Microsurgery

Microsurgery is a demanding surgical sub-section, in which operations are carried out under a microscope. Today it is an indispensable part of reconstruction surgery, in which the treatment of inherited disorders, congenital malformations and tumours is at the forefront. The object of the treatment is the optimum recovery of the shape and function.

When naked eyes are no longer sufficient to precisely detect the fine supply structures such as vessels or nerves, the tissue is then displayed and treated under the operating microscope. Modern operation microscopes can display linear magnifications of up to 40 times the original size. The operations can be followed on an interconnected monitor. The dissecting and stitching is done using special instruments, which are even finer than watchmaker’s tools. The actual needle is no thicker than 60 – 80 µm (this corresponds to approx. 1/15 mm). The thread has a diameter of 20 µm and this means that it is actually finer than human hair.
A specially trained team is needed to be able to conduct microsurgical operations. The nurse in charge of the operating theatre must be proficient in handling the instruments and the surgeon has to complete a specialised training course as well as continuous re-training courses.

Microsurgery enables body tissue to be transplanted (for example, from muscles or subcutaneous skin tissue from the forearms) for covering defects that have been caused by accidents or tumours. If it becomes necessary to remove a large section of the upper or lower jaw together with the mucous membrane covering it then bone from the fibular together with the skin lying above it can be used as an implant to replace the lost section. During the transplant the nutrimental blood vessels must also be transplanted simultaneously, as is the case in a heart or kidney transplant, which are then connected up to the blood vessels in the throat using microsurgery under the microscope ("microvascular surgery"). The functioning and the appearance will be clearly improved as a result of these expensive operations and tumour patients will also enjoy a considerable boost to their quality of life, which is made possible by the surgical therapy carried out in this extremely sensitive part of the body.

The oral surgeon member of our team, Barbara Iwan, has many years expertise in this specialisation, some of which she acquired during additional training in China.