Microsurgical techniques have been applied to cranial,spinal,and peripheral nerve operations.Some procedures in which microsurgery is of value are explorations of the posterior fossa,especially for tumors of the fourth ventricle or cerebellopontine angle,and removal of small acoustic neuromas,with resulting preservation of the facial nerve.Each time the surgeon must look away and then back to the surgical field,open wound time and anesthesia time are increased while the surgeon becomes reoriented to the field.A nursing action,in the scrub person role,directed toward assisting the surgeon in efficiency and expediting the microsurgical procedure would be:

Question

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Use of the microscope restricts the surgeon's field of vision and mobility;therefore the scrub person and surgical assistant must be proficient.Surgical personnel must understand the surgical procedure,the corresponding anatomy,and the names and uses of all microinstruments and be proficient at handing instruments without delay that are ready for use.Microsurgical instruments have been modified and adapted to the requirements of neurosurgery.These instruments often possess the following characteristics:bayonet shape,so that the surgeon's hand remains outside the line of vision and the beam of the microscope light;finely sprung and fluted grip;long length for access to deep structures;and slender and delicate tips that occupy as little space as possible.Instruments must be kept free from blood and tissue during use because the microscope also magnifies debris on the instruments,occluding the structure the surgeon is about to approach.

Microsurgical Techniques Have Been Applied to Cranial,spinal,and Peripheral Nerve Operations