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Microvascular anastomosis at 30-50x magnifications (super-microvascular anastomosis) in neurosurgery Matsumura N; Hayashi N; Kamiyama H; Kubo M; Shibata T; Okamoto S; Horie Y; Hamada H; Endo SSurg Neurol Int 2011[Jan]; 2 (ä): 6BACKGROUND: We report a safe and precise technique of microvascular anastomosis at higher magnifications (30 - 50 x) in neurosurgery and evaluate our experiences to examine the utility of this method for cerebral revascularization in various situations. METHODS: A retrospective review was carried out of patients who underwent microvascular anastomosis using a high-magnified operating microscope. This method was performed in 30 patients with 35 microvascular anastomoses in various situations. This microscope has two optical systems, a standard zooming system and a newly developed high magnification system. High resolution and good depth of focus are achieved by a new lens design in the optical system, which makes the image of the object very clear at higher magnifications. In this operating microscope, the combination of a 10 x eyepiece and the 200, 250, and 300-mm objective lens enables a range of final magnifications from 2.9 x to 50.4 x. RESULTS: This method enabled one to pay attention to performing atraumatic manipulations of small vessels and correct suturing, intima-to-intima, of vessel walls. Microvascular anastomoses were performed safely and precisely at higher magnifications. All anastomoses were patent. CONCLUSION: It is obvious that practical final magnifications of more than 30 x in neurosurgery would be super-magnified operative views. Microvascular anastomosis at 30 - 50 x magnifications (super-microvascular anastomosis) can help neurosurgeons to improve their skills, with good visualization, and to be safe and accurate when conducting cerebral revascularization in various situations.ä |
