EDITORIAL

MICROSURGERY 23:412–413 2003

‘‘FATHER’’ OF EXPERIMENTAL
MICROSURGERY: DR. SUN LEE

To date, millions of lives have been saved by organ

transplantation. Indeed, these remarkable achievements
would have been impossible without experimental organ
transplantation research in animal models. Today, 95%
of organ transplantation research projects are carried
out using rodents such as rats and mice. The key factor
to ensure the success of these experiments is state of the
art experimental microsurgery, which was developed by
Dr. Sun Lee in the late 1950s.
Dr. Sun Lee (Sil Heung Lee) was born in Korea and
came to the USA in 1950. Dr. Lee completed his surgical
residency at St. Francis Hospital in Pittsburgh and then
joined Dr. Bernard Fisher at the University of Pitts-
burgh in 1955. At that time, the University of Pitts-
Dr. Sun Lee
burgh, like most American universities, was equipped
with dog laboratory facilities where vascular surgeries
were performed to develop open heart surgery and Satinsky clamp and covered the tip of the clamp with
kidney transplantation techniques. At that period, rats rubber tubing. After many attempts and failures, an
were seldom used in surgical laboratories, despite a long end-to-side portacaval shunt was finally perfected in the
history of rat usage in allied biological research. En- rat by Dr. Lee in 1958. Dr. Fisher said in his book, ‘‘Do
couraged by Dr. Fisher, Dr. Lee started his pioneer you know what you have done just now? You have
experiments, performing portalcaval shunts in rats in opened an avenue to conduct allied physiological re-
1957. At that time, the 7-0 silk suture had just been search, transplantation investigation, and it may well
developed; however, no operating microscope and replace dog surgery in the years to come.’’ He further
microsurgery instruments were available to him. During stated, ‘‘We fully expect that vascular surgery will be
a 6-month struggle in searching for proper instruments, applied to smaller and smaller vessels, for such is pos-
Dr. Lee tried various shapes and sizes of women’s sible and will be utilized by those who are willing to
hairpins on rat blood vessels but they were soon dis- master the technical skill. In our laboratory, end-to-side
carded, being either too loose or too sharp for such portacaval shunt is being performed by Dr. S.H. Lee on
delicate blood vessels. By 1958, he designed a miniature 300 gm rats with routine success by the same suture
technique used in humans (7-0 silk), and the vascular
anastomoses remain patent indefinitely. Such technical
*Correspondence to: Dr. Robert Zhong, London Health Sciences Centre, 339 gymnastics might well be clinically utilizable, particu-
Windermere Road, London, Ontario N6A 5A5, Canada. E-mail: zzhong@
uwo.ca larly if organ transplantation became feasible.’’ Thus,
1958 marked the beginning of experimental microsur-
Published online in Wiley InterScience (www.interscience.wiley.com). DOI:
10.1002/micr.10177 gery.

ª 2003 Wiley-Liss, Inc.


‘‘I am so happy that I was one of those who foresaw
the mounting expenditures of employing domestic ani-
mals, and made it easier for the public to lessen their
sentiments toward the use of dogs and cats.’’ Sun Lee
said. Dr. Lee commented on the benefits from the rat
transplant model. ‘‘There will be many patients enjoying
extended lives from transplantation,’’ he stated.
However, publishing this landmark work was very
difficult. At the beginning, this paper was rejected by
Surgery and the editor commented, ‘‘Thank you for
submitting the very interesting paper entitled, Porta-
caval Shunt in the Rat, but we cannot accept it for
publication in Surgery at this time. We assume that such
surgery has been performed by other(s) and we would
like for you to write the following authors. If they deny
such performances of the surgery in the rat, then you
may claim your priority and it will be accepted for
publication in Surgery.’’ Enclosed were about 10 names
with addresses. Almost a year was spent in corre-
sponding with these authors, since many had moved.
None of these experts claimed to have carried out suture
anastomosis in the union of the inferior vena cava to the
portal vein in the rat. Dr. Lee then resubmitted to
Surgery, and the paper appeared in 1961. In the mean-
time, Dr. Lee used this technique to develop kidney
transplants in rats. The results were presented in an
exhibit at the Annual American College of Surgeon’s
Congress Exhibit Hall in the same year.
In 1964, Dr. Lee moved to Scripps Clinic at La Jolla
with Dr. Dixon, where he applied rat kidney transplant
techniques in immunological studies. There, and by
traveling overseas, Dr. Sun Lee taught many leading
scholars about rat blood vessel surgery and organ
transplant techniques. As a result, rodents have replaced
large animal organ transplantation works worldwide. In
the meantime, Dr. Lee developed and refined rat pan-
creaticoduodenum, liver (both in partial and whole,
heterotopic or orthotopic), stomach, spleen, and heart-
lung transplants.
Throughout the early phase of the development of
experimental microsurgery, Dr. Sun Lee was both a
pioneer and a great teacher. He has trained hundreds of
microsurgeons around the world by his unique hands-on
demonstration of organ transplantation in rats. For
example, Dr. Lee traveled to China to set up a micro-
‘‘Father’’ of Experimental Microsurgery: Dr. Sun Lee 413
surgery training course in Shanghai’s First Medical
School in 1982. Over 30 years have passed, and I still
vividly recall the exciting moment when I witnessed for
the first time a liver transplantation in rats performed by
Dr. Lee. His teaching method was largely empirical and
effective, since he knew all the practical aspects of his
specialty and strove to make the procedures simpler,
more effective, and easier to learn. Soon after this
workshop, many centers in China established organ
transplantation models in rats. Many of his students are
now leading transplant surgeons, scientists, and profes-
sors worldwide. Dr. Rowinski in Poland, Dr. Nozawa in
Japan, Drs. Thiede and Broelsch in Germany, Drs. Di-
Cataldo and Campsi in Italy, Dr. Hweidi in Egypt, Drs.
Y. Mullen, Qian, Yuqin Wang, and R. Guttman in the
USA, Dr. Chen in Canada, Drs. Y. Lee, Y.B. Koh, J.H.
Yoon, and C.H. Yoo in Korea, as well as many others,
are among them.
Dr. Lee is also founder of many international soci-
eties in the field of experimental microsurgery and
transplantation. Dr. Lee is an Honorable President of
the International Microsurgical Society and a founder of
the International Society of Experimental Microsurgery
(ISEM).
At age 82, Dr. Lee remains at the forefront of this
field. To solve the severe shortage of organs, his labo-
ratory is conducting many cutting-edge experiments in
consecutive organ transplantation. Amazingly, Dr. Lee
is still performing organ transplantation in rats. Dr. Lee
said, ‘‘Successful organ transplantation was considered
a miracle in human history. Using animal organs to save
human lives will be the foci of yet another miracle to
come. We may even see this milestone more towards the
beginning of this century.’’ Given Lee’s reputation in
this field, this is a profound statement indeed. ‘‘In 30
years there will be an extreme shortage of organ donors;
organs which have already been transplanted may then
be reused in future,’’ Dr. Lee thus elaborated.
Robert Zhong
Department of Surgery
University of Western Ontario
London, Ontario, Canada