Appropriate optimum setup is quite important for increasing surgical efficiency and the operators comfort. As you can see in this operating room set up, the surgical assistant is standing across the operating table from the surgeon. This set up allows the assistant to handle the instruments and transfer the instruments to the surgeon effectively in an unobstructed manner. I prefer the sitting position during the operation for myself because I can use the arm rest of the chair to stabilize my arm, therefore decreasing fatigue and reducing the risk of hand tremor. I also highly recommend the use of the mouthpiece or the mouth switch, to keep the image constantly in focus. During the operations where highly magnified operative fields are used, even a slight change in the distance between the lens of the microscope and the surgical target can lead to degraded and unfocused images. The level of the arm rest of the chair, is slightly higher than the level of the surgical target so that the operator's wrist can be slightly hanging. Providing the surgeon with flexible working angles during microsurgery. if gross movements of the microscope are necessary to adjust the working angles and working views through intradural operative corridors, the handle of the microscope is used. However, the use of the handles is minimized and the use of the mouth switch is maximized. Every time the handle of the microscope is used, the surgeon has to handle back the instrument to the surgical assistant, readjust the microscope and take back the instruments, and restart the routine of the operation. Frequent handling of the microscope through the handles of the scope can significantly increase the length of the operation. In the next inset image, you can appreciate the use of the mouthpiece as well. Thank you.
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