Microsurgery is a general term that is used to refer the use of an operating microscope during the surgery. Microsurgical procedures are usually preformed on parts of the body that are best visualized under microscope. Good examples of such structures include nerves, small blood vessels and tubes. By utilizing a magnification of up to 50 times of that produced by the naked eye and stiches that are finer than hair, surgeon are able to repair nerves and transected blood vessels that are less than one millimeter in diameter. Since its discovery in the early 1900s, microsurgery has witnessed advancements particularly in last decade including the emergence of face and hand transplantation. Nowadays, surgeons are able to provide a new lease of life to problems that cannot be solved by traditional techniques thanks to microsurgery. The benefits of microsurgery have led to its popularity particular in Singapore. Microsurgery procedures are not only effective and reliable; they are also having a short recovery time.
COMMONLY PERFORMED MICROSURGERY PROCEDURES IN SINGAPORE
- Sports injuries
- Nerve and tendons repairs
- Tennis elbow, trigger finger and carpel tunnel
- Cysts removal
- Crush and other traumatic injuries
- Reattachment of fingers, hands and arms
- Toes to thumb transplant among many others.
EQUIPMENT USED IN MICROSURGERY
Microsurgical equipment usually magnifies the operating field thus making it possible for surgeons to maneuver and operate structures that cannot be seen by the normal human eye. There are certain tools or equipment that makes it possible for surgeon to conduct microsurgery. They include:
- A microscope
Microscope is used to magnify the field that is being operated to enable the surgeon to see clearly what he/she is doing. Although the use of various microscopes may differ there are certain features that are standard. The microscope may be maintained on the floor, ceiling or it may have a movable arm that allows the surgeon to move the microscope as he wishes. Powerful lens and high light intensity enable the surgeon to view the surgical site. The surgeon can also zoom as he wishes. to properly view the operating field. A magnification of 5- 40 times is required for microsurgery. A lower magnification (5 times) is usually used to identify and expose structures while a higher magnification (40 times) is usually used when performing microsurgical repair.
- Microsurgical instruments
Instruments used in microsurgery differ from other convectional instruments because they usually manipulate body structures that are barely visible to the human eye. They also take into to account the tremor of the surgeon hand that is greatly magnified. Instruments used in microsurgery include:
- Needle holder
- Vascular clamps (used to control bleeding) and clamp applicators
- Irrigators (used to wash structures during and after surgery)
- Vessel dilators (used for opening cut end of a blood vessel)
- Various standard tools
PREPARING FOR MICROSURGERY
Before this surgical procedure is conducted, a number of factors are usually considered. Some of these factors include the extent of damage and previous medical history of the patient. The doctor can perform other medical test such x- ray to determine the extent of damage. Prior to surgery, the patient will be advised not to take substances such as tobacco because it will prolong or even complicate the healing process. In addition to that, the patient will also be advised not to eat certain foods or not to eat at all depending on where the surgery will be done. The doctor will also check the medical history of the patient.
After the surgery the patient is usually given an intravenous fluid before being given regular food. The surgeon will ensure that the patient is kept warm and well hydrated to speed up recovery process. The surgical site will be elevated to help drain excess fluids. Over the counter medication will be administered to help in the healing process as well as help manage the pain. The patient will only be discharge from the hospital if the surgeon is sure that he/she is stable and is responding well to medication given. After the patient is discharged, the doctor closely monitors the patient’s progress until the patient has fully recovered. Rehabilitation is often recommended after microsurgery. Rehabilitation programs such as exercise help to restore function to a transplanted or replanted body part. It will also help prevent blood circulation problems which usually occur after surgery.