PROF OWEN'S DEGREES

So what brought you into microsurgery?
I was always going to be a surgeon, I couldn't stand the fact that premature babies born with nasty congenital 'deformities were left to die. My burning desire was to get to the world's best children's hospital of the time and try to find a way to save them. I worked at the Great Ormond Street children's hospital in London in the 1960s. The problem was that the arteries and veins on a one-pound newborn baby are so small you can't see them let alone operate on them. I tried to use magnifying glasses, but it didn't work so I went to Carl Zeiss, the microscope makers in West Germany, with drawings of what I thought surgeons needed--foot controls, and optics that could be used by two surgeons sitting opposite each other. To my surprise, they were very enthusiastic and made one in a few weeks from the parts of other microscopes. Surgeons at Great Ormond Street encouraged me because I was an upstart Australian who'd be going back to Australia ,and so be no threat to anybody in England. We then did operations that were not possible before, repairing conditions such as oesophageal atresia where the tiny baby is born with the oesophagus going into the lung and the trachea into the stomach.. I felt like I was the Messiah coming back to Australia with new techniques that could?-and did-- go into every branch of surgery.

Does microsurgery seem old hat to you now?
No, because I love doing it. lt's meticulous and it brings me in contact with the Almighty, because I see living tissues in close up. Looking down, a microscope underneath the skin its just like looking at a coral reef, it's so full of colour and activity. You do a vasectomy reversal, or a facial nerve graft, and it sounds like there should be blood and gore, but there's none because we can see everything under the microscope, even the tiniest capillaries, and so avoid cutting anything that would cause bleeding. It's in terrific colour, it's three dimensional and you're sculpting some person's new personality if you're reconstructing. I'm the luckiest surgeon that ever lived. Surgeons usually just take things out. All I do is put things back.
So what will be next?
Every time I look down the microscope I see that when you put a micro-suture into tissue, the tissue shrinks away from it. The micro-suture could be a fifth of the width of one of the hairs on your finger, just 10 or 15 micrometres, and yet I watch myself damaging tiny little arteries or nerves. When we put three stitches into a bundle of nerve fibres, we destroy at least 25 per cent of the available axonal material., I wanted to find a way we could avoid using sutures in surgery, so for six or seven years we've been working on sutureless surgery. We've come up with a totally new concept. We use the energy of a beam from a micro laser and a special solder to join arteries and, veins end to end without any stitches. It's quite sensational and I am thrilled to pieces!

New Scientist* www.newscientist.com

‘NEW SCIENTIST’ Magazine , Published 18 July, 1968.

Tipping the balance in transplant surgery

As the lessons of six months of heart transplantation have made abundantly clear, the present methods of preventing rejection all to often result in overwhelming bacterial infections. A new approach, rapidly gathering experimental support from many parts of the world, might soon eliminate this danger - and may ultimately allow animal organs to be transplanted into humans.

For the last, and potentially most exciting word on the subject, it is worth going back to Earl Owen's Hunterian lecture. In it, he reported publicly for the first time the results of transplantation experiments between animals of different species using the antigen desensitization technique. He has transplanted kidneys from guinea pigs into rabbits. All the untreated controls rejected while still on the operating table. By contrast, all desensitized rabbits survived for longer, one for as long as three weeks. As the moment he has not got around to combining the antigen treatment with other techniques, but is very convinced, on past experiences that survival times will be further increased, perhaps to a considerable extent.

There is no need to emphasize the significance on this work on heterografts - that is organ graft between species. Once the last scientific objection to transplant surgery have been removed - as now looks like happening in the not too distant future - the practical and ethical problem associates with an adequate supply of human donors will remain. Until now, any discussion of the use of animal donors - baboons, for example - has been largely wishful thinking. It still is, of course: but for the first time the wish looks capable of fulfilment.