Video microsurgery: Evaluation of standard laparoscopic equipment for the practice of microsurgery

Traditional microsurgery involves the use of bulky and expensive stereo mic roscopes that have limited portability. Recent advances in video technology have enabled the exploration of alternative visualization methods. The pur pose of this study was to evaluate standard laparoscopic equipment for micr ovascular anastomoses. Eight surgeons completed anastomoses on rat femoral and synthetic vessels using stereo microsurgery and video microsurgery visu alization systems. All surgeons had previous experience with stereo microsu rgery and none had ever used video microsurgery, Data were collected on ove rall anastomosis and individual suture times. A sample of completed anastom oses was placed in a video database and evaluated by use of a quality ratin g scale (8 to 10, excellent; 6 to 7, adequate; less than 6, poor). All surg eons subjectively evaluated the video microsurgery system. A total of 48 an astomoses 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 wa s 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 anastomo ses underwent quality reviews The overall score of the stereo microsurgery group was 8.1 +/- 1.7, and the video microsurgery group had an overall scor e of 7.3 +/- 1.6. Survey results revealed that 75 percent of the participan ts thought that the video microsurgery would be useful for human operations and would improve surgeon comfort, but 87.5 percent would not use the pres ent video microsurgery system over stereo microsurgery in their practice. A lthough significant differences exist in overall anastomosis and individual suture completion times, no difference was found in the overall quality. V ideo microsurgery could become a useful tool on the basis of surgeon ergono mics; however, optical parameters require further refinement.