《外科学总论》课件：显微外科技术.ppt

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1、MICROSURGERICALTECHNIQUES显微外科技术一、ConceptMicrosurgeryisakindofsurgicaltechniquues,operatingontinystructuresunderthemicroscopewithsuturesthatarebarelyvisible.Itisaimportantadvancementinthemodernsurgery.History1921,Carl-OlofNylenandHolmgeninSwedenfirstu

2、sedtheoperatingmicroscopefortreatmentofotosclersis.Theyarethefoundersofmicrosurgery.Labstage:in1960,JacobsonandSuarezClinicalstage:From70s,microsurgerywasrapidlydeveloped,ithavebeenusedinallbranchesofsurgery.Broadapplicationshaveinvolved:example:repl

3、antationsurgery;microvascularfreetransferofflaps,omentum,toes,bonesandmuscles;microlymphaticsurgeryandsoon.二、ConditionsofMicrosurgeryTechniquesSuitablemagnificationAppropriatelyinstrumentandsuturesTrainingtoacquirehand-eye-coordinationthroughthemicro

4、scope（一）surgicalmagnifyingloupesandoperatingmicroscope1.Loupes:singleusedbeheadsmagnifyingfrom2~4times,evento6timesworkingdistance20~25cmworkingview2~5cmItiscommonlyusedformicro-dissectionandobtainingafreeflap,butthesurgeonfeelseasilytiredwithusingit

5、.2.OperatingMicroscope:opticalsystemLightingSupportSupplementaryinstallationSingle-headed-binocularwarmlightingontablecameradouble-headed-binocularcoldlightingstandingmovie-cameradouble-headed-binocularhangedvideo+observationtubeRequisite:Magnifying1

6、0~40timesWorkingdistance>20cmEnoughbrighterRecordsystemThemicroscopeisusedfortheactualrepairbecauseofthehighermagnificationandbrighterilluminationavailable.Itsmainbenefitisimprovedvisionofsmallstructuresthroughopticalmagnificationandbrighterilluminat

7、ion.(二)InstrumentandmicrosuturesInstrument:Toensureahighsuccessrateinmicrosurgery,speciallydesignedinstrumentsarenecessary.Theseinstrumentsareveryfine,smallandofgoodquality.Thefollowingarethekeyinstrumentsthatmustbeavailabletoamicro-surgeon.non-tooth

8、edorsmoothforceps(2)micro-scissors(angledandstraight)(3)springloadedmicro-needleholder(4)microvascularclamp(angledandstraight)(5)microvascularclips(6)vesseldilatingforceps(7)approximatingclampandsoon2.Micro-sutures:monofilamentnylon7-0,8-0,9-0,11-09-