Surgical microscope

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The surgical microscope is in the minimally invasive surgery and microsurgery applied microscope with a relatively low magnification (approximately 6- to 40-fold) and provides an upright and three-dimensional image. The magnification goes beyond that of magnifying glasses . It is used in almost all surgical directions in the medical field.

history

The surgical microscope was first used in September 1921 by Carl Olof Siggesson Nylen for an oto-rhino-laryngological operation. In 1922, Nylén's boss and teacher G. Holmgren (1875–1954) modified a binocular microscope from Carl Zeiss by adding a light source and a stand for use in fenestration operations. In 1950 it was introduced into ophthalmology . Horst Ludwig Wullstein , dissatisfied with the rigid dissection microscopes used at the time, built his own, significantly more mobile surgical microscope.

Advantages over magnifying glasses

Operating microscope with stand and co-observation station for microsurgery

Compared to magnifying glasses, a higher magnification is possible (up to 40 instead of 2 to 7 times). Furthermore, the operating field is calmer, since involuntary head movements do not disturb the field of vision. In addition, the surgeon and the assistant see the same operating area without having to get too close to the surgical site with their head . In contrast to magnifying glasses, vision and lighting follow an almost identical beam path, which is reflected in significantly better illumination of the operating field. When the beam path is separated with a movable co-observer system, different focussing within the operating area is also possible.

The additional use of camera systems within the microscope enables digital enlargements and documentation of the operation as well as the transmission of the operating field to other monitors.

In addition, there are systems which, through the use of special cameras, are able to record the blood flow in the tissue (IR camera) as well as special tissue areas (cancer cell fluorescence) and to display them optically via monitors and microdisplays. This allows the surgeon to receive auxiliary lines and tissue boundaries resulting from data from an MRT or X-ray examination.

Using suitable image processing systems, these virtual tissue boundaries can also be rotated in space and adapted to the position of the respective observer. It is also possible to perform a 3D analysis and import a section of an operating theater area.

Special supplements

The microscope can be covered with a special sterile film ( drape ), which does not disturb the view, but allows aseptic work.

In order to ensure simple operation and a steady image, large microscopes are mounted on feet and equipped with an active brake balance system, which is usually operated with handgrips and enables the position to be changed easily without any effort.

The settings of the microscope, such as focusing and magnification, can be made by the surgeon using foot switches. Some microscopes also offer the option of unlocking the brakes with an electronically controlled mechanism that is operated via a mouth switch.

Manufacturer

Surgical microscopes are u. a. manufactured by Carl Zeiss Meditec , Leica Microsystems , Möller-Wedel , Arri Medical and Kaps Optik .

Web links

Individual evidence

  1. ↑ a b Wolfgang Klimm: Endodontology: Basics and Practice . Deutscher Zahnärzte Verlag, 2003, ISBN 978-3-934280-13-7 ( page 189 in the Google book search).
  2. ↑ Zeiss: 50 years of surgical microscopes (PDF; 935 kB)
  3. ↑ a b Georg Heberer, Rudolf Zenker: Gefäßchirurgie (special edition 2004) . Springer, 2004, ISBN 978-3-540-40564-1 ( page 89 in the Google book search).