Assessment of Three Dimensional High Definition Visualization Technology to Perform Microvascular Anastamosis

Introduction: Since microsurgical cases require prolonged periods of physical and visual strain, the optimization of ergonomic modalities is not only relavent, but may also potentially impact the "lifespan" of a practicing microsurgeon.  Recently, three-dimensional high definition (3DHD) heads up displays have been used in high precision procedures in neurosurgery and ophthamology.  The goal of this study was to assess the safety and potential benefit of using 3DHD displays for performing microvascular anastamoses in a reproducible animal model.  We were also interested in the application of this technology for teaching purposes.

Methods: Thirteen participants of various skill levels (novice, intermediate, and expert) performed rat femoral microvascular anastamoses using both traditional and 3DHD microscopy (TrueVision Systems, Santa Barbara CA).  Pre- and post-survey data was collected prospectively.  

Results:  One hundred percent of the microsurgical anastamoses were sucessful using both traditional and 3DHD modalities.  Users felt that traditional microscopy provided easier depth perception, fewer focus and depth of field adjustments, higher technical precision, and overall ease of use.  We found the potential benefits of 3DHD to be reduced eye, head and neck strain, greater visual field, better teaching tool, and ability to perform longer periods of microsurgery.

Conclusions:  3DHD microsurgery is a safe alternative to traditional microscopy that may limit ergonomic strain and also be a valubale teaching modality.