Microsurgery Health Article

Definition

Microsurgery is surgery that is performed on very small structures, such as blood vessels and nerves, with specialized instruments under a microscope.

Purpose

Microsurgical procedures are performed on parts of the body that are best visualized under a microscope. Examples of such structures are small blood vessels, nerves, and tubes. Microsurgery uses techniques that have been performed by surgeons since the early twentieth century, such as blood vessel repair and organ transplantation, but under conditions that make traditional vascular surgery difficult or impossible.

The first microvascular surgery, using a microscope to aid in the repair of blood vessels, was described by Jules Jacobson of the University of Vermont in 1960. The first successful replantation (reattachment of an amputated body part) was reported in 1964 by Harry Bunke. This replantation of a rabbit's ear was significant because blood vessels smaller than 0.04 in (0.1 cm)—similar in size to the blood vessels found in a human hand—were successfully attached. Two years later, the successful replantation of a toe to the hand of a monkey was made possible using microsurgical techniques. Soon thereafter, microsurgery began being used in a number of clinical settings.

Numerous surgical specialties utilize the techniques of microsurgery. Otolaryngologists (ear, nose, and throat doctors) perform microsurgery on the small, delicate structures of the inner ear or the vocal cords. Cataracts are removed by ophthalmologists (eye doctors), who also perform corneal transplants and treat eye conditions like glaucoma. Urologists can reverse vasectomies (male sterilization), and gynecologists can reverse tubal ligations (female sterilization), giving people new choices about having children. Microsurgical techniques are used by plastic surgeons to reconstruct damaged or disfigured skin, muscles, or other tissues, or to transplant tissues from other parts of the body. And, importantly, a number of specialties can collaborate to treat patients who have limbs or other body parts; under certain circumstances, amputated parts can be reattached, or another body part can be replanted in the place of one lost (for example, a great toe replacing a lost or damaged thumb).

Today, microsurgery can be lifesaving. Neurosurgeons can treat vascular abnormalities found in the brain, and cancerous tumors can be removed.