Microsurgery is a modern surgical technique that allows surgeons to operate on tiny blood vessels, nerves, tubes and organs. Using microscopes, highly precise instruments — some adapted from jewelers’ tools –and surgical techniques developed in the last 50 years, microsurgeons can perform a variety of delicate procedures.
During the past two decades, microsurgical techniques have been perfected to a remarkable degree. Microsurgery is extremely useful in repair of birth defects, tissue loss from other surgery, such as tumor removal, tissue transplantation, known as free flaps, and organ transplantation. Microsurgery is invaluable for reattachment of amputated limbs and in breast reconstruction.
TYPES OF MICROSURGERY
Amputated body parts, such as fingers, toes, hands, feet, ears and scalps, are reattached with microsurgical procedures. The goal is always to preserve as much function as possible. Replantation involves the reconnection of many different kinds of tissues including bone, tendons, arteries, veins, nerves and skin.
Treatment of vascular disorders and disease
Tissue flaps and replantation are used to treat traumatic injuries to veins and arteries. Chronic vascular diseases, such as atherosclerosis, aneurysms and blocked vessels, may require other microsurgical techniques such as vessel repair, grafting, or clot removal.
Nerve repair and grafting
Microsurgical repair of injured nerves allows patients to regain some or all movement in the affected body part. As a result of successful microsurgery, the patient may regain the ability to flex the foot or wrist, bend the fingers or toes, cross the thumb across the palm, known as thumb opposition, or move facial muscles.
SURGEONS WHO USE MICROSURGERY
Microsurgery is frequently used in plastic surgery to reconstruct damaged or disfigured skin, muscles, or other tissues, or to transplant tissues from one part of the body to another. This is frequently used on patients who have suffered traumatic injury. Surgeons in the following specialties may also use microsurgical techniques:
- Plastic Surgery
Often microsurgery is used by surgeons from two or more specialties working in collaboration during complex procedures, such as the reattachment of amputated limbs or the replanting of one body part for another. An example of replantation is the attachment of the great toe to replace a lost thumb.
PROCEDURE OF MICROSURGERY
Microsurgery may differ in particulars depending on which type is being performed. There are, however, standard features of microsurgical procedures which include:
The microscope for microsurgery may be mounted on the floor or on the ceiling and has a moveable arm to allow the surgeon to manipulate its position with great precision to zoom and focus. In many cases, the movement of the microscope is controlled by a foot or mouth switch which leaves the doctor's hands free to operate. Magnification during surgery can be anywhere from 5 to 40 times. For lower magnifications, the surgeon may wear magnification lenses mounted on a pair of eyeglasses.
High intensity light source
The high intensity light source enables the surgeon and surgical assistant to view the operating field with great clarity. To further intensify its effect, the operating room is kept at a low level of light.
RECOVERY FROM MICROSURGERY
After microsurgery, the patient usually stays in the hospital for at least 5 days so that the patient’s overall condition and the healing of the surgical site can be monitored. The patient will most probably experience swelling and pain for 2 to 3 weeks after the surgery for which medication may be prescribed. It is important for the patient to follow the physician’s post-surgical instructions carefully in order for recovery to proceed smoothly.