Microsurgical Technique

Microsurgical technique refers to surgical procedures performed under high magnification using an operating microscope and specialized fine instruments. It enables precise manipulation of delicate neurovascular and parenchymal structures, essential in neurosurgery, otology, ophthalmology, and reconstructive surgery.

• Operating microscope: High-resolution, variable magnification with coaxial illumination.
• Microsurgical instruments: Fine-tipped dissectors, microforceps, scissors, bipolar forceps.
• Microsutures and microvascular clamps in vascular procedures.
• Use of neuronavigation, neurophysiological monitoring, and high-speed drills when indicated.

• Atraumatic dissection and preservation of normal neurovascular structures.
• Maintenance of clear surgical planes, often subarachnoid or subpial.
• Precise hemostasis using bipolar coagulation.
• Use of CSF drainage and brain relaxation techniques to avoid retraction injury.
• Dynamic retraction with suction or handheld instruments rather than fixed blades.

• Tumor resection: gliomas, meningiomas, schwannomas.
• Vascular surgery: aneurysms, AVMs, bypasses.
• Skull base surgery: anterior, middle, posterior fossa.
• Epilepsy surgery: temporal lobectomy, selective amygdalohippocampectomy.
• Spine microsurgery: herniated discs, intradural tumors.

• Enhanced visualization and precision
• Minimizes neural trauma
• Enables complex resections or reconstructions with low morbidity
• Facilitates neurovascular preservation

• Requires extensive training and dexterity
• Prolonged operating times in certain cases
• High initial investment in equipment and infrastructure

• Yasargil MG. Microneurosurgery. Thieme.
• Spetzler RF, Kalani MYS. The Techniques of Microsurgery in Neurosurgery. Thieme.
• Rhoton AL. Cranial Anatomy and Surgical Approaches. Neurosurgery, Supplement 1, 2003.