title: [An alternative to the usual operating microscope and loupe magnification for free microvascular tissue transfer. Varioscope AF3-A].
abstract: OBJECTIVE
  Free microvascular tissue transfers have become today a key instrument for the surgical treatment of wide loss of tissue, but their employment implies mandatory use of the right visual magnification means. Until now these instruments were mainly loupes and operating microscopes. Our study is focusing on the use of a new visual system--Varioscope AF3-A--in the reconstructive microsurgery field.
  
  
  METHODS
  Varioscope AF3-A (Life Optics, Vienna, Austria) has been employed in our Institute in 10 microvascular reconstructions, where different free flaps were used in head and neck reconstruction.
  
  
  RESULTS
  All the flaps took and only one developed a partial necrosis. We have also noticed, by using this new instrument, a learning curve with a progressive contraction of the operating time. In all cases we have operated on 2 mm caliber vessels or more and on tissues that didn't previously undergo radiation therapy.
  
  
  CONCLUSIONS
  The employment of a visual magnification mean, as Varioscope AF3-A, allows autofocus (from 3.6X to 7.2X) and a wide vision. It can be easily used with substantial advantages for the surgeon in performing microvascular anastomosis. Partial drawbacks are the equipment high cost and weight, compared to the loupes and a stronger ocular stress due to the continuous autofocus compared to the static operating microscopes.
authors.affiliation: Dipartimento di Chirurgia Plastica e Ricostruttiva, Università degli Studi La Sapienza, Roma.
authors.forename: S
authors.initials: S
authors.lastname: Chiummariello
authors.forename: C
authors.initials: C
authors.lastname: Alfano
authors.forename: P
authors.initials: P
authors.lastname: Fioramonti
authors.forename: N
authors.initials: N
authors.lastname: Scuderi
mesh_terms: D006801:Humans; D007909:Lenses; D008853:Microscopy; D008866:Microsurgery / Q000295:instrumentation*; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D013524:Surgical Flaps / Q000098:blood supply*; D016378:Tissue Transplantation / Q000379:methods*; D016896:Treatment Outcome