Microsurgery at North Austin Campus

Microvascular surgery, also known as microsurgery, is a surgical technique that uses specialized instruments and a microscope to repair or reconstruct small blood vessels and nerves. Microsurgery can be used to bring skin, fat, muscle or bone from one part of the body to another to help reconstruct something that is missing or to help the function of something that is broken. Our team at Texas Children’s North Austin has specialists who have done advanced fellowship training in this powerful technique. 

• Whether a child’s difference is from birth or results from the effects of trauma or a tumor, microsurgery has a broad range of applications. When part of the body is formed differently or is harmed or is removed, reconstructive microsurgery is often used to help how that body part works and/or looks.
   
• Some examples of when microsurgery may be used are in complex craniofacial or jaw conditions, in arm or leg reconstruction, in treating paralyzed muscles (such as in facial palsy), in repairing damaged nerves, and in reattachment of a body part such as a finger after trauma. 
   
• The microsurgery procedure often takes several hours in the operating room. After surgery your child will stay in the hospital for several day. Children usually go to the pediatric intensive care unit (PICU) for the first few days so that we can closely monitor the flap. 
   
• It is important that the blood flow in and out of the flap continues and does not become disrupted or clogged. A low dose blood thinner is used to help decrease the risk of blood clots within the flap. The most critical time after a microsurgery procedure is during the first three days. Once the early, most critical phase of flap monitoring is over, your child will move to a regular hospital room for a few days before discharge from the hospital. 
   
• If the microsurgery procedure involves an arm or a leg, there is usually a period of bedrest needed to keep the flap safe. Our physical and occupational therapy team will work with your child during and after their time in the hospital to help them move around safely. 

Fig 1 Child with a tumor of the right lower jaw that needs to be removed (red)

Fig 2 The small bone of the lower leg (fibula, in yellow) is used to replace the missing lower jaw. We used computer planning to create a guide (white) to show the surgeon exactly where to cut the bone and drill holes for the custom plate

Fig 3 Our microsurgeon connected the bone from the lower leg (green) to the blood vessels in the neck to replace the missing bone

Fig 4 We designed a custom plate to fit perfectly and hold the bone in place. This saved a lot of time in the operating room