Morphofunctional evaluation of end-to-side neurorrhaphy through video system magnification.

Background: The surgical microscope is an essential tool for microsurgery. Nonetheless, several promising alternatives are being developed, including endoscopes and laparoscopes with video systems. However, these alternatives have only been used for arterial anastomoses so far. The aim of this study was to evaluate the use of a low-cost video-assisted magnification system in end-to-side neurorrhaphy in rats.

Materials And Methods: Forty rats were randomly divided into four matched groups: (1) normality (sciatic nerve was exposed but was kept intact); (2) denervation (fibular nerve was sectioned, and the proximal and distal stumps were sutured-transection without repair); (3) microscope; and (4) video system (fibular nerve was sectioned; the proximal stump was buried inside the adjacent musculature, and the distal stump was sutured to the tibial nerve). Microsurgical procedures were performed with guidance from a microscope or video system. We analyzed weight, nerve caliber, number of stitches, times required to perform the neurorrhaphy, muscle mass, peroneal functional indices, latency and amplitude, and numbers of axons.

Results: There were no significant differences in weight, nerve caliber, number of stitches, muscle mass, peroneal functional indices, or latency between microscope and video system groups. Neurorrhaphy took longer using the video system (P < 0.05). The amplitude was higher in the microscope group than in the video group.

Conclusions: It is possible to perform an end-to-side neurorrhaphy in rats through video system magnification. The success rate is satisfactory and comparable with that of procedures performed under surgical microscopes.