Microvascular surgery or microsurgery is a surgical technique for joining or repairing the damaged blood vessels and nerves during reconstructive surgery of body parts. Reconstructive surgery restores the functioning of the body parts by improving the circulation.
Reconstructive surgery is the transfer of muscles and large segments of skin, fat, and bone from one part of the body to the other. Microsurgery is performed in patients with head and neck cancer, nerve injuries, and fractured limb. This surgery also helps patients to avoid amputation (complete removal of the injured or deformed part). Microsurgery is indicated in various specialties including ENT, opthalmology, urology, gynecology, dermatology, aesthetics, and orthopedics.
Your surgeon uses an operating room microscope, specialized instruments, tiny needles, and ultra-fine sutures to repair the blood vessels that are not visible to the human eye. A microscope having a magnification of 5 to 40x is used for microsurgery.
The damaged blood vessels are washed with water and held with clamps until the procedure is completed. A piece of contrast material is placed behind the injured area for easy identification and visualization. The magnification of the microscope is increased. The blood vessels that need to be anastomosed (joined together) should be in close proximity so that the there is no leakage or damage of the blood vessels due to tension. After the vessels are stitched, the clamps are released to allow the blood to flow. If the bleeding still continues, the vessels are again held by clamps and additional sutures are placed. Usually, arteries of 1 mm diameter require 5-8 stitches and veins of the same size require between 7 and 10 stitches.
Anastomosis is done in two different ways
Anastomosis may be performed using different techniques
Some of the different microvascular surgical techniques include
The common risks of microvascular surgery include mild asymmetry of the limbs, slow healing in older people, numbness or tingling sensation, accumulation of blood (hematoma) or fluid (seratoma), blood loss, and blood clots.