《外科学总论》课件-1-microsurgery.ppt

MICROSURGERICAL TECHNIQUES 一、Concept Microsurgery is a kind of surgical techniquues, operating on tiny structures under the microscope with sutures that are barely visible. It is a important advancement in the modern surgery. History1921, Carl-Olof Nylen and Holmgen in Sweden first used the operating microscope for treatment of otosclersis. They are the founders of microsurgery.Lab stage: in 1960, Jacobson and SuarezClinical stage: From 70s, microsurgery was rapidly developed, it have been used in all branches of surgery. Broad applications have involved:example: replantation surgery; micro vascular free transfer of flaps, omentum, toes, bones and muscles; microlymphatic surgery and so on. 二、Conditions of Microsurgery Techniques Suitable magnification Appropriately instrument and sutures Training to acquire hand-eye-coordination through the microscope （一）surgical magnifying loupes and operating microscope 1.Loupes: single used be heads magnifying from 2~4times, even to 6 times working distance 20~25cm working view 2~5cm It is commonly used for micro-dissection and obtaining a free flap, but the surgeon feels easily tired with using it. 2. Operating Microscope:optical system Lighting Support Supplementary installationSingle -headed -binocular warm lighting on table cameradouble-headed-binocular cold lighting standing movie-cameradouble-headed-binocular hanged video +observation tube Requisite: Magnifying 10~40 times Working distance 20cm Enough brighter Record system The microscope is used for the actual repair because of the higher magnification and brighter illumination availab