{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T10:25:03Z","timestamp":1794219903827,"version":"4.8.0"},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>This historical review examines Dr. Harry J. Buncke\u2019s development of microsurgical instrumentation and anastomotic techniques for submillimeter vessels, discusses the 1966 Vermont Microvascular Surgery Conference where technical knowledge was exchanged between plastic surgeons and neurosurgeons, and highlights how Buncke\u2019s methods directly informed Dr. M. Gazi Ya\u015fargil\u2019s cerebral revascularization procedures. Buncke\u2019s innovations in microsuture technology, jeweler\u2019s tool adaptation, vasospasm control protocols, and vessel repair techniques for arteries &lt; 1 mm in diameter, demonstrated through successful rabbit ear replantation in 1964, provided the technical foundation for intracranial vessel anastomosis. The 1966 conference facilitated direct transmission of these peripheral vessel techniques to neurosurgical applications, with Ya\u015fargil performing the first superficial temporal artery\u2013to\u2013middle cerebral artery bypass in 1967 using instruments and methods derived from Buncke\u2019s work. This cross-specialty collaboration established the laboratory training paradigm, atraumatic handling principles, and anastomotic protocols that remain fundamental to contemporary microneurosurgical practice, including current surgical management of moyamoya disease and complex cerebrovascular pathology.<\/jats:p>","DOI":"10.3171\/2026.1.jns252641","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:37Z","timestamp":1780444837000},"page":"560-567","source":"Crossref","is-referenced-by-count":0,"title":["Harry J. Buncke to M. Gazi Ya\u015fargil: a historical lesson in cross-specialty microsurgical innovation"],"prefix":"10.3171","volume":"145","author":[{"given":"Jacob C.","family":"Harris","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Om H.","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Almasri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Edavettal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Glauser","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah H.","family":"Feroze","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Kovach","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric L.","family":"Zager","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Choudhri","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pennsylvania, Philadelphia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Vasc Surg","first-page":"515","article-title":"The end-to-end anastomosis of John B. Murphy","volume":"62","author":"Friedman SG","year":"2015","unstructured":"Friedman SG. The end-to-end anastomosis of John B. Murphy. J Vasc Surg. 2015;62(2):515\u2013517. doi:10.1016\/j.jvs.2015.03.046"},{"issue":"2","key":"b2","series-title":"Bioengineering (Basel)","first-page":"75","article-title":"The history and innovations of blood vessel anastomosis","volume":"9","author":"Moritz WR","year":"2022","unstructured":"Moritz WR, Raman S, Pessin S,  The history and innovations of blood vessel anastomosis. Bioengineering (Basel). 2022;9(2):75. doi:10.3390\/bioengineering9020075"},{"issue":"1","key":"b3","series-title":"J Biomed Opt","first-page":"010901","article-title":"Comprehensive review of surgical microscopes: technology development and medical applications","volume":"26","author":"Ma L","year":"2021","unstructured":"Ma L, Fei B. Comprehensive review of surgical microscopes: technology development and medical applications. J Biomed Opt. 2021;26(1):010901. doi:10.1117\/1.JBO.26.1.010901"},{"issue":"6","key":"b4","series-title":"Am J Otol","first-page":"877","article-title":"The history of the microscope for use in ear surgery","volume":"21","author":"Mudry A","year":"2000","unstructured":"Mudry A. The history of the microscope for use in ear surgery. Am J Otol. 2000;21(6):877\u2013886."},{"issue":"2","key":"b5","series-title":"Mayo Clin Proc","first-page":"e25","article-title":"The history of otorhinolaryngology at Mayo Clinic","volume":"92","author":"Carlson ML","year":"2017","unstructured":"Carlson ML, Olsen KD. The history of otorhinolaryngology at Mayo Clinic. Mayo Clin Proc. 2017;92(2):e25\u2013e45. doi:10.1016\/j.mayocp.2016.11.010"},{"key":"b6","series-title":"Surg Forum","first-page":"243","article-title":"Microsurgery in anastomosis of small vessels","volume":"11","author":"Jacobson JH","year":"1960","unstructured":"Jacobson JH, Suarez EL. Microsurgery in anastomosis of small vessels. Surg Forum. 