Extracranial-intracranial bypass surgery at high magnification using a new high-resolution operating microscope: technical note

Nobuhisa Matsumura MD, Takashi Shibata MD, Kimiko Umemura MD, Seiya Nagao MD, Yukio Horie MD
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引用次数: 7

Abstract

Background

We report a precise technique for EC-IC bypass surgery using a stereoscopic high-resolution microscope at magnifications of 40× and 50×.

Methods

A stereoscopic operating microscope (Mitaka MM50 Surgical Microscope; Mitaka Kohoki Co, Tokyo, Japan) was used in STA-MCA anastomosis. This microscope has 2 optical systems, a standard zooming system, a newly developed high-magnification system, and 4 fixed working distances of 200, 250, 300 and 350 mm, with highest magnifications of 50.4× at 200 mm and 40.3× at 250 mm. High resolution is achieved by a new lens design in the optical system, which makes the image of the object very clear at high magnification. The magnification can be changed depending on the circumstances in a given procedure. The STA-MCA anastomoses were performed using this microscope.

Results

Very small vessels were observable, and arterial anastomosis could be performed precisely at high magnification. All anastomoses were patent on postoperative angiograms.

Conclusions

Use of the new microscope allows visualization and manipulation of small vessels at high magnification and high resolution and may be very useful in EC-IC bypass surgery.

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使用新型高分辨率手术显微镜进行高倍率的颅外-颅内搭桥手术:技术说明
我们报道了一种使用40倍和50倍放大的立体高分辨率显微镜进行EC-IC搭桥手术的精确技术。方法立体手术显微镜(Mitaka MM50外科显微镜;使用Mitaka Kohoki Co, Tokyo, Japan)进行STA-MCA吻合。该显微镜有2个光学系统,一个标准的变焦系统,一个新开发的高倍放大系统,200、250、300和350 mm 4个固定工作距离,200 mm和250 mm的最高倍率分别为50.4倍和40.3倍。高分辨率是通过光学系统中的一种新的透镜设计实现的,它使物体的图像在高放大倍率下非常清晰。放大倍数可以根据给定程序的具体情况而改变。在此显微镜下进行STA-MCA吻合。结果观察到细小血管,高倍镜下可精确吻合动脉。所有吻合口术后血管造影均通畅。结论该显微镜能以高倍率和高分辨率显示和操作小血管,在EC-IC搭桥手术中具有重要的应用价值。
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Surgical Neurology
Surgical Neurology 医学-临床神经学
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