Microsurgical

Microsurgical refers to the set of surgical techniques that rely on magnification, typically through an operating microscope, to perform precise manipulation of small anatomical structures such as tiny blood vessels, nerves, and tissue components. These methods enable repair and reconstruction at a microscopic scale.

Key tools include the operating microscope, microinstruments, microvascular sutures (often very fine nylon), and specialized retractors. Common microsurgical procedures include microvascular anastomosis (connecting small vessels), microdissection and coaptation of nerves, and the transfer of tissue with its own blood supply (free tissue transfer or free flaps) for reconstruction. Microsurgical methods are also applied in lymphatic surgery, tendon repair, and certain eye and brain procedures.

History and scope: Microsurgical techniques emerged in the mid-20th century with advances in optics, suturing materials, and anesthesia; they expanded reconstructive options and were rapidly adopted in plastic and reconstructive surgery, neurosurgery, ENT, and ophthalmology.

Training and outcomes: Mastery requires specialized training, often through fellowships following residency in plastic surgery, general surgery, or related fields. Success depends on meticulous technique, tissue handling, and postoperative monitoring. Outcomes vary by procedure but microsurgical reconstructions can restore form and function with high tissue viability when performed by experienced teams.