The following is a summary of “High magnification versus optical magnification in hypospadias surgery: a randomized controlled trial,” published in the November 2023 issue of Urology by Radwan et al.
Hypospadias stands as the most prevalent congenital urethral abnormality affecting live male births, and its incidence is on the rise, likely linked to increasing pollution. Over the past five decades, surgical tools and optical systems advancements have empowered surgeons to delve into microsurgical procedures. Optical magnification plays a crucial role in pediatric surgery, with magnifying loupes being the most commonly utilized despite their tendency to cause neck pain in surgeons. Recent progress has introduced a compact video microscope, VITOM (Karl Storz Endoscopy GmbH, Tuttlingen, Germany), capable of displaying high-definition magnified images on a flat screen.
This study aims to assess VITOM’s potential as a viable alternative to loupes in complex open pediatric procedures and to explore its effectiveness as an intraoperative teaching tool for open surgery.
Fifty-two patients participated in the study, divided into two groups: Group A (26) utilized high magnification with either VITOM (Karl Storz Endoscopy GmbH, Tuttlingen, Germany) or a surgical microscope (Carl Zeiss Microscopy GmbH) in conjunction with microsurgical instruments. Urethroplasty involved the use of Vicryl 8-0 sutures. Group B (26) patients underwent surgery with conventional instruments (fine tip but not microsurgical), sutures, and magnification (3.5×), assisted by loupes. Urethroplasty employed
Group B experienced more complications. VITOM resulted in less neck pain for the surgeon, improved visualization, and a more conducive teaching environment.
Utilizing high-magnification tools during hypospadias surgery reduces post-operative complications. These tools enhance the identification of penile anatomy and topography, facilitating reconstruction techniques and contributing to the surgeon’s comfort.
Source: aops.springeropen.com/articles/10.1186/s43159-023-00268-6
