Science topic

Microsurgery - Science topic

The performance of surgical procedures with the aid of a microscope.
Questions related to Microsurgery
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My project involves inducing intestinal IRI in mice via occlusion of the superior mesenteric artery (where it branches off the abdominal aorta). After scouring the literature I’ve finally gotten a fairly detailed protocol written up, but cannot find the best approach to isolating and occluding the superior mesenteric artery. If you can provide any resources that may be helpful (tips, papers, and especially videos) I would be very grateful.
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This article includes a video of the surgical procedure. It doesn't show the isolation of the intestines, but it should be fairly simple to evert them through the abdominal incision and then isolate the artery. Their approach uses multiple surgical clips on the various branches of the mesenteric artery to induce ischemia, which I would think is safer and more reliable than ligating closer to the aorta.
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Is there any selective advantage to the brachial plexus being a network instead of independent nerves? Same question for the lumbosacral plexus.
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i have found it is difficult to get clear answers to questions about the original design of the body...
why would the taste sense of the anterior part of the tongue run through the middle ear
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There is an obvious trend towards endoscopic endonasal surgical removal of craniopharyngiomas. My question is whether it is really advantageous and less harmful to the patient or just a fashion.
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Dear Dr. Venelin Gerganov,
The endoscopic endonasal approach (EEA) for craniopharyngiomas offers great advantanges in terms of improved visualization and gross-total resection with reduced brain retraction and complications compared to fronto-lateral approach. EEA is generally indicated for midline tumors (sellar, suprasellar and third ventricle). If cranio extends laterally, a fronto-lateral craniotomy would be needed. It would be interesting to analyse long-term outcomes between EEA and interhemispheric subfrontal approach.
Best,
Emanuele
References:
1. Komotar, R. J. et al. (2012) ‘Endoscopic Endonasal Compared with Microscopic Transsphenoidal and Open Transcranial Resection of Craniopharyngiomas’, World Neurosurgery, 77(2), pp. 329–341. doi: 10.1016/j.wneu.2011.07.011.
2. Moussazadeh, N. et al. (2016) ‘Endoscopic endonasal versus open transcranial resection of craniopharyngiomas: a case-matched single-institution analysis’, Neurosurgical Focus, 41(6), p. E7. doi: 10.3171/2016.9.FOCUS16299.
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We are looking for a source of micro silicone tubing with wall thickness approximately 0.05mm and OD ranging from 0.5mm to 3.0mm, as used in the microsurgical study below:
I have been unable to get into contact with the authors to determine their source. The smallest silicone tubing we have been able to acquire has a wall thickness 0.1mm. Any recommendations?
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Theoretically, it is possible to protect the interior chanel and etch the walls, e.g. by concentrated KOH or HF + HNO3. I am not sure about the tubing, but I have used such technique for AFM cantilevers (silicon) modification.
Good luck! 
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Hi everyone,
This is Dr. Tommy Chang from Chang-Gung Memororial Hospital in Taiwan.
Now we are doing this international survey to study life and working of microsurgeons, also the surgical preferences in specific cases. We sincerely invite you to present your personal opinion through our link (the questionnaire).
From our preliminary data we have already found some differences between the junior/senior, and area difference, will keep update.   
thanks!
best
Tommy
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thanks! if you know someone doing microsurgery please feel free to forward.
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Microsurgery is a technique which provide a wide range of possibilities in different surgical specialities. But what your indications for microsurgery in your field? Do you think that having good microsurgical skills could improve your surgical technique?
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Hi,
I agree with everyone here and being teaching microsurgery for many many years to many different surgical specialties and to surgeons and not only surgeons with different experiences proved to me that skills like micro significantly improve quality of technical skills everyone who has it. It not easy to obtain but in a way of learning microsurgery people also learn quite many other skills as well ( sometime without even realizing it :) like gentleness of handling and dissecting, attention to details, self-control and patience and decision making, etc I really believe that learning and using microsurgery is a very useful in many aspects and should be taught to all surgeons while they are in training even thought they are not will be using it in practice, they just will be better surgeons !!! thank you for the opening this discussion. 
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Has anyone participated in the mouse microsurgery and small animal echocardiography workshop organized by the Northeast Ohio Medical University? How good is it? Is it worthwhile to travel from Holland to this course?
Your advise is greatly appreaciated.
