Assessment of three-dimensional high-definition visualization technology to perform microvascular anastomosis.
OBJECTIVE
Traditional visualization techniques in microsurgery require strict positioning in order to maintain the field of visualization. However, static posturing over time may lead to musculoskeletal strain and injury. Three-dimensional high-definition (3DHD) visualization technology may be a useful adjunct to limiting static posturing and improving ergonomics in microsurgery. In this study, we aimed to investigate the benefits of using the 3DHD technology over traditional techniques.


METHODS
A total of 14 volunteers consisting of novice and experienced microsurgeons performed femoral anastomoses on male Sprague-Dawley retired breeder rats using traditional techniques as well as the 3DHD technology and compared the two techniques. Participants subsequently completed a questionnaire regarding their preference in terms of operational parameters, ergonomics, overall quality, and educational benefits. Efficiency was also evaluated by mean times to complete the anastomosis with each technique.


RESULTS
A total of 27 anastomoses were performed, 14 of 14 using the traditional microscope and 13 of 14 using the 3DHD technology. Preference toward the traditional modality was noted with respect to the parameters of precision, field adjustments, zoom and focus, depth perception, and overall quality. The 3DHD technique was preferred for improved stamina and less back and eye strain. Participants believed that the 3DHD technique was the better method for learning microsurgery. Longer mean time of anastomosis completion was noted in participants utilizing the 3DHD technique.


CONCLUSIONS
The 3DHD technology may prove to be valuable in improving proper ergonomics in microsurgery. In addition, it may be useful in medical education when applied to the learning of new microsurgical skills. More studies are warranted to determine its efficacy and safety in a clinical setting.
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA. Electronic address: Alex.Wong@med.usc.edu.
Alex K
AK
Wong
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Gabrielle B
GB
Davis
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
T JoAnna
TJ
Nguyen
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Kenneth J W S
KJ
Hui
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Brian H
BH
Hwang
Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Linda S
LS
Chan
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Zhao
Z
Zhou
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Wesley G
WG
Schooler
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Bala S
BS
Chandrasekhar
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.
Mark M
MM
Urata
D000714:Anastomosis, Surgical / Q000193:education / Q000379:methods; D000818:Animals; D001291:Attitude of Health Personnel; D006804:Ergonomics; D005263:Femoral Artery / Q000601:surgery; D013502:General Surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D007396:Internship and Residency; D008297:Male; D008866:Microsurgery / Q000193:education / Q000379:methods*; D055806:Microvessels / Q000601:surgery*; D009140:Musculoskeletal Diseases / Q000209:etiology*; D009784:Occupational Diseases / Q000209:etiology*; D011187:Posture; D051381:Rats; D017207:Rats, Sprague-Dawley; D013337:Students, Medical; D013518:Surgery, Plastic; D011795:Surveys and Questionnaires; D014656:Vascular Surgical Procedures / Q000193:education / Q000379:methods*
Ergonomics; Microsurgery; Three-dimensional; Visualization