TY  - JOUR
A1  - Will-Marks, Patrick
A1  - Hirche, Christoph
A1  - Berner, Juan Enrique
A1  - Kneser, Ulrich
A1  - Gazyakan, Emre
T1  - Lymphovenous anastomoses with three-dimensional digital hybrid visualization: improving ergonomics for supermicrosurgery in lymphedema
T2  - Archives of Plastic Surgery
N2  - The conventional approach of looking down a microscope to perform microsurgical procedures is associated with occupational injuries, anti-ergonomic postures, and increased tremor and fatigue, all of which predispose microsurgeons to early retirement. Recently, three-dimensional (3D) visualization of real-time microscope magnification has been developed as an alternative. Despite its commercial availability, no supermicrosurgical procedures have been reported using this technology to date. Lymphovenous anastomoses (LVAs) often require suturing vessels with diameters of 0.2–0.8 mm, thus representing the ultimate microsurgical challenge. After performing the first documented LVA procedure using 3D-augmented visualization in our unit and gaining experience with this technique, we conducted an anonymized in-house survey among microsurgeons who had used this approach. The participants considered that 3D visualization for supermicrosurgery was equivalent in terms of handling, optical detail, depth resolution, and safety to conventional binocular magnification. This survey revealed that team communication, resident education, and ergonomics were superior using 3D digital hybrid visualization. Postoperative muscle fatigue, tremor, and pain were also reduced. The major drawbacks of the 3D visualization microscopic systems are the associated costs, required space, and difficulty of visualizing the lymphatic contrast used.
KW  - Lymphedema
KW  - Microsurgery
KW  - Ergonomics
KW  - Digital hybrid visualization
KW  - Imaging, three-dimensional
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62827
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-628276
SN  - 2234-6171
VL  - 48
IS  - 4
SP  - 427
EP  - 432
PB  - Georg Thieme Verlag KG
CY  - Stuttgart
ER  -