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I participated in this workshop in 2014 as a postdoc and thought it was excellent for my needs. I had observed numerous surgical procedures and performed human and animal echo before attending, but I wanted to perform PV loops and TAC surgeries.  (You don't need prior experience, but you might get the info faster if you have some.)
The best part for me was having a dedicated week to practice surgical technique. We were provided several mice per day. (You will still need to go home and practice before starting an experiment.) They provided nearly 1 staff for every 2 participants and all were very generous with their time. The organizer and most of the staff have experience so they can help you troubleshoot if you ask them questions.  They also have reps/techs from ADInstruments, Transonics, and Visualsonics.
Their website lists all of the surgical techniques, and if you or your trainee were starting from scratch, it can be a good way to get started. I spent most of my time on 1 or 2 procedures, but with their teaching and handouts, I could probably do all of the techniques (for example I never attempted an MI but I understand the steps). I think about half of my cohort focused on a specific technique, while half tried everything at least once. You don't need buy tools ahead of time, so your costs are travel and course fees. Their materials also provide a comprehensive list of tools for each technique and step-by-step protocols.
Is it worth traveling? For me it was worth the short drive to have the dedicated time/training. On the other hand, if there was someone at my institution (or close by) that I could have collaborated with to save my funds, I might not have gone -and I doubt I would have traveled overseas. While I had a good experience, I recommend staying in Holland because of costs unless 1) can't find someone to teach you, 2) you need the dedicated learning time, or 3) you are certain you will perform at least one technique regularly in your lab. Here in the US, there are plenty of experienced core-labs and/or collaborators who could better perform these experiments for investigators for individual studies. I think you can find similar in Holland/near by in Europe.
If you want echo training and have access to a Visualsonics system, I'd recommend asking a collaborator or Visualsonics for onsite training. (I recommend this even if you do attend the workshop; there was very limited time to work with the ultrasound system.)  
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I would like to know about the experience in microsurgery flaps in children under less 10 years old in 
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Free flaps are easy and feasible in children. The size of vessels is not as small as you might think. Dissection is easier than adults and the chance of thrombosis postoperative is smaller than adults. The only problem is the postoperative compliance of the child.
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I am currently working on my thesis and I am looking for more detailed articles about the surgical procedures used in hands and fingers re-plantations.
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Unfortunately the couplers are for veins only, ment to be used for reducing surgical time in larger vessels anastomoses and require an excess length of vessel which is not really available in most replants. There have been several research projects in the 80's trying to address the question you asked such as using lasers instead of sutures, doing continuous as opposed to interrupted sutures, sleeve anastomosis etc. I suggest you look up these studies
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Inguinal seems to be safer but less effective. Is this true?
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I agree with Darby
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What is the rate of success?
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Drs. Plock and O'Boyle have answered all the aspects of this unpleasant situation. Fortunately however, we do not come across with total amputations frequently and in cases of clean cut injuries success rate is very high.
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An operation on the unforgiving spinal cord in a patient suffering severe pain for 7 years, and he is pain-free now with no deficit. This is probably the first of such kind of operation in our country.
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we have done 7 cases so far for intractable Post Brachial plexus pain and all patients are happy at average followup of 1 year and without pain
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I need to examine the urinary tract in mice for UTIs and need to extract the kidneys and bladder for histological examination. I planned to fix the tissue samples in 10% NBF for 24 hours, but I have conflicting reports on procedures for storage post-fixation. I've been told to store them in 0.1M PBS, while another colleague has said that she's stored samples in NBF up to 5 days. I've found online resources that say to store in 70% EtOH after washing the tissues well with PBS. What's the best/proper procedure?
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There really is no universal "best or proper" procedure for fixation. Every fixation procedure does lead to some change in the tissue being fixed. As can be seen from all the replies above the fixation procedure will depend on what you need to do with the tissue later. From your question you have mentioned histological examination. For most histological procedures fixation in 10% buffered formalin give adequate morphological preservation for routine H&E as well as most commonly used histochemical staining procedures. But if you are planning Immuohistochemistry / immunofluorescence or any other immunological procedure then it really depends on the antigenic epitope that is being studied and the available antibodies. You may then have to look at the best fixation procedure and if any antigen retrieval etc would be required later. I do not think storing in PBS is a good idea esp since you plan to study UTI. The bacterial growth that is invariably likely esp if your tissue are already infected may vitiate the results.