Organs renewed with microsurgery

Microscope, thread that is so fine that it cannot be seen with naked eye, materials so fine that can handle the mini vessels... All these are used in the microsurgery technique which enables joining of extremely fine vessels and nerves by stitching. Thanks to this technique, a solution can be found against tissue or organ loss occurring in almost any site of the body.


Head-neck site

Assoc. Prof. Dr. Şükrü Yazar, Esthetic Plastic and Reconstructive Surgery Specialist, indicates that many organs in head and neck site can be renewed or reconstructed using microsurgical surgery, for instance, the whole or part of mandibular may be required to be removed due to tumor by surgical operation. Consequently, life quality of the patient is severely compromised due to big tissue loss in mandible site. At this points, microsurgery gets involved. By this technique, bone and skin is taken from leg, inguinal or back site together with the vessels feeding them, transplanted to the tissue loss site, and the mandibular is restored. For feeding of those new tissues transplanted, the vessels of the tissues transplanted with the vessels in that site are stitched end-to-end under microscope so that they will enable blood flow. Moreover, a nose is constructed from the tissues taken from the forearm and transplanted to the patients who have lost their noses due to tumor or trauma.
Work accidents are commonly encountered problems in our country. Dr. Yazar tells highlights that the when a hairy skin that when the snatched in machines or completely sheared particularly in workshops is arrived to the hospital in appropriate conditions, it can be stitched with microsurgery technique, or highlights that it is possible to stitch an ear sheared due to accident in its place using microsurgery technique.
Destruction of nose, maxilla and mandibular as a result of injury by firearms can disrupt the whole life of human. Today, it is possible to make tissue transplantation from arm, hip and leg to the facial site at the same time. By Microsurgery method, it is possible to constructs a new maxilla, mandibular and nose for the patient. Furthermore, the arm skin is shaped tubular by microsurgery method, and it becomes possible to restore the esophagus lost due to tumor. Muscles and nerves are transplanted at the same time in order to bring in motion to the face of a patient who has facial paralysis due to accident or tumor. By this way, the paralyzed site can gain functioning in time. Furthermore, in Romberh disease that localizes on facial site, all soft tissues, all fat tissue as well as bone tissue dissolve. This may be either unilateral or bilateral. In these patients, the section on back or abdominal skin is thinned and used for filling using microsurgery method. By this way, the cave on the face of the patient is eliminated.


Arm site

Microsurgery is an integral part of hand surgery. According to Dr. Yazgan, hand or other organs sheared due to trauma should be immediately stitched in their places. But this sometimes cannot be possible. In these patients, namely those whose hand fingers have sheared, but could not be stitched in place on time, or in children born with missing fingers, foot fingers can be transplanted in place of the missing hand fingers so as to bring in a functionality for convenient use in daily activities, and a better esthetic look. Microsurgery offers solution also for such solutions as hand and upper extremity nerve compressions, shape malformations and functional disorders developed due to rheumatoid arthritis and other arthritis, hand birth anomalies like polydactility or syndactility, bonds on hand due to burnt. Dr. Yazar states that the microsurgery technique is used for bringing in again the lost functions of an organ. For example, if the nerve that induces the hand fingers cut due to trauma is not healed, the muscle on that site may become non-functioning. In this case, a muscle taken from another site of the body is transferred to the concerned site , and it is enabled that the organ regains its function.


Body (breast restoration)

Breast cancer may require complete removal of the breast the cancer is localized in unless detected early. Since breast is the icon of femininity, most women fall into depression following mastectomy method. At that point, reconstruction technique again gets involved; skin and fat tissue with the similar characteristics are taken from the abdomen and a new breast is constructed for the patient. Dr. Yazar indicates that this procedure is performed without damaging the abdominal muscle thanks to the developments in microsurgery techniques. In breast reconstruction, generally thee own tissue of the patients is preferred. Usually, the skin and fat tissue beneath skin in the abdominal site and the muscle enabling feed of these are prepared so that they will form a breast shape. Afterwards, the muscle is flip-flapped and carried to the breast site. Since one of the muscles constituting the front abdominal wall is used in this method, sometimes such risks like weakening or hernia occurrence may arise out. But thanks to the developments in microsurgery, the vessels feeding the skin and the fat tissue beneath skin can be picked up without using the abdominal muscle and damaging the muscle, and the prepared tissue is brought to the breast site together with tissue vessels. Then the vessels that will feed the tissues in the breast site are carefully stitched under microscope.  By this way, functions of the abdominal site muscle are maintained. Thereby, the patient both attains a new breast and gets discharged of the fat in abdominal site. It is possible to construct a new breast using microsurgical method as well in the patients who have formerly undergone abdominal surgery or whose abdominal tissue cannot be used for breast construction with the tissue to be taken from the hip or leg.


Leg site

Another important field of microsurgery is restoration of tissue losses developed in leg site that is one of the mostly exposed sites to trauma in traffic accidents. Dr. Yazar indicates that generally skin, muscle or bone tissue is taken from the other leg or another site of the body, and transferred to the damaged site; bone healing lasts longer, or even osteisitis may develop in the leg site sections where soft tissue cover is missing particularly in case of traffic accidents or open fractures.  Microsurgery method is very important particularly in closure of open wounds around ankle. Transplantation of back and abdominal muscles to the ankle brings significant benefits to the patient. By this way, the bone re-joins, infection growth is eliminated, and the patient gains the opportunity of walking again. In case osteitis has developed in leg injuries formerly suffered, but not treated adequately, the infected bone section is removed in several operations performed together with orthopedists. Afterwards, soft issue and muscle are transplanted to that site. Consequently, the bone begins healing rapidly. In addition to these, sheared leg and ankle can also be stitched in place using microsurgery method.


Sexual organs (penis and vagina restoration)

We often see the news of penis lost due to accident on visual and printed media. In such cases, penis can be reconstructed with tissues transferred from arm or leg together with bone. If penis is to be constructed from arm, a penil prosthesis is inserted in the same or in the second stage so that the male is enables that he has sexual relationship.  
In vulva cancers, broad tissue defects occur due to removal of tumor from a broad section, or n case of congenital vulva defects, vulva can be reconstructed by microsurgical method.