Evaluation of Smartphone Magnification vs. Microscope in Microvascular Anastomosis: An Experimental Study

Surgical loupes and microscopes are the gold standard in microvascular surgery, but they have various pitfalls. Smartphones have recently bridged the gap and are able to provide a high-quality image in a cost effective manner. But is this enough to replace traditional methods? The objective of this study was to compare the time taken to perform end-to-end microvascular anastomosis, and the error rate in head and neck oncology, in which a free fibula graft was used for reconstruction using smartphones and standard operative microscopes.

Twenty-four patients were divided into three groups of eight for each magnification method. Smartphone 1, Smartphone 2 and Microscope. Patients undergoing free fibula graft reconstruction in head and neck oncology were enrolled for this study. A single microvascular surgeon operated. Anastomosis time and error rate based on Anastomosis Lapse Index was recorded.

Anastomosis time was increased in smartphone 1 and smartphone 2 compared to the microscope (p = 0.002) and (p = 0.001), respectively. Error rate was not statistically significant.

Microvascular anastomosis can be performed effectively with a smartphone with an experienced surgeon.