula creation: a randomised controlled trial. Lancet 388(10049):1067–1074. https://doi.org/10.1016/S0140-6736(16)30948-5
Dallenbach KM (1939) Pain: history and present status. Am J Psychol 52:331–332
Riese W, Arrington GE Jr (1963) The history of Johannes Müller’s doctrine of the specific energies of the senses: original and later versions. Bull Hist Med 37:179–183
Moore J (1784) A method of preventing and diminishing pain in several operations of surgery. Cadell, London, p 50
Collins VJ (1979) The history of anesthesiology. In: Collins VJ (ed) The principles of anesthesiology, 2nd edn. Lea & Febiger, Philadelphia, pp 3–30
Atkinson RS, Rushwan GB, Lee AJ (1987) Regional technique. 10th ed. Chapter 31. Synopsis of anaesthesia, pp 593–594
Ring ME (2007) The history of local anesthesia. J Calif Dent Assoc 35(4):275–282
Koller C (1928) Historical notes on the beginning of local anesthesia. JAMA 90:1742–1743
Halsted WS (1885) Practical comments on the use and abuse of cocaine; suggested by its invariably successful employment in more than a thousand minor surgical operations. N Y Med J 42:294–295
Kappis M (1914) Erfahrungen mit Lokalanasthesie bei Bauchoperationen. Verh Dtsch Ges Chir 43:87
Bier A (1908) “Ueber einen neuen weg localanasthesie in den gliedmaassen zu erzeugen. Langenbeck’s Archiv für Klinische Chirurgie 86:1007–1016 (in German)
Hirschel G (1911) Die Anaesthesierung des Plexus brachialis bei Operationen an der oheren Wremitat. Munch Med Wochenschr 29:1555–1556
Kulenkampff D (1911) Die anaesthesierung des Plexus hrachialis. Zbl F Chir 40:1354–1356
Greenblatt GM, Denson JS (1962) Needle nerve stimulator-locator: nerve blocks with a new instrument for locating nerves. Anesth Analg 41:599–660
von Perthes G (1912) Uber Leitungsanasthesis unter Zuhilfenahme Elektrischer Reizung. Munch Med Wochenschr 47:2545–2548
Kapral S, Krafft P, Eibenberger K, Fitzgerald R, Gosch M, Weinstabl C (1994) Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 78(3):507–513
Gerrard AD, Brooks B, Asaad P, Hajibandeh S, Hajibandeh S (2017) Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement. Eur J Orthop Surg Traumatol 27(1):61–72
Lehmann LJ, Loosen G, Weiss C, Schmittner MD (2015) Interscalene plexus block versus general anaesthesia for shoulder surgery: a randomized controlled study. Eur J Orthop Surg Traumatol 25(2):255–261
Malt RA, McKhann CF (1964) Replantation of severed arms. JAMA 189:716–722
Buncke HJ Jr, Schulz WP (1965) Experimental digital amputation and replantation. Plast Reconstr Surg 36:62–70
Komatsu S, Tamai S (1968) Successful replantation of a completely cut-off thumb. Plast Reconstr Surg 42:374–377
Meyer VE, Maillard G, Maass D, Azzoni Z (1976) Successful replantation of a hand amputated through the metacarpus. J Bone Jt Surg Br 58:474–477
Biemer E (1977) Vein grafts in microvascular surgery. Br J Plast Surg 30:197–199
Soucacos PN, Beris AE, Anastasiou ED (1994) The first thumb. Orthopedics 6:13–15
Daniel RK, Taylor GI (1973) Distant transfer of an island flap by microvascular anastomoses: a clinical technique. Plast Reconstr Surg 52:111–117
Gilbert A, Teot L (1982) The free scapular flap. Plast Reconstr Surg 69:601–604
Baudet J, Guimberteau JC, Nascimento E (1976) Successful clinical transfer of two free thoraco-dorsal axillary flaps. Plast Reconstr Surg 58:680–688
Godina M (1986) Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg 78:285–292
Georgescu AV, Capota I, Matei I et al (2009) The place of local/regional perforator flaps in complex traumas of the forearm. J Hand Microsurg India 1:25–31
Buncke HJ Jr, Buncke CM, Schulz WP (1966) Immediate Nicoladoni procedure in the Rhesus monkey, or hallux-to-hand transplantation, utilising microminiature vascular anastomoses. Br J Surg 19:332–337
Foucher G, Merle M, Maneaud M, Michon J (1980) Microsurgical free partial toe transfer in hand reconstruction: a report of 12 cases. Plast Reconstr Surg 65:616–627
Terzis JK, Skoulis TG, Soucacos PN (1995) Vascularized nerve grafts. Int Angiol 14:264–277
Brunelli GA, Vigasio A, Brunelli GR (1994) Different conduits in peripheral nerve surgery. Microsurgery 15:176–178
Millesi H, Meissl G, Berger A (1972) The interfascicular nerve-grafting of the median and ulnar nerves. J Bone Jt Surg (Am) 54:727–750
Dubernard JM, Owen E, Herzberg G et al (1999) Human hand allograft: report on first 6 months. Lancet 353:1315–1320
Ravindra KV, Wu S, Bozulic L, Xu H, Breidenbach WC, Ildstad ST (2008) Composite tissue transplantation: a rapidly advancing field. TPS 40(5):1237–1248
Swearingen B, Ravindra K, Xu H, Wu S, Breidenbach WC, Ildstad ST (2008) Science of composite tissue allotransplantation. Transplantation 86(5):627–635
Levin LS (2018) From autotransplantation to allotransplantation: a perspective on the future of reconstructive microsurgery. J Reconstr Microsurg 34:681–682
Tintle SM, Levin LS (2013) The reconstructive microsurgery ladder in orthopaedics. Injury 44:376–385
Terzis JK (2008) History of microsurgery: 5 generations from 1957. LuLu Publishing, Morrisville
Soucacos PN, Anastasiou ED (1994) The first finger. Acta Orthop Hellenica 45:21–28
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Mavrogenis, A.F., Markatos, K., Saranteas, T. et al. The history of microsurgery. Eur J Orthop Surg Traumatol 29, 247–254 (2019). https://doi.org/10.1007/s00590-019-02378-7
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DOI: https://doi.org/10.1007/s00590-019-02378-7