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[用于游离微血管组织移植的常规手术显微镜和放大镜放大的替代方案。可变焦显微镜AF3-A]

[An alternative to the usual operating microscope and loupe magnification for free microvascular tissue transfer. Varioscope AF3-A].

作者信息

Chiummariello S, Alfano C, Fioramonti P, Scuderi N

机构信息

Dipartimento di Chirurgia Plastica e Ricostruttiva, Università degli Studi La Sapienza, Roma.

出版信息

Minerva Chir. 2005 Dec;60(6):505-9.

Abstract

AIM

Free microvascular tissue transfers have become today a key instrument for the surgical treatment of wide loss of tissue, but their employment implies mandatory use of the right visual magnification means. Until now these instruments were mainly loupes and operating microscopes. Our study is focusing on the use of a new visual system--Varioscope AF3-A--in the reconstructive microsurgery field.

METHODS

Varioscope AF3-A (Life Optics, Vienna, Austria) has been employed in our Institute in 10 microvascular reconstructions, where different free flaps were used in head and neck reconstruction.

RESULTS

All the flaps took and only one developed a partial necrosis. We have also noticed, by using this new instrument, a learning curve with a progressive contraction of the operating time. In all cases we have operated on 2 mm caliber vessels or more and on tissues that didn't previously undergo radiation therapy.

CONCLUSIONS

The employment of a visual magnification mean, as Varioscope AF3-A, allows autofocus (from 3.6X to 7.2X) and a wide vision. It can be easily used with substantial advantages for the surgeon in performing microvascular anastomosis. Partial drawbacks are the equipment high cost and weight, compared to the loupes and a stronger ocular stress due to the continuous autofocus compared to the static operating microscopes.

摘要

目的

游离微血管组织移植如今已成为外科治疗大面积组织缺损的关键手段,但其应用意味着必须使用合适的视觉放大工具。到目前为止,这些工具主要是放大镜和手术显微镜。我们的研究聚焦于一种新型视觉系统——Varioscope AF3 - A——在重建显微外科领域的应用。

方法

Varioscope AF3 - A(奥地利维也纳Life Optics公司)已在我们研究所用于10例微血管重建手术,这些手术在头颈部重建中使用了不同的游离皮瓣。

结果

所有皮瓣均成活,仅1例出现部分坏死。通过使用这种新仪器,我们还注意到存在一条学习曲线,手术时间逐渐缩短。所有病例中,我们处理的血管口径均为2毫米及以上,且组织此前未接受过放射治疗。

结论

使用Varioscope AF3 - A这种视觉放大工具可实现自动对焦(从3.6倍至7.2倍)并拥有广阔视野。在进行微血管吻合时,它能轻松使用,对外科医生具有显著优势。与放大镜相比,部分缺点是设备成本高且重量大,与静态手术显微镜相比,由于持续自动对焦会导致更强的眼部压力。

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