Surgery => Microsurgery
Microsurgery, specialized surgical technique performed with a high-powered binocular microscope designed for the operating room, and precision instruments. Microsurgical procedures are used to connect or dissect minute nerves, blood vessels, and other tissues in delicate procedures such as the reattachment of a severed limb to the body, repair of the eye's retina, graft of a coronary bypass, removal of tumors from previously inaccessible areas of the brain and spinal cord, and transplantation of organs, muscles, or tendons.
During microsurgery, surgeons view the operating field through a microscope that magnifies the area from 6 to 40 times, providing a functional look at nerves and blood vessels too small to see clearly with the naked eye. An operating microscope has several binocular eyepieces so more than one person can participate in the surgery. In addition, surgeons usually wear special magnifying glasses that further enlarge the field of view. Many operating microscopes are equipped with television cameras so the progress of a microsurgical procedure can be viewed on a television monitor by other members of the surgical team or medical students.
The first surgery using an operating microscope was performed on the delicate bones of a patient's inner ear in 1921. By 1960 advances in optics provided surgeons microscopes that enabled them to rejoin microvessels (tiny blood vessels with external diameters of 2.0 mm/0.08 in). Specialized surgical instruments that are smaller and more precise than those used in conventional surgery were developed as microsurgery techniques advanced, and by the 1970s surgeons were also operating on micronerves.
Continued improvements in both operating microscopes and surgical instruments have made possible microsurgical procedures involving even smaller blood vessels and nerves. Microsurgery has lowered mortality rates for life-threatening diseases such as cancer and heart disease and improved the results of conventional surgical procedures in which microsurgery is one part of the operation. Microsurgery is now applied in cell, embryo, and biomedical research.
A revolutionary development utilizing state-of-the-art computer technology allows surgeons to perform microsurgery without a microscope. Known as three-dimensional on-screen microsurgery system (TOMS), this procedure utilizes two cameras in a video microscope that project a magnified three-dimensional image on one or more television monitors. Initial studies at medical schools in the United States, Canada, and The Netherlands show that surgeons who have used TOMS in both laboratory and clinical settings have improved views of the operating field and experience reduced eye strain.