Director:
Feng Zhang, M.D., Ph.D. (
email
)
The use of
the operating microscope augments the visual capability of surgeons.
Microsurgery
technique has been now extensively used in the realm of surgery. It is applied
in transplantation with vascular anastomosis of various free tissues, including
the omentum, segments of intestine, muscle, bones, joints, and skin, and in
branches of surgery, such a cardiovascular surgery, brain surgery, urology,
obstetrics and gynecology, and surgery of the lymphatic system.
Microsurgery is also an
extremely important adjunct in experimental surgery, especially experimental
organ transplantation. Using microsurgical technique enables performance of
operations difficult or quite impossible with unmagnified natural vision, and
animal models to advance from the large animal model to a less expensive small
animal model. Another aspect to be taken under consideration in our efforts
to use a small animal model is the greater availability of immunobiological
products utilizing rodents. For example, inbred strains of mice can be
immunogenetically
bred, and a greater molecular biological understanding of these animals has
been achieved, mice models are more equipped to be used in the study of
transplantation.
The development of highly inbred, recombinant, and mutant strains of mice would
allow the use of the many immunologic reagents and molecular probes that are
not available in the large animal models.
As the part of a core research
laboratory of the surgery department, a microsurgical laboratory in the medical
center should have extensive facilities, which support teaching, practice, and
research.
1. Cooperative project
Besides research in the plastic surgery field, such as studies of free flap,
reperfusion injury, anti-thrombogenic agents, vascular anastomosis, peripheral
nerve regeneration, etc., microsurgery technique can be applied to various
surgical
research areas. We have established multiple experimental models and
collaborated
with different fields of surgical training and research such as:
-
Neurosurgery:
Gene therapy approaches to the treatment of arteriovenous malformations
by using microsurgical technique;
Peripheral nerve repair and healing;
Nerve grafting;
Reinnervation of transplanted muscle.
-
General surgery:
Primary common bile duct anastomosis in the rat using microsurgical technique;
Reconstruction of bile duct with vein graft;
Microsurgical techniques of breast reconstruction;
Intestine transplantation research.
-
Cardiovascular surgery:
A new heart failure model in rat by an end-to-side femoral vessel anastomosis;
De novo autoimmunity to cardiac myosin after heart transplantation and its
contribution to the rejection process.
-
Urology:
Reconstruction of ureteral defect with vein graft;
Small animal models of KUB visualization;
Immunosuppressive agents in kidney transplantation model.
-
Bioengineering:
Polypeptides resurfacing hyaluronan acid to enhance fibroblast adhesion;
Comparison of semisynthetic and autologous connective tissue grafts.
-
Hyperbaric oxygen therapy:
Effect of hyperbaric oxygen on survival of the composite ear graft in rats;
Effect of hyperbaric oxygen on microvascular anastomosis healing and patency
in the Rat.
2. Cooperative grant
development
Animal models are very
useful tools to test the results from basic scientific research. Microsurgery
techniques can be used to establish animal models to evaluate the results of
basic science research before clinical application. We can develop cooperative
grants with various fields of surgical research.
We are developing the program
of complex wound management on flap designs for complex reconstruction,
transplantation
of limbs and skin, and models of surgical infection with ENT, neurosurgery,
oncology, transplantation, surgical infection, and breast surgery.
3. Microsurgery training
for multiple disciplines and OR personnel
The use of a microscope
enables surgical operations to advance from their originally macroscopic to
the microscopic sphere, and enables surgeons to improve the quality of surgical
care of the acutely injured and the deformed. Microsurgery training will provide
surgical trainees with an opportunity to acquire a basic orientation to
experimental
and clinical microsurgery, and initiate a learning process to develop superior
microsurgical technique in cardiovascular surgery, neurosurgery, urology,
obstetrics
and gynecology, and ENT surgery, and operating room personnel.
4. Cooperative administration
Cooperative administration
enables teaching, practice, and research to be integrated into a more effective,
practical, comprehensive, and well organized learning environment for the
trainees
and vehicle designed for the development of potential clinical applications
utilizing microsurgical techniques.
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