Prof. M. Gazi YaÅŸargil
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On July 6, 2025, the Department of Neurosurgery at the University Hospital of Zurich will celebrate the 100th birthday of Professor YaÅŸargil, former Chair and Head of Neurosurgery at USZ from 1973 to 1992, and who in 1999 was named Neurosurgeon of the Century by the international community, as the pioneer and founding father of microneurosurgery and modern neurosurgery. If neurosurgery exists in its current form today, and if neurosurgery is capable of offering relief and effective treatments even for the most complex conditions once considered inoperable, if neurosurgery has become a daily reality worldwide, benefiting millions of people, patients, and families, it is thanks to the insights, intellect, intelligence, and tireless work of Professor YaÅŸargil.
Born in Turkey on July 6, 1925, and raised in Ankara, M. Gazi YaÅŸargil began his medical studies in Germany, in Jena, and in April 1945 moved to Basel to complete his studies. He began his neurosurgical training in Zurich in 1953 under the guidance of Professor Krayenbühl, the founder of neurosurgery in Switzerland and who established the neurosurgery department at USZ, at a time when neurosurgery was just beginning to take shape and explore possibilities and new horizons. He initially focused on spinal surgery, carotid surgery, stereotactic surgery, and direct puntion of the carotid and vertebral arteries for angiography, writing an acclaimed monograph on the subject together with Professor Krayenbühl.
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The history (with a capital H) began precisely in front of an angiography of a young girl, operated on by the USZ cardiothoracic surgeon Professor Ake Senning, another legend in his field. The girl had a blocked cerebral artery due to an embolism, likely caused during the cardiothoracic surgery. Professor Senning rushed to the neurosurgeons, demanding a solution, perhaps a bypass to restore the patency of the blocked vessel. YaÅŸargil’s embarrassed admission of helplessness—no one in the world had ever performed a cerebral bypass—did not calm Senning's frustration, and he stormed into Krayenbühl’s office to ask for an explanation, ending the conversation with “Why don't you try it first yourselves?”
Krayenbühl and YaÅŸargil accepted a seemingly impossible challenge: cerebral vessels have very small diameters, sometimes even under a millimeter. Performing a bypass between such tiny vessels seemed impossible. However, YaÅŸargil learned that Dr. Donaghy in Burlington, USA, directed a microsurgical training laboratory on animals. The laboratory was highly regarded in vascular and cardiothoracic surgery circles, and YaÅŸargil decided to spend a year there training, learning how to suture vessels under a millimeter in diameter. During this year, he also mastered bipolar coagulation, a particularly precise and selective hemostasis technique ideal for controlling microsurgical bleeding.
It was 1965, and working under the microscope allowed YaÅŸargil to hone his manual skills, performing microanastomoses and bypasses on vessels as thin as a hair. More importantly, it revealed a completely new way of seeing—and therefore understanding—brain anatomy and pathology. When viewed with the naked eye, as was common in neurosurgery at the time, the brain appeared as a soft mass, difficult to handle, accessible only at its surface, with thin vessels running at depths only reachable after invasive lobectomies. But when seen under the microscope, at a millimetric scale, the brain revealed a refined logical architecture of convolutions, interspersed with subarachnoid spaces that organized the brain's topography into a rational grid of sulci, fissures, and cisterns, with delicate vascular patterns following these paths. This new perspective made the brain no longer intimidating or incomprehensible, but open to analysis, exploration, and manipulation. The manipulation techniques, now micro-surgical, no longer seemed frightening - and not only allowed microanastomoses but, most importantly, granted exploration of the brain along natural pathways, such as the cerebrospinal fluid spaces, which now made it possible to reach even the deepest regions without damaging the brain. “Follow the nature” or “listen to nature,” YaÅŸargil would say on several occasions, and to follow nature, one must first observe, interpret, and explore it—qualities that transcend those of a surgeon and align more with those of great scientists and humanists.
Around these qualities, YaÅŸargil's career naturally developed, reaching heights never before achieved by any neurosurgeon. On January 18, 1967, the first microneurosurgery operation was performed at the University Hospital of Zurich, marking the beginning of a new era. The first cerebral bypass performed on a human was followed by numerous other surgical milestones (trans-sylvian amygdalo-hippocampectomy, trans-cisternal approaches to deep gliomas, the concept of tumorectomy, etc.). In 1973, YaÅŸargil became a full professor and head of the department, which soon became the beacon of worldwide neurosurgery.
The range of Professor YaÅŸargil's achievements applying the principles of microneurosurgery was nothing short of a marvel for the global neurosurgical community, attracting visitors from all over the world who came to Zurich to observe, learn, and later replicate the techniques. Between 1973 and 1992, when he retired, more than 3,000 neurosurgeons visited Zurich, many of whom later assumed prominent positions in their respective countries, helping to spread microneurosurgery worldwide.
Neurosurgery's Man of the Century
In 1993, Professor YaÅŸargil moved to Little Rock, Arkansas, in the United States, at the invitation of Professor Al-Mefty, where he continued his surgical and academic career. In 1999, he was named Neurosurgery's Man of the Century by the CNS. In 2013, he moved to Istanbul, where he continued his academic career at Yeditepe University.
Professor YaÅŸargil's scientific legacy is hard to measure in mere numbers, though they are significant: over 300 scientific publications, including the six-volume monograph “Microneurosurgery,” published in the 1990s, which remains the reference text for microneurosurgery worldwide.
He has received numerous scientific and civil awards and honors, including a series of stamps dedicated to him by the Turkish postal service and streets named in his honor.
In 2024, the YaÅŸargil Academy was founded, bringing together the best of microneurosurgery worldwide with the goal of continuing the objectives of microneurosurgery in the spirit of YaÅŸargil. In 2024, Professor YaÅŸargil returned to live in Zurich, his adoptive homeland, together with his beloved wife, Ms. Dianne YaÅŸargil.
"I accomplished a micro-climb on a well-installed pathway on the Swiss Alps (Stoos 1600 m).
To the younger generation, I wish courage and hard work to pass to the higher levels."
(Prof. M. Gazi YaÅŸargil: A Legacy of Microneurosurgery: Memoirs, Lessons and Axioms.
Neurosurgery, Vol 4, No 5, November 1999)