A Case of Successful Replantation of an Amputated Hand Using the Digital Microscope

More progress in the use of digital microscopes for surgery is expected to occur in the near future. The authors reported a case of successful replantation of an amputated hand using an industrial digital microscope. The right hand of a 21-year-old man was amputated ly by an electric saw. An operating microscope with the lenses and light source removed was used in combination with an industrial digital microscope VHX-100 used with a long distance zoom lens (VH-235; Keyence Japan Corp.). Replantation of the right hand was performed using the digital microscope system. The postoperative course was uneventful, with the patient returning to work as a construction worker 6 months after the operation. Advances in supermicrosurgery have permitted the anastomosis of blood vessels 0.3–0.5 mm in diameter. Replantation of amputated fingertips and lymphaticovenular anastomosis for the prevention of lymphedema are now being done clinically. The conventional surgical light microscope has a maximum magnification of × 20–32, although surgical microscopes with higher magnification ( × 50) are being developed with advancing technology. At the same time, industrial digital microscopes are also evolving. The digital microscope VHX-100 used in this study with a long-distance zoom lens has a magnification of × 35–245 and an observation distance of 54.0 mm. At × 50, the field depth is 5.0 mm. More progress in the development of digital microscopes for surgery is expected to occur in the near future. The biggest disadvantage of the digital microscope is difficulty with a stereoscopic view on the monitor. However, this device can be rated as very useful in allowing confirmation of the entry of an 11–0 suture needle into a blood vessel.