Microsurgery

What is Microsurgery?

Microsurgery is the use of fine and precise instrumentation with the help of magnification to enhance handling of fine tissue. Microsurgical principles of delicate handling, fine and accurate dissection and approximation, and proper haemostasis ensure better healing with less scarring and adhesion formation.

When is Microsurgery performed?

Microsurgery can be done both via open surgery, laparoscopy, or robotic surgery. For gynaecology, it is usually used for fertility enhancing surgery, when fine and delicate tissue such as the fallopian tubes and ovaries are handled.

What type of gynaecological surgery is suitable for microsurgery?

Examples include:

  • Tubal reanastomosis, which is the joining of fallopian tubes to either bypass a blockade or to reverse a sterilisation.
  • Microscopic adhesiolysis, which is the release of adhesions or scar tissue around the tubes or ovaries.
  • Neosalpingostomy, which is the re-opening of blocked fallopian tubes at the end of the tubes (fimbriae end of the tube that collects the egg from the ovary)
  • Ovarian transplantation, which is the re-implantation of ovarian tissue that has been removed and frozen while waiting for a patient with cancer to recover.

How long has microsurgery been in use?

Microsurgery has been in use for decades. A/Prof Fong performed the first laparoscopic tubal reanastomosis in NUH in 2004, after which the patient went on to have two successful pregnancies. In 2014, he also performed the first successful ovarian transplantation in Singapore which led to Asia’s first baby conceived naturally after implanted ovarian tissue. (https://www.todayonline.com/singapore/first-asian-baby-conceived-naturally-implanted-ovarian-tissue-born-nuh)