Introduction to microsurgery.

Abstract

An updated definition of microsurgery includes the application of magnification techniques to basic surgical principles and the functional restoration of body structures by means of the direct union of parts or transfer of tissue using microsurgical techniques. Nylen performed the 1st surgery under magnification with the use of an operating microscope in Sweden in 1921. With the expanding scope of microsurgery, it becomes obvious that it is a surgical technique clinically applicable in every surgical specialty. The equipment for microscopy is microscopes, sutures, jeweler's forceps, needle holders, scissors, and coagulators. In microsurgery, all surgical movements have been reduced to a pinch mechanism between thumb and index. The instruments have been designed with this in mind and are characterized by small precision tips, light balanced proportions, pinch closure, and nonreflective surfaces. Long handled instruments are necessary for neurosurgery and gynecology due to the depth of the working field. The perfection of the microsurgery technique begins with extensive practice in the research laboratory. Clinical microsurgical reconstruction should be attempted only when competence has been achieved in the laboratory.