PROGRESS IN
MICROSURGERY

Professor Earl Owen AO MICROSURGEON

At first "Microsurgery" was known for either FINGERS being replaced or clever eye surgery, but it actually started decades before in Sweden with ear surgeons treating otosclerosis under magnification.

In 1970 in Sydney Paul Lendvai and I reconstructed a 2 year old child's amputated index finger using a much more sophisticated motorised Zeiss Operating Microscope and newly designed microinstruments. Within 5 years the Americans, German and French were benefitting from Sydney's and Melbourne's experiences with our large number of such REPLANTS, but the replant numbers fell when WORKCOVER and strict factory safety regulations were enforced in the 1980's.

Using new techniques only possible under intense magnification better peripheral nerve repairs and grafts were soon possible, and G. Ian Taylor's anatomical studies led to him pioneering the "free flap" of both soft, and bone included, composite tissue free flaps.

Availability of equipment led to the use of Microsurgery also in Urology, Gynaecology and Hand surgery and Neurosurgery, but surprising little use in Vascular surgery and only rarely in Coronary Artery surgery.

Due to Microsurgery progress Australian Hand Surgeons are now better equipped to repair fine digital nerves and arteries. Experienced Microsurgeons with sufficient specialist training can now confidently tackle amputated body part reconstructions, "reverse" tubal ligations and vasectomies, perform long nerve grafts (even with their feeding blood vessels) to power paralysed faces, limbs and their own clever "free flaps" of composite body tissues.

And, of course, Microsurgery is necessary for the success of composite tissue transplantations.