Video Microsurgery: Evaluation of Standard Laparoscopic Equipment for the Practice of Microsurgery

Abstract

Traditional microsurgery involves the use of bulky and expensive stereo microscopes that have limited portability. Recent advances in video technology have enabled the exploration of alternative visualization methods. The purpose of this study was to evaluate standard laparoscopic equipment for microvascular anastomoses. Eight surgeons completed anastomoses on rat femoral and synthetic vessels using stereo microsurgery and video microsurgery visualization systems. All surgeons had previous experience with stereo microsurgery and none had ever used video microsurgery. Data were collected on overall anastomosis and individual suture times. A sample of completed anastomoses was placed in a video database and evaluated by use of a quality rating scale (8 to 10, excellent; 6 to 7, adequate; less than 6, poor). All surgeons subjectively evaluated the video microsurgery system. A total of 48 anastomoses were completed. The average total anastomosis time for the stereo microsurgery was 1018.9 +/- 463.2 seconds versus 1738.9 +/- 460.1 seconds for the video microsurgery. The average individual suture placement time was 114.6 +/- 60.6 seconds for the stereo microsurgery versus 211.7 +/- 128.4 seconds for the video microsurgery (p < 0.05). Twenty-five of the anastomoses underwent quality review. The overall score of the stereo microsurgery group was 8.1 +/- 1.7, and the video microsurgery group had an overall score of 7.3 +/- 1.6. Survey results revealed that 75 percent of the participants thought that the video microsurgery would be useful for human operations and would improve surgeon comfort, but 87.5 percent would not use the present video microsurgery system over stereo microsurgery in their practice. Although significant differences exist in overall anastomosis and individual suture completion times, no difference was found in the overall quality. Video microsurgery could become a useful tool on the basis of surgeon ergonomics; however, optical parameters require further refinement.

An experimental model to retraining in microvascular suture

“…This amount should be added to the operative time in the research operative room, cost of anesthetics and microsurgical supplies. The utilization of the exceeding population of rats, common at research facilities of great ongoing research from times to times, may give the provider some relief to reduce costs substantially 1,11,12 .…”

Video‐assisted versus conventional microsurgical training: A comparative study in the rat model

“…The system is massive and fixed around the wound, being difficult to handle even for the foot pedal controlled microscope. 5 The surgeon's position is sometimes uncomfortable, because of the anatomic area where he/she wishes to work and even more so for the assisting personnel.…”

“…[2][3][4][5][6][7] The greatest advantage is that it can be built using the components of a laparoscopic surgery support tower, which is used in various surgical fields. The overall costs for the health-care unit are therefore substantially reduced and can be paid off in the shortest time.…”

“…The overall costs for the health-care unit are therefore substantially reduced and can be paid off in the shortest time. [4][5][6][7] The Storz 1 three-chip zoom camera in combination with the new Sony 1 HDTV monitor enhance the image significantly, providing the surgeon with great image quality and comfort similar to that obtained through the microscope.…”

Plastic and reconstructive robotic microsurgery – a review of current practices

“…Previous failures of endoscopic microvascular surgery may have also deterred plastic hand and soft tissue reconstructive surgeons from attempting robotic surgery [7,8]. Study has shown transfer of skills in experienced microsurgeons is limited when compared to relative novices [9].…”