Historical review of small and microvascular vessel surgery

The history of small and microvessel surgery is reviewed to aid the beginning microvascular surgeon in gaining a perspective of the surgical techniques used on vessels less than 3 mm in diameter. Although microvascular surgery uses sophisticated microscopes, instruments, and sutures, the fundamental operative procedures are similar to those first worked out on larger vessels. The trial and error methods of past surgeons from many different disciplines have led to ever-expanding possibilities for treatment of sick and injured patients and to laboratory investigation of disease processes. We have tried to highlight the major steps in the development of vascular surgery leading up to our present core of microvascular techniques. We recognize that many of these will become obsolete tomorrow; however, in developing the new it is wise to avoid the mistakes of the past.