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Microsurgery is one of the branches of modern operative surgery. Microsurgeons study and perform surgical interventions on small anatomical structures. During the manipulation, special tools and optical devices are used for the convenience / accuracy of medical actions. What you need to know about the direction, how safe and effective is microsurgical intervention?
General characteristics of the direction
The instrumentation of surgery consists of an operating microscope, a special magnifying glass, microsurgical instruments and an extremely thin suture thread. The miniature size is justified by the area of intervention and the size of the affected organ. It is impossible to apply a standard suture to a vessel, nerve or retina. Additionally, microsurgery is used in gynecology, otolaryngology, ophthalmology, neurosurgery and other areas of medicine.
Microsurgical intervention became possible only in the early 20s. It was during this period that operating microscopes were created. The first surgical microscope was intended for operations on the middle ear. Science does not stand still, therefore, modern microsurgical instruments are equipped with various attachments, light sources and optical magnification.
A fiber light guide and a halogen lamp are built into the microscopes. They give a cool white light and give the doctor complete control over what is happening. Nozzles and interchangeable units are equipped with an automatic optical zoom adjustment function. Microsurgical instruments include: scalpels, blade holders, scissors, tweezers for holding tissues / tying threads, microvascular clamps, needle holders with spring handles, various hooks, drills, wound dilators.
The result of the operation largely depends on the suture material. This is a specific thread that is used to connect fabrics. For example, for operations on vessels with a diameter of 0,3 to 0,6 millimeters, metalized suture material is used. Metal is applied to the end of the synthetic thread and subjected to special processing. The compacted thread becomes like a kind of needle, which ensures the accuracy of manipulations.
What is included in the list of duties of a specialist?
Surgery is considered one of the most complex branches of medicine. Narrow-profile specialists must master the full range of knowledge about the norms and pathologies of the human body before embarking on practical activities. Microsurgery is closely related to other specialties, since surgery can be required for any organ, from the lens of the eye to the limbs.
| Organ | Area of intervention | Pathology |
|---|---|---|
| Heart | coronary vessels | Atherosclerosis |
| Heart valves | Rheumatism, endocarditis | |
| ductus arteriosus | Heart disease with patent ductus arteriosus | |
| Brain | All parts of the brain | Cancer |
| hearing organs | Eardrum | Mechanical damage to the membrane |
| Middle ear | Purulent otitis media | |
| Auditory nerve | Acoustic nerve damage or congenital deafness | |
| organs of vision | Retina | Cancer, exfoliation |
| Eye | Glaucoma, presence of foreign bodies, contusion, strabismus | |
| Lenticular | Cataract | |
| Leather | Whole body | Burns, defects, scars, curvature |
| Limbs | Hands, feet, fingers | Fracture, arterial/nerve injury, thermal burns, necrosis, inflammatory or congenital processes |
| Teeth | Pulp (teeth) | Pulpitis |
| hard tissue of the tooth | Caries | |
| Tooth | Fracture |
Methods of diagnosis
Diagnosis allows you to refute or confirm the diagnosis. Additionally, the doctor receives complete information and an image of the area of future intervention. For each separate group of diseases, a specific type of diagnosis is used.
- Heart disease: coronary angiography, electrocardiography, Holter monitoring, blood test for troponins, computed or magnetic resonance imaging.
- Disorders of the ENT organs (ear, throat, nose, neck, head): video endoscopy of the tympanic membrane and region, audiometry, computed tomography of the head.
- Diseases of the organs of vision: diagnosis of eye pressure, visual acuity, retinoscopy.
- Pathologies of the spinal cord or brain: magnetic resonance or computed tomography, rheoencephalography.
- Mechanical injuries of the hands: computed tomography, X-ray.
- Diseases of the vascular system: vascular ultrasound, dopplerography, magnetic resonance imaging, aortography, ankle-brachial index.
What symptoms should see a specialist?
Before consulting a microsurgeon, a general practitioner is usually visited. The therapist will assess the general condition of the body, determine the risks and write out a referral to a highly specialized specialist. The patient should be alerted to any causeless deviations of the norm. Acute chest pain, shortness of breath, palpitations, dry mouth, excessive sweating, and development of anxiety clearly indicate an internal problem that needs to be addressed, not ignored.
Sharp pain in the limbs, difficulty in movement, enlarged veins, cyanosis of the skin indicates problems with blood vessels, and a burning sensation behind the sternum and an increased pulse indicate cardiac pathologies. Hearing impairment, partial deafness, unusual discharge from the sink indicate diseases of the ENT spectrum. The patient may have a damaged tympanic membrane or auditory nerve that is preventing the system from working properly.
Microsurgeons are engaged in reconstructive operations. The doctor will help correct congenital or acquired defects in any part of the body (for example, after a fire or severe injury).
What other symptoms should I look out for? Unexplained pain in the eyes, a sharp deterioration in vision, partial blindness, mechanical damage to the eye, clouding, pain when blinking and the inability to focus should prompt a person to go to an ophthalmologist. Frequent headaches that cannot be stopped with medication, nausea / vomiting, tremors, impaired coordination and loss of consciousness may indicate brain diseases, and paralysis of the lower extremities – a pathology of the spinal cord.
No need to convulsively make an appointment with a microsurgeon after the first episodic pain. First of all, contact a general practitioner, pass the necessary list of tests and undergo a comprehensive diagnosis. A referral to a microsurgeon is issued only if the therapist has recorded serious malfunctions in the body and the need for surgical intervention.
Features of therapy and prevention
After the diagnosis, the microsurgeon draws up a therapeutic plan, determines the areas of intervention and features of the operation. Some patients will need removal and replacement of the lens with a synthetic material, others will need to sew the vessels and nerves of the limbs, and others will need to remove a brain tumor. The complexity, duration of the operation and subsequent rehabilitation depend on a number of factors. The nuances of surgery and rehabilitation are negotiated with the doctor on an individual basis before starting therapy.
Microsurgeons work in both elective and emergency services. In some cases, only a few hours or minutes pass between the diagnosis and the operation, which are aimed at saving the patient’s life. Urgent care is provided for acute injuries, advanced inflammatory / infectious processes, when there is a real threat to life.
To preserve the health of patients, microsurgeons are advised to monitor all aspects of life. At first glance, they seem simple and meaningless, but it is routine practice that will help to avoid serious illnesses. Always watch TV at a distance of 3-4 meters, and after 2-3 hours of work on the computer, do eye exercises, look out the window, warm up and take a short break. In case of progressive deterioration of vision, be sure to consult an ophthalmologist, choose a correction method (glasses / lenses / surgery), stock up on drops and vitamins with blueberries.
To avoid pathologies of the cardiovascular system, normalize nutrition, engage in feasible physical activity, give up bad habits and do not close your eyes to increased heart rate or chest pain. Remember that timely diagnosis is the key to successful therapy. In case of specific symptoms (congenital pathologies, increased risk group), strictly follow the doctor’s recommendations and do not neglect consultations. Go through a general medical examination at least once a year to control your own body and prevent complications.