1960;11:243\u2013245."},{"key":"b7","series-title":"JAMA","first-page":"716","article-title":"Replantation of severed arms","volume":"189","author":"Malt RA","year":"1964","unstructured":"Malt RA, McKhann C. Replantation of severed arms. JAMA. 1964;189:716\u2013722. doi:10.1001\/jama.1964.03070100010002"},{"issue":"4","key":"b8","series-title":"Semin Plast Surg","first-page":"211","article-title":"History of microsurgery: the legacy of Harry J. Buncke, MD","volume":"36","author":"Buncke GM","year":"2022","unstructured":"Buncke GM. History of microsurgery: the legacy of Harry J. Buncke, MD. Semin Plast Surg. 2022;36(4):211\u2013220. doi:10.1055\/s-0042-1758130"},{"issue":"5","key":"b9","series-title":"J reconstr Microsurg","first-page":"377","article-title":"Obituary: Harry Buncke M.D.(1922-2008)","volume":"24","author":"Strauch B.","year":"2008","unstructured":"Strauch B. Obituary: Harry Buncke M.D.(1922-2008). J reconstr Microsurg. 2008;24(5):377\u2013378. doi:10.1055\/s-0028-1082024"},{"issue":"1","key":"b10","series-title":"Br J Plast Surg","first-page":"15","article-title":"Total ear reimplantation in the rabbit utilising microminiature vascular anastomoses","volume":"19","author":"Buncke HJ Jr","year":"1966","unstructured":"Buncke HJ Jr, Schulz WP. Total ear reimplantation in the rabbit utilising microminiature vascular anastomoses. Br J Plast Surg. 1966;19(1):15\u201322. doi:10.1016\/S0007-1226(66)80003-6"},{"issue":"4","key":"b11","series-title":"Br J Plast Surg","first-page":"332","article-title":"Immediate Nicoladoni procedure in the Rhesus monkey, or hallux-to-hand transplantation, utilising microminiature vascular anastomoses","volume":"19","author":"Buncke HJ Jr","year":"1966","unstructured":"Buncke HJ Jr, Buncke CM, Schulz WP. Immediate Nicoladoni procedure in the Rhesus monkey, or hallux-to-hand transplantation, utilising microminiature vascular anastomoses. Br J Plast Surg. 1966;19(4):332\u2013337. doi:10.1016\/s0007-1226(66)80075-9"},{"key":"b12","article-title":"Top 10 suture manufacturers. Medico Sutures","unstructured":"Top 10 suture manufacturers. Medico Sutures. Accessed March 9, 2026. https:\/\/medicosutures.com\/top-10-suture-manufacturers\/"},{"issue":"3","key":"b13","series-title":"Br J Surg","first-page":"181","article-title":"New instruments for microvascular surgery","volume":"59","author":"Acland R","year":"1972","unstructured":"Acland R. New instruments for microvascular surgery. Br J Surg. 1972;59(3):181\u2013184. doi:10.1002\/bjs.1800590307"},{"issue":"5","key":"b14","series-title":"Urology","first-page":"971","article-title":"The history of microsurgery in urology","volume":"85","author":"Pastuszak AW","year":"2015","unstructured":"Pastuszak AW, Wenker EP, Lipshultz LI. The history of microsurgery in urology. Urology. 2015;85(5):971\u2013975. doi:10.1016\/j.urology.2014.12.059"},{"issue":"4","key":"b15","series-title":"Neurosurgery","first-page":"899","article-title":"History of the operating microscope: from magnifying glass to microneurosurgery","volume":"42","author":"Kriss TC","year":"1998","unstructured":"Kriss TC, Kriss VM. History of the operating microscope: from magnifying glass to microneurosurgery. Neurosurgery. 1998;42(4):899\u2013908. doi:10.1097\/00006123-199804000-00116"},{"issue":"6","key":"b16","series-title":"J Neurosurg","first-page":"1163","article-title":"Personal considerations on the history of microneurosurgery","volume":"112","author":"Ya\u015fargil MG","year":"2010","unstructured":"Ya\u015fargil MG. Personal considerations on the history of microneurosurgery. J Neurosurg. 2010;112(6):1163\u20131175."},{"issue":"3","key":"b17","series-title":"Hand Clin","first-page":"411","article-title":"Revascularization of the digits and palm","volume":"17","author":"Al-Shammari S","year":"2001","unstructured":"Al-Shammari S, Gupta A. Revascularization of the digits and palm. Hand Clin. 2001;17(3):411\u2013417.viii. doi:10.1016\/S0749-0712(21)00520-5"},{"issue":"4","key":"b18","series-title":"Plast Reconstr Surg","first-page":"374","article-title":"Successful replantation of a completely cut-off thumb","volume":"42","author":"Komatsu S","year":"1968","unstructured":"Komatsu S, Tamai S. Successful replantation of a completely cut-off thumb. Plast Reconstr Surg. 1968;42(4):374\u2013377. doi:10.1097\/00006534-196810000-00021"},{"issue":"2","key":"b19","series-title":"Surgery","first-page":"185","article-title":"Microvascular anastomosis: a device for holding stay sutures and a new vascular clamp","volume":"75","author":"Acland RD","year":"1974","unstructured":"Acland RD. Microvascular anastomosis: a device for holding stay sutures and a new vascular clamp. Surgery. 