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Microvascular Surgery

What is Microvascular Surgery?

Microvascular Surgery includes novel and intricate surgical techniques to join together tiny blood vessels and helps to transfer large amount of tissues e.g. muscle, bone, tendon or cartilage from distant parts of the body to reconstruct wounds and tissue defects. Microvascular Surgery is carried out routinely for reconstruction in the head and neck area, upper and lower extremity and for re-implantation of a finger, hand or a limb following accidental amputation. The Microvascular Surgery techniques require great care and accuracy and are performed with the aid of a microscope, specialized instruments and tiny needles with ultra fine sutures.

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Where can I get Microvascular Surgery?

Country Cost with MedSolution
India $3,262 (inquire)
All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.

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What are the different techniques of Microvascular Surgery?

Rule of Thumb:

  • Excellent manual dexterity on the part of microvascular surgeon is critical as the technique must be performed accurately.
  • The blood vessel should be constantly irrigated at 37 degree centigrade with normal saline or Ringer's solution to prevent thrombosis and spasm of the blood vessel.
  • Tension or redundancy in the length of the blood vessel should be avoided to prevent kinking or twisting.
  • Align all the layers of blood vessel wall as accurately as possible.
  • The sutures must be placed carefully in a symmetrical manner with knots lying flat and apply just the right amount of tension.
  • Ensure that fine suture material and tiny needles are used.

Different Techniques used for Microvascular Surgery

All the Microvascular Surgery techniques are performed under high magnification using a microscope to ensure accuracy and absolute attention to detail.

  • End-To-Side Anastomosis using continuous or interrupted suture technique - This technique of Microvascular Surgery is utilized when an anastomosis is created between blood vessels whose lumen size does not match.
  • End-To-End Anastomosis - This method of Microvascular Surgery is used very commonly for arterial as well as venous anastomosis. Part of the outer lining of the blood vessel wall is stripped off so that it does not get caught during suturing. The vessels to be anastomosed should be approximated close enough so that there is no leak and not damage on the inner blood vessel wall due to tension.
  • Interpositional Vein Graft - A Vascular Pedicle that is not long enough to approximate without tension, another vein or artery from the same side is used for anastomosis.
  • Laser Assisted Anastomosis - In this kind of Microvascular Surgery, Laser energy is used to 'weld' the blood vessels together.
  • Stapling Device - 'Staples' are used in this technique of Microvascular Surgery to sew the blood vessels together.
  • 3M Microvascular Anastomotic Coupling Device - The anastomosis technique using this device is much simpler and quicker when compared to suture techniques.

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Who is not an ideal candidate for Microvascular Surgery?

Elderly persons, people with cardiovascular diseases, atherosclerosis, diabetes, or connective tissue disorders are not ideal candidates for Microvascular Surgery.

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How do I prepare for Microvascular Surgery?

Microvascular Surgery is technically demanding; it is very important for your microvascular surgeon to perform a careful pre-operative assessment. With the advent of animation technology, most Facial Microvascular Surgeons use facial animation as part of pre-operative work-up. Selection of donor site for free Skin Flap Grafting is crucial in the successful outcome of the surgery. Make sure that you inform your plastic surgeon about your health conditions and all the prescription and non-prescription medications that you are taking (including vitamin, mineral and herbal products). Stop smoking at least 2 weeks before Microvascular Surgery and do not smoke for at least 2 weeks after the surgery. Inform your surgeon if you have any problems with clotting of your blood or if you are taking any blood thinning medications.

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What is the recovery period like following Microvascular Surgery?

You will be hospitalized for about a week following Microvascular Surgery. Avoid any pressure on the surgery site that might compromise the blood supply. Antibiotics, aspirin (to prevent clot formation) are given and a close observation is made for hematoma formation. Clinical assessment for viability of Skin Flap is confirmed based on the color, texture, vascularity and a daily prick test.

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B . R . A . N . D . of Microvascular Surgery

Benefits of Microvascular Surgery

  • Microvascular Surgery has multidisciplinary approach that allows your healthcare team to provide the most appropriate care for your problem. The techniques used in Microvascular Surgery can also be used for tendon transfers, treatment of infections, microvascular bone and soft-tissue reconstruction, non-union of infected fractures, and nerve reconstruction. The goal of Microvascular Surgery is to allow you to be able to return to full function and activities.

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Risks of Microvascular Surgery

  • Asymmetry - Mild asymmetry is normal.
  • Slow Healing - This is a common problem in older people.
  • Numbness / Tingling - This problem is often and may result from injury to sensory or motor nerves.
  • Healing Irregularities
  • Accumulation of fluid or blood (seroma or hematoma)
  • Excessive blood loss
  • Blood Clots (DVT) - These can be fatal. They can be prevented during recovery period if you do not stay in one position for too long and flex your feet often.
  • Loose Sutures - Such problems would require additional surgery.

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Alternatives to Microvascular Surgery

  • Microvascular Surgery comprises of novel techniques that have proven successful outcomes in specialties like plastic surgery, orthopedic and hand surgery, as well as general surgery, neurosurgery, urology, gynecology, and otolaryngology. These techniques are the best and have the highest standards as a surgical specialty.

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Now or Never

  • More recently reconstructive surgeons have been using Microvascular Surgery techniques more commonly than before. This surgery has results that most patients are delighted with. Microvascular Surgery has revolutionized reconstructive surgery and requires a well-trained microsurgical team.

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Decision to have Microvascular Surgery

  • Free Tissue transfer technique used in Microvascular Surgery has rescued unsalvageable tissue defects due to size, location, or chronicity. The dramatic clinical successes of Microvascular Surgery have substantially improved the functional and cosmetic results of surgery, in addition to decreasing the morbidity seen in complex problems.

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Keywords: Limb Amputation, Wound Reconstruction, Tissue Defects, Hematoma, Seroma, Deep Vein Thrombosis (DVT), Free Tissue Transfer Technique, Microsurgery, Finger Amaputation, Facial Microvascular Surgery, Facial Animation, Reconstructive Surgery

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