Microsurgery

In microsurgery, a reconstructive surgeon uses a microscope or magnifying device in the operating room to operate on small blood vessels and nerves.  These procedures are complex reconstructive surgery techniques, performed when other options are deemed inadequate.

Microsurgery is used in free tissue transfer procedures. Free tissue transfer involves the placement of tissue grafts called flaps, which correct or improve defects and abnormalities.  During these procedures, blood vessels are reconnected in the graft recipient site with meticulous care.

Candidates for Microsurgery

Plastic and reconstructive surgeons use microsurgical techniques to restore function or appearance after trauma or a removal of tumors.  The following are common indications (or capabilities) for a free tissue transfer using microsurgical techniques:

• Covering exposed vital structures: joint surfaces, tendons, vessels, and bone
• Restoring shape to the body, such as in breast reconstruction after mastectomy
• Restoring function, such as in the muscles of the face

These procedures often require several hours, so a good candidate must be able to tolerate a surgery lasting as long as 8 hours.  You should be capable of understanding the risks and possible complications involved, including the effects of flap loss.

Flap Indications

The size and location of the defect will determine the indications for a microsurgical reconstruction procedure, as well as the type of flap that will be used.  Defects may be a single, isolated tissue type or a combination of tissues including skin, subcutaneous tissue, nerves, muscle, tendons, cartilage, bone, and mucosa.

Procedures

The tumor or diseased area is cut out and the recipient site is prepared for microsurgery.  After carefully matching and preparing the tissues and blood vessels, your surgeon connects the vessels of the graft with the vessels of the recipient site, in a technique called anastomosis.  The surgeon checks to ensure blood vessels do not have excessive tension and are not kinked or twisted.  Blood flow is established and checked as well.  The flap is closely monitored after surgery to ensure viability.