https://doi.org/10.1177/1553350617704755
Surgical Innovation
1–4
© The Author(s) 2017
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DOI: 10.1177/1553350617704755
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Original Article
Introduction
Peripheral nerves are frequently affected by traumatic
lesions, as total or partial section, stretch, compression,
avulsion, and crush cause the reduction or interruption of
the nerve transmission, causing a reduction in the
innerved area or loss of sensitivity and motility.
1
If not
adequately treated, those lesions will result in significant
deficits, disturbing patients’ quality of life or even limit-
ing functional capacity to work and an increase of loss of
working days.
1,2
The gold standard treatment for peripheral nerve inju-
ries is the neurorrhaphy.
1-3
However, the lack of trained
professionals and the high cost of the microscope limits
the population to have this sort of assistance.
3
This defi-
ciency is caused by the high cost of equipment necessary
for microsurgical practices.
3-5
Several alternatives are
currently under development to avoid this situation and
are showing promising results, such as endoscopes
6,7
and
laparoscopes.
8,9
These devices have started a new era of
video microsurgery; however, despite the high quality of
their images, these devices have major limitations related
to their short focal distance and high cost.
The quality of digital imaging in video cameras has
significantly improved over the past decade, inspiring
some researchers to try to use video systems as magnifica-
tion.
10-12
These systems have advantages such as low cost,
elimination of the need to look into the microscope’s ocu-
lar lenses to see the operating field,
10,11
and a more ergo-
nomic design.
12
Conversely, the microscope adds to the
stereoscopic effect through using binocular lenses.
6-12
A literature review of the use of video systems for magni-
fication has suggested that, so far, this novel magnification
system has only been used to perform arterial anastomoses.
One of the most important applications of microsurgery is
704755SRI XX X 10.1177/1553350617704755Surgical InnovationMonteiro de Barros et al
research-article 2017
1
State University of Pará, Belém, Brazil
Corresponding Author:
Renan Kleber Costa Teixeira, Department of Experimental Surgery,
Universidade do Estado do Para, Perubebui St, Belem 66113-200,
Brazil.
Email: renankleberc@hotmail.com
High-Definition Video System for
Peripheral Neurorrhaphy in Rats
Rui Sergio Monteiro de Barros, PhD, MD
1
,
Marcus Vinicius Henriques Brito, PhD, MD
1
,
Renan Kleber Costa Teixeira, MS, MD
1
, Vitor Nagai Yamaki, MD
1
,
Felipe Lobato da Silva Costa, MD
1
, Marcelo Ferreia Sabbá, MD
1
,
Marcos Vinicius Vieira Lemos, MD
1
, Igor Costa Parente, MD
1
,
and Daniel Haber Feijó
1
Abstract
Background: Although all microsurgeries are based on the use of surgical microscopes, several alternative
magnification systems have shown promising results. Improvements in image quality facilitated the use of video
systems in microsurgeries with safety and accuracy. The aim of this study was to evaluate the use of a low-cost,
video-assisted magnification system in peripheral neurorrhaphy in rats. Methods: Twenty Wistar rats were randomly
divided into 2 matched groups according to the magnification system used: the microscope group, with neurorrhaphy
performed under a microscope with an image magnification of 40×; and the video system group, with the procedures
performed under a video system composed of a high-definition Sony camcorder DCR-SR42 set to 52× magnification,
macro lenses, 42-inch television, and a digital HDMI cable. We analyzed weight, nerve caliber, total surgery time,
neurorrhaphy time, number of stitches, and number of axons in both ends (proximal and distal). Results: There
were no significant differences between groups in weight, nerve caliber, or number of stitches. Neurorrhaphy under
the video system took longer (video: 5.60 minutes; microscope: 3.20 minutes; P < .05). Number of axons was similar
between groups, both in proximal and distal stumps. Conclusion: It is possible to perform a peripheral neurorrhaphy
in rats through video system magnification, but with a longer surgical time.
Keywords
surgical anastomosis, microsurgery, rats