microvascular_surgery

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.

  • 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
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
  • Plastic surgery: Free flaps (fibula, radial forearm, ALT)
  • Hand surgery: Digital/limb replantation
  • ENT and urology: Microvascular decompression, penile revascularization
  • 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
  • Microsurgical labs with:
    • Chicken wing or rat femoral artery models
    • Synthetic vessel simulation
    • VR-based microanastomosis simulators

Related topics:

  • microvascular_surgery.txt
  • Last modified: 2025/07/11 10:28
  • by administrador