Operating microscope

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A podiatrist prepares for microsurgery. Foot Laser Surgery.jpg
A podiatrist prepares for microsurgery.

An operating microscope or surgical microscope is an optical microscope specifically designed to be used in a surgical setting, typically to perform microsurgery. [1]

Contents

Design features of an operating microscope are: magnification typically in the range from 4x-40x, components that are easy to sterilize or disinfect in order to ensure cross-infection control.

There is often a prism that allows splitting of the light beam in order that assistants may also visualize the procedure or to allow photography or video to be taken of the operating field.

Typically an operating microscope might cost several thousand dollars for a basic model, more advanced models may be much more expensive. Additionally, specialized microsurgical instruments may be required to make full use of the improved vision the microscope affords. It can take time to master use of an operating microscope. [2]

Fields of medicine that make significant use of the operating microscope include plastic surgery, dentistry (especially endodontics), ENT surgery, ophthalmic surgery, and neurosurgery. [3]

In eye surgery

In Eye (ophthalmic) surgery, there are procedures which routinely utilize a surgical microscope, such as cataract surgery and corneal transplantation. An Optical coherence tomograph (OCT) can be added to aid the surgeon, especially during retinal surgery.

In dentistry

In dentistry, an example of a procedure which commonly uses an operating microscope would be endodontic retreatment, where the magnification provided by the operating microscope improves visualisation of the anatomy present leading to better outcomes for the patient. [4] It has been suggested that the well-focused illumination and magnification should be part of a standard of care in endodontic therapy. [5] [6] However, a Cochrane review did not find any studies that met the inclusion criteria to confirm or dispute the hypothesis; therefore suggesting further research. [7]

Other procedures

Surgical microscopes are used in anastomosis procedures carried out to join blood vessels in vascular surgery. [8]

Surgical microscopes are often used for the insertion of the Tympanostomy tube particularly in pediatric cases. [9] [10]

See also

Related Research Articles

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<span class="mw-page-title-main">Optical coherence tomography</span> Imaging technique

Optical coherence tomography (OCT) is an imaging technique that uses interferometry with short-coherence-length light to obtain micrometer-level depth resolution and uses transverse scanning of the light beam to form two- and three-dimensional images from light reflected from within biological tissue or other scattering media. Short-coherence-length light can be obtained using a superluminescent diode (SLD) with a broad spectral bandwidth or a broadly tunable laser with narrow linewidth. The first demonstration of OCT imaging was published by a team from MIT and Harvard Medical School in a 1991 article in the journal Science. The article introduced the term "OCT" to credit its derivation from optical coherence-domain reflectometry, in which the axial resolution is based on temporal coherence. The first demonstrations of in vivo OCT imaging quickly followed.

<span class="mw-page-title-main">Endodontics</span> Field of dentistry which studies the interior tissue (pulp) of teeth

Endodontics is the dental specialty concerned with the study and treatment of the dental pulp.

An extracorporeal procedure is a medical procedure which is performed outside the body. Extracorporeal devices are the artificial organs that remain outside the body while treating a patient. Extracorporeal devices are useful in hemodialysis and cardiac surgery.

A myringotomy is a surgical procedure in which an incision is created in the eardrum to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. A tympanostomy tube may be inserted through the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid. Without the insertion of a tube, the incision usually heals spontaneously within two to three weeks. Depending on the type, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure.

<span class="mw-page-title-main">Microsurgery</span> Surgery requiring an operating microscope

Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves which have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Microsurgical techniques are utilized by several specialties today, such as general surgery, ophthalmology, orthopedic surgery, gynecological surgery, otolaryngology, neurosurgery, oral and maxillofacial surgery, endodontic microsurgery, plastic surgery, podiatric surgery and pediatric surgery.

<span class="mw-page-title-main">Tympanostomy tube</span> Medical device inserted into the eardrum

Tympanostomy tube, also known as a grommet,myringotomy tube, or pressure equalizing tube, is a small tube inserted into the eardrum via a surgical procedure called myringotomy to keep the middle ear aerated for a prolonged period of time, typically to prevent accumulation of fluid in the middle ear. The tube itself is made in a variety of designs, most often shaped like a grommet for short-term use, or with long flanges and sometimes resembling a T-shape for long-term use. Materials used to manufacture the tubes are often made from fluoroplastic or silicone, which have largely replaced the use of metal tubes made from stainless steel, titanium, or gold.

<span class="mw-page-title-main">Corneal cross-linking</span> Surgical procedure

Corneal cross-linking (CXL) with riboflavin (vitamin B2) and UV-A light is a surgical treatment for corneal ectasia such as keratoconus, PMD, and post-LASIK ectasia.

