Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 44:
The Microsurgical Laboratory
  Microsurgery, like playing a musical instrument, is an acquired skill that requires constant practice if the surgeon is to remain adept. Because of the need for constant practice, a microsurgical laboratory is a necessity.

The microsurgical laboratory minimally consists of a small room containing an operating microscope, a microscope table, an adjustable stool, a set of microsurgical instruments, sutures, anaesthetic agents, experimental animals, a bipolar coagulator, and a few additional supplies that will be mentioned later.

Microsurgical laboratories in medical centers that have microsurgical services should have far more extensive facilities than the minimal-practice ones mentioned above. These facilities, which support teaching, practice, and research, should be located in a part of the medical center that is reasonably quiet, away from patient and visitor areas, isolated from most employee areas, but easily accessible to individuals using the facilities. The laboratory should consist of a room with one or more workstations, an area for animals being used that day, a storeroom or storage area, a work area where instruments and equipment can be repaired, an office, an animal room with a controlled environment, and a video room where videotapes can be viewed without disturbing others who are using the laboratory.


The laboratory should be a place that is quiet (background music is often desirable), calm, free of unnecessary disturbances, and well lighted, with comfortable workstations. The importance of being comfortable while working at the microscope cannot be overemphasized. Folded towels under the forearms allow greater hand stability and comfort while working under the microscope. If the optics of the microscope are not properly adjusted, the surgeon will develop eyestrain within an hour or so, and will not be able to see well enough to perform tasks properly under the microscope. If the stool is not set to the proper height, a backache will often begin within 1 or 2 hours, and if the microscope is too far from the surgeon, there is a tendency to place the elbows on the table, lean forward, and place weight on the elbows. This posture greatly magnifies any tremor that is already present.

Workstations consist of an operative microscope, a table of comfortable height (30 to 32" for an individual of average height), an adjustable chair or stool with a springback, and a cart or a small cabinet that will hold a bipolar coagulator, instruments, and supplies.

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