[An alternative to the usual operating microscope and loupe magnification for free microvascular tissue transfer. Varioscope AF3-A]

AIM: Free microvascular tissue transfers have become today a key instrument for the surgical treatment of wide loss of tissue, but their employment implies mandatory use of the right visual magnification means. Until now these instruments were mainly loupes and operating microscopes. Our study is focusing on the use of a new visual system--Varioscope AF3-A--in the reconstructive microsurgery field. METHODS: Varioscope AF3-A (Life Optics, Vienna, Austria) has been employed in our Institute in 10 microvascular reconstructions, where different free flaps were used in head and neck reconstruction. RESULTS: All the flaps took and only one developed a partial necrosis. We have also noticed, by using this new instrument, a learning curve with a progressive contraction of the operating time. In all cases we have operated on 2 mm caliber vessels or more and on tissues that didn't previously undergo radiation therapy. CONCLUSIONS: The employment of a visual magnification mean, as Varioscope AF3-A, allows autofocus (from 3.6X to 7.2X) and a wide vision. It can be easily used with substantial advantages for the surgeon in performing microvascular anastomosis. Partial drawbacks are the equipment high cost and weight, compared to the loupes and a stronger ocular stress due to the continuous autofocus compared to the static operating microscopes.