Mikrosurgi

Mikrosurgi is a surgical discipline that uses magnification, precise instrumentation, and refined technique to operate on small structures such as blood vessels, nerves, ducts, and microanatomical components. Procedures are performed under an operating microscope or with high-magnification loupes, enabling delicate suturing and tissue handling that are not possible with naked-eye approaches. Mikrosurgi spans several medical specialties, including plastic and reconstructive surgery, neurosurgery, ophthalmology, and otolaryngology.

Development began in the mid-20th century with the adoption of the operating microscope and microsutures. Early work demonstrated that tiny vessels and nerves could be reconnected with high reliability, paving the way for free tissue transfer, nerve repair, and delicate reconstructive techniques. Since then, microsurgery has expanded to complex reconstructions to restore form and function after injury, cancer resections, or congenital defects.

Key tools include the operating microscope, microinstruments, and ultra-fine sutures (for example, nylon sizes 7-0 to 10-0). Microsurgical techniques emphasize vessel and nerve anastomosis, microdissection, precise hemostasis, and meticulous tissue handling. Anesthesiology, imaging, and neurophysiological monitoring often accompany procedures to protect function and guide real-time assessment.

Applications include digital replantation and nerve repair, free tissue transfer for reconstruction after cancer or trauma, regional flap procedures, and selected ophthalmic and neurosurgical operations.

Training typically occurs within plastic and reconstructive surgery, neurosurgery, or ophthalmology residencies, followed by dedicated microsurgery fellowships. Certification varies by country. Outcomes depend on case complexity and surgeon experience; microsurgical skills are associated with high success rates in hands with rigorous training, though risks include thrombosis, infections, tissue loss, and prolonged operative times.