Enhancing precision or adding complexity? The impact of surgical microscope use in palatal cleft repair: A...

Area of Science:

• Cleft Palate Repair
• Surgical Technology
• Pediatric Surgery

Background:

• Operating microscopes offer potential benefits in visualization and ergonomics for surgical procedures.
• Clinical adoption of operating microscopes in cleft palate repair is limited.
• Comparison between operating microscopes and surgical loupes in cleft palate repair is needed.

Purpose of the Study:

• To compare surgical efficiency, intraoperative visualization, and complication rates between operating microscope and surgical loupe use in cleft palate repair.
• To evaluate the learning curve associated with operating microscope use in this patient population.

Main Methods:

• Prospective, quasi-randomized controlled study involving 40 pediatric patients with isolated nonsyndromic secondary incomplete cleft palate.
• Patients were allocated to either surgical loupe or operating microscope magnification.
• Data collected included operative time, intraoperative visualization scores, and postoperative complications.

Main Results:

• Mean operative time was significantly longer with the operating microscope (76.75 min) versus surgical loupes (60.91 min), with the difference decreasing over time.
• Intraoperative visualization scores were significantly higher with the microscope, as rated by the anesthesiologist and scrub nurse.
• Postoperative complication rates were similar between the microscope and loupe groups.

Conclusions:

• The operating microscope enhances intraoperative visualization and surgical ergonomics in cleft palate repair.
• An initial increase in operative time with the microscope is attributed to a learning curve, diminishing with experience.
• The benefits of the operating microscope may justify its routine use in cleft palate repair despite initial challenges.