<span class="mw-page-title-main">Apicoectomy</span> Endodontic root end surgery

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<span class="mw-page-title-main">Surgical anastomosis</span> Surgical technique

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Microsurgical endodontics is that aspect of endodontics which evolved after the introduction of the Surgical Operating Microscope (SOM) to endodontics in the early 1990s. The recent addition of SOM's to endodontic therapy can allow better visualization and management of the surgical field by endodontists during endodontic procedures through magnification and greatly improved high intensity lighting. SOM's typically magnify in the 4X to 25X range. The other commonly used magnification aide, through lens eyeglass mounted surgical telescopes, provide 2.5X to 4.5X magnification. Surgical operating microscopes have a steep learning curve and require training, as well as patience and practice to master.

<span class="mw-page-title-main">Crown lengthening</span> Dental procedure

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<span class="mw-page-title-main">Loupe</span> Magnifying device

A loupe is a simple, small magnification device used to see small details more closely. They generally have higher magnification than a magnifying glass, and are designed to be held or worn close to the eye. A loupe does not have an attached handle, and its focusing lens(es) are contained in an opaque cylinder or cone. On some loupes this cylinder folds into an enclosing housing that protects the lenses when not in use.

<span class="mw-page-title-main">Root canal treatment</span> Procedure to disinfect and fortify the interior of a tooth

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<span class="mw-page-title-main">Tympanosclerosis</span> Medical condition

Tympanosclerosis is a condition caused by hyalinization and subsequent calcification of subepithelial connective tissue of the tympanic membrane and middle ear, sometimes resulting in a detrimental effect to hearing.

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<span class="mw-page-title-main">Nance–Horan syndrome</span> Rare X-linked dominant condition

Nance–Horan syndrome, also known as X-linked congenital cataracts and microcornea, X-linked cataract–dental syndrome, cataracts-oto-dental syndrome, cataract–dental syndrome, and mesiodens–cataract syndrome, is a rare X-linked syndrome characterized by eye and teeth abnormalities, intellectual disability, and facial deformities.

In the dental specialty of endodontics, periradicular surgery is surgery to the external root surface. Examples of periradicular surgery include apicoectomy, root resection, repair of root perforation or resorption defects, removal of broken fragments of the tooth or a filling material, and exploratory surgery to look for root fractures.

References

  1. Cordero, Ismael (2014). "Understanding and caring for an operating microscope". Community Eye Health. 27 (85): 17. ISSN   0953-6833. PMC   4069782 . PMID   24966460.
  2. Schaefer, Madison A.; Nelson, Heather N.; Butrum, John L.; Gronseth, James R.; Hines, Jacob H. (2023-03-09). "A low-cost smartphone fluorescence microscope for research, life science education, and STEM outreach". Scientific Reports. 13 (1): 2722. doi:10.1038/s41598-023-29182-y. ISSN   2045-2322.
  3. Fichter, Andreas M.; Wolff, Constantin T.; Grabenhorst, Alex; Koss, Leonard H.; von Bomhard, Achim; Nieberler, Markus; Wolff, Klaus-Dietrich; Ritschl, Lucas M. (2023-07-05). "Comparison of a high-definition three-dimensional digital camera system with a conventional state-of-the-art operation microscope for microsurgical anastomoses". Scientific Reports. 13 (1): 10867. doi:10.1038/s41598-023-37530-1. ISSN   2045-2322.
  4. "Use of Microscopes and OtherMagnification Devices" (PDF). American Association of Endodontists. 2020.
  5. Cohen S, Hargreaves KM. Pathways of the Pulp. 9th Edition. St Louis, MO: Mosby, 2006.
  6. Kim S. Modern endodontic practice: instruments and techniques. Dental Clinics of North America 2004;48(1): 1–9.
  7. Del Fabbro, Massimo; Taschieri, Silvio; Lodi, Giovanni; Banfi, Giuseppe; Weinstein, Roberto L. (2015). "Magnification devices for endodontic therapy". Cochrane Database of Systematic Reviews. 2015 (12): CD005969. doi:10.1002/14651858.CD005969.pub3. hdl: 2434/434134 . PMC   7389255 . PMID   26650099.
  8. Malzone, Gerardo; Menichini, Giulio; Innocenti, Marco; Ballestín, Alberto (2023-08-27). "Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial". Scientific Reports. 13 (1): 14003. doi:10.1038/s41598-023-41143-z. ISSN   2045-2322.
  9. "An Overview of the Tympanostomy Tube". NLM.
  10. Spaw, Mark; Agarwal, Nikki; Camacho, Macario (2024), "Tympanostomy Tube Insertion", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   33351417 , retrieved 2024-11-12

Further reading