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CC BY-NC 4.0 · Arch Plast Surg 2017; 44(06): 490-495
DOI: 10.5999/aps.2017.01060
Original Article

Cleft Lip and Palate Repair Using a Surgical Microscope

Motoi Kato
Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, Japan
,
Azusa Watanabe
Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, Japan
,
Shoji Watanabe
Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, Japan
,
Hiroki Utsunomiya
Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, Japan
,
Takayuki Yokoyama
Department of Plastic and Reconstructive Surgery, Saitama Children’s Medical Center, Saitama, Japan
,
Shinya Ogishima
Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan
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Background Cleft lip and palate repair requires a deep and small surgical field and is usually performed by surgeons wearing surgical loupes. Surgeons with loupes can obtain a wider surgical view, although headlights are required for the deepest procedures. Surgical microscopes offer comfort and a clear and magnification-adjustable surgical site that can be shared with the whole team, including observers, and easily recorded to further the education of junior surgeons. Magnification adjustments are convenient for precise procedures such as muscle dissection of the soft palate.

Methods We performed a comparative investigation of 18 cleft operations that utilized either surgical loupes or microscopy. Paper-based questionnaires were completed by staff nurses to evaluate what went well and what could be improved in each procedure. The operating time, complication rate, and scores of the questionnaire responses were statistically analyzed.

Results The operating time when microscopy was used was not significantly longer than when surgical loupes were utilized. The surgical field was clearly shared with surgical assistants, nurses, anesthesiologists, and students via microscope-linked monitors. Passing surgical equipment was easier when sharing the surgical view, and preoperative microscope preparation did not interfere with the duties of the staff nurses.

Conclusions Surgical microscopy was demonstrated to be useful during cleft operations.

Keywords

Microscope - Cleft lip - Cleft palate

This article was presented at the Japanese Society of Microsurgery on November 16-17, 2016, in Hiroshima, Japan.




Publication History

Received: 15 June 2017

Accepted: 24 August 2017

Article published online:
20 April 2022

© 2017. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Sommerlad BC. The use of the operating microscope for cleft palate repair and pharyngoplasty. Plast Reconstr Surg 2003; 112: 1540-1
    CrossrefPubMedGoogle Scholar
  • 2 Onizuka T. A new method for the primary repair of unilateral cleft lip. Ann Plast Surg 1980; 4: 516-24
    CrossrefPubMedGoogle Scholar
  • 3 Furlow Jr LT. Cleft palate repair by double opposing Z-plasty. Plast Reconstr Surg 1986; 78: 724-38
    CrossrefPubMedGoogle Scholar
  • 4 Sommerlad BC. A technique for cleft palate repair. Plast Reconstr Surg 2003; 112: 1542-8
    CrossrefPubMedGoogle Scholar
  • 5 Rossell-Perry P. Flap necrosis after palatoplasty in patients with cleft palate. BioMed Res Int 2015; 2015: 516375
    PubMedGoogle Scholar
  • 6 Daniels KM, Yu EY, Maine RG. et al. Palatal fistula risk after primary palatoplasty: a retrospective comparison of humanitarian operations and tertiary hospitals. Lancet 2015; 385 Suppl 2: S37
    PubMedGoogle Scholar
  • 7 Schonmeyr B, Wendby L, Campbell A. Early surgical complications after primary cleft lip repair: a report of 3108 consecutive cases. Cleft Palate Craniofac J 2015; 52: 706-10
    CrossrefPubMedGoogle Scholar
  • 8 Paine KM, Tahiri Y, Wes AM. et al. An assessment of 30-day complications in primary cleft lip repair: a review of the 2012 ACS NSQIP Pediatric. Cleft Palate Craniofac J 2016; 53: 283-9
    CrossrefPubMedGoogle Scholar
  • 9 Smarius B, Breugem C. Surgical learning curve in performing palatoplasty: a retrospective study in 200 patients. J Craniomaxillofac Surg 2015; 43: 1868-74
    CrossrefPubMedGoogle Scholar
  • 10 Allori AC, Mulliken JB, Meara JG. et al. Classification of cleft lip/palate: then and now. Cleft Palate Craniofac J 2017; 54: 175-88
    CrossrefPubMedGoogle Scholar
  • 11 Sandham A. Classification of clefting deformity. Early Hum Dev 1985; 12: 81-5
    CrossrefPubMedGoogle Scholar
  • 12 Podolsky DJ, Fisher DM, Wong KW. et al. Evaluation and implementation of a high-fidelity cleft palate simulator. Plast Reconstr Surg 2017; 139: 85e-96e
    CrossrefPubMedGoogle Scholar
  • 13 Podolsky DJ, Fisher DM, Wong Riff KW. et al. Infant robotic cleft palate surgery: a feasibility assessment using a realistic cleft palate simulator. Plast Reconstr Surg 2017; 139: 455e-465e
    CrossrefPubMedGoogle Scholar