Microvascular anastomosis in an optical cavity: is it possible?

Area of Science:

• Plastic Surgery
• Microsurgery
• Surgical Technology

Background:

• Microsurgery is a specialized surgical procedure with various applications, notably in plastic surgery.
• While operating microscopes are standard, alternative visual aids like endoscopes are explored for microsurgery.
• Cost-effective and accessible equipment is sought for microsurgical applications, especially in confined spaces.

Purpose of the Study:

• To investigate the feasibility of using endoscopes for microsurgical procedures.
• To evaluate endoscopes as a less costly and more accessible alternative to operating microscopes.
• To assess the utility of endoscopes in creating and operating within an optical cavity.

Main Methods:

• Experimental microsurgical vascular anastomoses (arterial and venous) and nerve anastomoses were performed on the femoral vessels of Sprague-Dawley rats.
• A prefabricated skin retraction model was used to create an optical cavity in the groin area.
• Procedures were conducted using endoscopes as the primary visual-assisting equipment.

Main Results:

• Microsurgical anastomoses of femoral vessels and nerves were successfully performed with ease and surgeon comfort.
• Mean operative times were recorded for arterial (28.1 min), venous (27.3 min), and neural (19.2 min) anastomoses.
• High success rates were achieved: 90% vascular patency and 100% accurate neural anastomoses.

Conclusions:

• Endoscopic microsurgery is a feasible technique, offering potential advantages in cost and accessibility.
• This method provides a viable alternative for microsurgical procedures, particularly in situations requiring an optical cavity.
• The technique presents a promising area for research and application for emerging microsurgeons.