1974;75(2):185\u2013187."},{"issue":"1","key":"b20","series-title":"Indian J Surg","first-page":"77","article-title":"The legacy of Yasargil: the father of modern neurosurgery","volume":"78","author":"Lovato RM","year":"2016","unstructured":"Lovato RM, Vitorino Araujo JL, de Paula Guirado VM, Veiga JC. The legacy of Yasargil: the father of modern neurosurgery. Indian J Surg. 2016;78(1):77\u201378. doi:10.1007\/s12262-015-1421-6"},{"issue":"5","key":"b21","series-title":"Chin Med J (Engl)","first-page":"295","article-title":"Thumb reconstruction utilizing second toe transplantation by microvascular anastomosis: report of 78 cases","volume":"92","author":"Dongyue Y","year":"1979","unstructured":"Dongyue Y, Yudong G. Thumb reconstruction utilizing second toe transplantation by microvascular anastomosis: report of 78 cases. Chin Med J (Engl). 1979;92(5):295\u2013309. doi:10.1097\/00006534-198005000-00078"},{"issue":"4","key":"b22","series-title":"J Bone Joint Surg Br","first-page":"677","article-title":"Free digital transfer. Report of a case of transfer of a great toe to replace an amputated thumb","volume":"51","author":"Cobbett JR","year":"1969","unstructured":"Cobbett JR. Free digital transfer. Report of a case of transfer of a great toe to replace an amputated thumb. J Bone Joint Surg Br. 1969;51(4):677\u2013679. doi:10.1302\/0301-620X.51B4.677"},{"key":"b23","series-title":"World Neurosurg","first-page":"146","article-title":"Great hospitals: the history of neurosurgery at the University of Vermont Medical Center\u2014a macroscopic examination of microscope-savvy pioneers","volume":"174","author":"Silveira L","year":"2023","unstructured":"Silveira L, Duffy L, Adams D, Muse J, Liebelt B, Tranmer B. Great hospitals: the history of neurosurgery at the University of Vermont Medical Center\u2014a macroscopic examination of microscope-savvy pioneers. World Neurosurg. 2023;174:146\u2013156. doi:10.1016\/j.wneu.2023.03.093"},{"issue":"3 Pt 2","key":"b24","series-title":"J Hand Surg Am","first-page":"S34","article-title":"Forty years of microsurgery: what\u2019s next?","volume":"20","author":"Buncke HJ","year":"1995","unstructured":"Buncke HJ. Forty years of microsurgery: what\u2019s next? J Hand Surg Am. 1995;20(3 Pt 2):S34\u2013S45. doi:10.1016\/s0363-5023(95)80168-5"},{"key":"b25","article-title":"Micro-Vascular Surgery; Report of First Conference, October 6-7, 1966, Mary Fletcher Hospital, Burlington, Vermont.","author":"Donaghy RMP","year":"1967","unstructured":"Donaghy RMP, Ya\u015fargil MG. Micro-Vascular Surgery; Report of First Conference, October 6-7, 1966, Mary Fletcher Hospital, Burlington, Vermont.CV Mosby;1967."},{"issue":"2","key":"b26","series-title":"Plast Reconstr Surg","first-page":"133","article-title":"Successful replantation of an avulsed scalp by microvascular anastomoses","volume":"58","author":"Miller GD","year":"1976","unstructured":"Miller GD, Anstee EJ, Snell JA. Successful replantation of an avulsed scalp by microvascular anastomoses. Plast Reconstr Surg. 1976;58(2):133\u2013136. doi:10.1097\/00006534-197608000-00001"},{"key":"b27","article-title":"U.S. home to world\u2019s best neurosurgeon. Newswise","unstructured":"U.S. home to world\u2019s best neurosurgeon. Newswise. Accessed March 9, 2026. https:\/\/www.newswise.com\/articles\/us-home-to-worlds-best-neurosurgeon"},{"key":"b28","series-title":"Stroke.","first-page":"1417","article-title":"77\u2014Extracranial to intracranial bypass for cerebral ischemia","author":"Newell DW","year":"2011","unstructured":"Newell DW, Vilela MD. 77\u2014Extracranial to intracranial bypass for cerebral ischemia. In: Mohr JP, Wolf PA, Grotta JC, Moskowitz MA, Mayberg MR, von Kummer R, eds.Stroke.5th ed. WB Saunders,2011:1417-1425."},{"issue":"5","key":"b29","series-title":"J Neurosurg","first-page":"970","article-title":"Electrosurgery. Technical note","volume":"85","author":"Malis LI","year":"1996","unstructured":"Malis LI. Electrosurgery. Technical note. J Neurosurg. 