Head of the Depaartment Dubrovnik General Hospital Dubrovnik, Croatia
Introduction: In the late 1950s and early 1960s, a group of innovative neurosurgeons introduced the operative microscope, which enhanced visualization through magnification and improved lighting. This paper reviews the history of microneurosurgery, highlighting significant events and influential figures who contributed to its evolution from humble beginnings to its impressive current state.
Methods: In 1921, Carl Nylén performed the first microsurgery using a monocular dissecting microscope to visualize the pituitary gland. In 1957, Theodor Kurze became the first neurosurgeon to successfully use a microscope in the operating room to remove a schwannoma from the cerebellopontine angle. The following year, Raymond Donaghy established the first microsurgery laboratory, focusing on perfecting vascular anastomoses in small cerebral vessels. In 1967, G. M. Yaşargil performed the first microvascular extra-to-intracranial bypass in Zurich, Switzerland. He is recognized as a leader figure in neurosurgery due to his significant contributions to microneurosurgery.
Results: In the 1970s and 1980s, significant advancements were made in microneurosurgery techniques for various procedures, including skull base surgeries, treatment of intracranial aneurysms and arteriovenous malformations, peripheral nerve surgeries, and transsphenoidal pituitary surgery. These advancements were pioneered by notable figures such as J. L. Pool, M. Samii, R. F. Spetzler, P. Janetta, V. Dolenc, L. N. Sekhar, O. Al-Mefty, and many others.
Conclusion : Microneurosurgery has experienced significant growth over the past 50 years. It enhances surgical outcomes by improving the visual accuracy of neural and vascular structures. This technique reduces postoperative tissue damage and allows neurosurgeons to tackle complex lesions in areas that were previously considered inoperable. As a result, microneurosurgery has become the standard in modern neurosurgery.
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