When Julius H. Jacobson II, M.D., took up the posts of Associate Professor of Surgery and Director of Surgical Research at the University of Vermont College of Medicine in October 1959, an investigator from the Department of Pharmacology inquired how the murine carotid artery could be completely denervated. Dr. Jacobson attempted to transect / reanastomose the artery under an operating microscope used for ear surgery. This was the start of his investigations into microvascular anastomosis. It proved a challenging task as all the instruments and suture materials available at that time were too bulky for use under magnification. Thereafter, he ordered a two-person operating microscope from the Carl Zeiss Co. and prepared several instruments for performing microvascular anastomoses as well as fine suture materials.
Jacobson and Suarez published a short article entitled “Microsurgery in Anastomosis of Small Vessels” in Surgical Forum 11 : 243-245, 1960, which has been called the “Bible of Microsurgery”.
This technique has been introduced in the fields of brain-neurosurgery, coronary surgery, peripheral neurosurgery, orthopedic and plastic surgery. In particular, in reconstructive surgery it was applied to limb / digit replantation and several composite tissue transplantation procedures from the beginning of the 1970s.