1996;85(5):970\u2013975. doi:10.3171\/jns.1996.85.5.0970"},{"issue":"2","key":"b30","series-title":"Neurosurg Rev","first-page":"93","article-title":"History of bipolar coagulation","volume":"29","author":"Bulsara KR","year":"2006","unstructured":"Bulsara KR, Sukhla S, Nimjee SM. History of bipolar coagulation. Neurosurg Rev. 2006;29(2):93\u201396. doi:10.1007\/s10143-005-0012-6"},{"issue":"5","key":"b31","series-title":"Neurosurgery","first-page":"1025","article-title":"A legacy of microneurosurgery: memoirs, lessons, and axioms","volume":"45","author":"Ya\u015fargil MG","year":"1999","unstructured":"Ya\u015fargil MG. A legacy of microneurosurgery: memoirs, lessons, and axioms. Neurosurgery. 1999;45(5):1025\u20131092."},{"issue":"3","key":"b32","series-title":"Plast Reconstr Surg","first-page":"268","article-title":"Autotransplant of omentum to a large scalp defect, with microsurgical revascularization","volume":"49","author":"McLean DH","year":"1972","unstructured":"McLean DH, Buncke HJ Jr. Autotransplant of omentum to a large scalp defect, with microsurgical revascularization. Plast Reconstr Surg. 1972;49(3):268\u2013274. doi:10.1097\/00006534-197203000-00005"},{"issue":"2","key":"b33","series-title":"Ann Plast Surg","first-page":"121","article-title":"Eleven consecutive combined latissimus dorsi and serratus anterior free muscle transplantations","volume":"27","author":"Franceschi N","year":"1991","unstructured":"Franceschi N, Yim KK, Lineaweaver WC,  Eleven consecutive combined latissimus dorsi and serratus anterior free muscle transplantations. Ann Plast Surg. 1991;27(2):121\u2013125. doi:10.1097\/00000637-199108000-00005"},{"issue":"5","key":"b34","series-title":"Plast Reconstr Surg","first-page":"666","article-title":"Successful replantation of two avulsed scalps by microvascular anastomoses","volume":"61","author":"Buncke HJ","year":"1978","unstructured":"Buncke HJ, Rose EH, Brownstein MJ, Chater NL. Successful replantation of two avulsed scalps by microvascular anastomoses. Plast Reconstr Surg. 1978;61(5):666\u2013672. doi:10.1097\/00006534-197805000-00002"},{"issue":"6","key":"b35","series-title":"Plast Reconstr Surg","first-page":"1604","article-title":"Successful replantation of an amputated tongue","volume":"101","author":"Buntic RF","year":"1998","unstructured":"Buntic RF, Buncke HJ. Successful replantation of an amputated tongue. Plast Reconstr Surg. 1998;101(6):1604\u20131607. doi:10.1097\/00006534-199805000-00026"},{"key":"b36","series-title":"Front Surg","first-page":"966430","article-title":"Surgical techniques and indications for treatment of adult moyamoya disease","volume":"9","author":"Nguyen VN","year":"2022","unstructured":"Nguyen VN, Parikh KA, Motiwala M,  Surgical techniques and indications for treatment of adult moyamoya disease. Front Surg. 2022;9:966430. doi:10.3389\/fsurg.2022.966430"},{"issue":"4","key":"b37","series-title":"Semin Plast Surg","first-page":"243","article-title":"Great toe transplantation","volume":"36","author":"Forte AJ","year":"2022","unstructured":"Forte AJ, Maita KC, Torres-Guzman RA,  Great toe transplantation. Semin Plast Surg. 2022;36(4):243\u2013252. doi:10.1055\/s-0042-1758689"},{"key":"b38","series-title":"Front Surg","first-page":"23","article-title":"Supermicrosurgery: history, applications, training and the future","volume":"5","author":"Badash I","year":"2018","unstructured":"Badash I, Gould DJ, Patel KM. Supermicrosurgery: history, applications, training and the future. Front Surg. 2018;5:23. doi:10.3389\/fsurg.2018.00023"},{"issue":"1","key":"b39","series-title":"J Korean Neurosurg Soc","first-page":"23","article-title":"Indocyanine green videoangiography for confirmation of bypass graft patency","volume":"50","author":"Schuette AJ","year":"2011","unstructured":"Schuette AJ, Dannenbaum MJ, Cawley CM, Barrow DL. Indocyanine green videoangiography for confirmation of bypass graft patency. J Korean Neurosurg Soc. 2011;50(1):23\u201329. doi:10.3340\/jkns.2011.50.1.23"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/145\/2\/article-p560.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/145\/2\/article-p560.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/145\/2\/article-p560.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T09:56:19Z","timestamp":1794218179000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/145\/2\/article-p560.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":39,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2026.1.jns252641","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]}}}