Surgical Techniques in the Lesions of Peripheral Nerves

Abstract

This chapter aims to provide a popular overview of various contemporary techniques applied in peripheral nerve surgery. These may be broadly subdivided into three categories: (a) techniques used in illumination, magnification, and exposure in general and as pertinent to nerve surgery, (b) techniques of nerve repair, and (c) techniques of intraoperative diagnostics of nerve lesions. All the three subdivisions are not tools that stand alone on individual rights; they rather intertwine with each other to produce a flow of excellence in contemporary nerve surgery. Illumination, magnification, and exposure of the target operative field are achieved using tools such as binocular loupes, the operating microscope, the endoscope, and the exoscope. Nerve repair techniques involve microminiature sutures, biological glues, sutureless nerve coaptation technology, and grafting. Intraoperative diagnostics of nerve lesions consist of delineation of the morphological (i.e., imaging) and functional (i.e., electrical conduction) aspects of the target nerve. The relevant technological tools used to achieve the respective goals find mention in the respective divisions. A detailed description of individual operative procedures, although relevant, is out of the scope of a book dealing in conceptualism; it rather belongs in a manual of operative surgery of peripheral nerves. We should be cognizant of the fact that technology is seen primarily as a means to an end.