Microsurgery operationtechnique refers to the use of fine microsurgical instruments and suture materials by surgeons to perform delicate operations on small tissues with the aid of the magnification of an operating microscope. Microsurgery operation is a specialized surgical technique that is now widely used in various specialties of the surgical discipline.
1. Features of microsurgery operation
When performing surgery under the operating microscope, the tissue is magnified, which can not only see the small tissues that are not visible to the naked eye in the surgical field, but also has a three-dimensional sense, which is beneficial for the surgeon to accurately dissect, cut and suture various tissues. However, even surgeons who are very experienced in suturing blood vessels with the naked eye, if they do not have special training, are still very unaccustomed to microsurgery operation at the beginning, and often have hand-eye incoordination, which affects the operation under the microscope. Therefore, it is necessary to Skillfully operating under the operating microscope requires a period of training and adaptation. Features of microsurgical techniques:
(1) Due to the small field of view of the microscope, surgical instruments and needles are often out of the field of view and are difficult to find.
(2) Due to the limited depth of field, a slight movement up and down will result in blurred surgical field of view.
(3) The jitter that cannot be seen by the naked eye is very obvious under the microscope, so the slight jitter will affect the operation.
(4) Since the eye muscles have an adjustment process for different focal lengths, the eye cannot see the fine structure immediately after leaving the eyepiece and then returning.
2. Basic techniques of microsurgery operation
The basic techniques of microsurgery operation are different from those of general surgery. Surgeons must have a process of adaptation and retraining in microsurgical techniques when performing microsurgical small canal anastomosis.
(1) Micro incision and separation technology, in order to make the tissue incision less damaged and accurate, generally use a No. 1 blade or a No. 15 blade, so that the incision technology is the same as the micro-carving technology. The separation of microstructures is mainly sharp separation, which is separated with a pointed blade or sharp scissors.
(2) Microstructure lifting and holding technology, using pointed, toothless microscopic tweezers to lift the tissue. During microsurgical anastomosis of small ducts, only use forceps to hold the adventitia of the small ducts to avoid damage to the intima.
(3) For the traction exposure technique of microscopic tissue, the surgical field of view is exposed with a small surgical retractor; for the retraction of blood vessels and nerves, a thin rubber sheet is often used for traction. During vascular anastomosis, a small automatic spreader is often used to expose the surgical field.
(4) Ligation and hemostasis in microsurgery operation, and bipolar coagulators are often used for hemostasis. The hemostasis of the branches of the anastomosed blood vessels is mainly ligation.
(5) The debridement technique of microsurgery operation requires the elimination of necrotic tissue as much as possible and the creation of vascular and neural beds with good blood supply. Using atraumatic cleaning can reduce infection.
Microsurgery operation has been widely carried out in hand and foot plastic surgery for many years. Looking forward to the future, microsurgery operation will develop in an all-round way in the 21st century. The application of microsurgical techniques to carry out experimental surgery, fetal surgery and the close integration of high-tech will surely transform the entire medicine. Therefore, it is no exaggeration to say that microsurgery operation will be the main theme of medicine in the 21st century.
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