Microvascular surgery utilizing the endoscope as the sole source of visual assistance

With the introduction of endoscopy to surgery, it has become apparent that magnification similar to the magnification provided by the surgical microscope can be achieved with its use. Endoscopic techniques provide both magnification and the ability to operate at a distance, potentially increasing the applications of microsurgery. An endoscopic unit is significantly less expensive than the operating microscope. Furthermore, it enables invasive techniques utilizing smaller incisions. The purpose of this project was to investigate whether the visual assistance provided by the endoscope is sufficient to perform a microvascular anastomosis. An initial experiment with six rats is presented. The right femoral artery was isolated, divided, and reconstructed by standard microanastomosis with the visual assistance provided by a 4-mm endoscope. All anastomoses were patent at 7 days by microangiography and histology. The magnification provided by the endoscope is sufficient for the creation of a microvascular anastomosis.