Show pageBacklinksCite current pageExport to PDFBack to top This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong. ====== Microvascular Surgery ====== **Microvascular surgery** is a highly specialized surgical technique used to connect small blood vessels (typically <3 mm in diameter) using a microscope and microsurgical tools. It is essential in revascularization, free tissue transfer, and neurovascular reconstruction. ===== 🔬 Core Principles ===== * Use of **operating microscope** (up to 40x magnification) * Delicate **microsurgical instruments** (fine forceps, micro-scissors, needle holders) * Use of ultrafine sutures (e.g., **8-0 to 11-0 nylon**) * **Intraoperative patency assessment**: * Micro-Doppler * Indocyanine green (ICG) angiography * Direct visualization ===== 🧠Neurosurgical Applications ===== ^ Indication ^ Purpose ^ | **EC–IC bypass** | Augment cerebral perfusion (e.g., moyamoya, ICA occlusion) | | **Aneurysm trapping with bypass** | Bypass flow before vessel sacrifice | | **AVM resection** | Repair/reconstruction of feeding arteries | | **Skull base tumors** | Reconstruction of vessels post-resection | ===== 🩺 Other Surgical Applications ===== * **Plastic surgery**: Free flaps (fibula, radial forearm, ALT) * **Hand surgery**: Digital/limb replantation * **ENT and urology**: Microvascular decompression, penile revascularization ===== ✅ Critical Success Factors ===== * Minimize **ischemia time** * Precise **vessel size matching** * Intra- and post-op **antithrombotic management** (e.g., heparin, aspirin) * Continuous **flap monitoring**: * Doppler signal * Capillary refill * Skin temperature and turgor ===== 🎓 Training and Simulation ===== * **Microsurgical labs** with: * Chicken wing or rat femoral artery models * Synthetic vessel simulation * VR-based microanastomosis simulators ---- **Related topics**: * [[neurovascular:ec_ic_bypass|EC–IC Bypass]] * [[surgical_techniques:free_flaps|Free Flap Transfer]] * [[neurovascular:icg|ICG Angiography in Neurosurgery]] microvascular_surgery.txt Last modified: 2025/07/11 10:28by administrador