Microvascular surgery: how does it work?

Written in association with: Professor Kavin Andi
Published: | Updated: 13/04/2023
Edited by: Robert Smith

Microvascular surgery involves taking tissue from one area of the body to reconstruct areas of a body that have been affected by cancer or by trauma. Recent innovations in this procedure have allowed for miraculous results, transforming the lives of many.


We recently got in contact with Mr Kavin Andi, an award-winning consultant oral and maxillofacial surgeon and head and neck surgeon, to discuss microvascular surgery and how it is performed. We found out how safe the surgery is and how long it’s been around for.

 

What is microvascular surgery?

Microvascular surgery involves harvesting skin muscle or bone with its own blood supply from another part of the body and transferring the tissues to another part of the body where the blood vessels are reconnected. The blood vessels are stitched using a microscope with up to 25 times magnification with stitches which are smaller in diameter than a human hair.

 

When is microvascular surgery needed for the head and neck?

Microvascular surgery is commonly used in head and neck cancer surgery to reconstruct parts of the body which have been invaded by the tumour. For example, the tongue can be reconstructed utilising the skin and blood vessels from the forearm, the jaw can be reconstructed using bone from the lower leg or hip, and large areas of the scalp can be reconstructed using skin and muscle from the side of the body.

 

How effective is microvascular surgery?

This reconstructive technique is very effective at replacing lost issues such as the skin of the face, the tongue, the floor of mouth, the upper and lower jaws and the neck.

 

How long does microvascular surgery take?

Reconstructive procedures are long operations which may take 6 to 10 hours to complete depending on the complexity of the reconstruction.

 

Is microvascular surgery safe?

This surgical technique has been deployed since the 1980s with good results however, like any complex surgery, there are risks such as infection and bleeding which may compromise the flap. It is for these reasons that the microvascular free flap is carefully monitored on a half-hourly basis in the first 12 hours after the procedure in the intensive therapy unit, and frequently thereafter until day 7 following which less frequent monitoring can be utilised.
 

If you would like to find out more about this procedure, we recommend getting in contact with an expert such as Mr Kavin Andi, he is highly experienced in all areas of maxillofacial surgery. Click here to visit his Top Doctors profile today.

By Professor Kavin Andi
Oral & maxillofacial surgery

Professor Kavin Andi is an award-winning consultant oral and maxillofacial surgeon and head and neck surgeon based in London who specialises in head and neck cancer.

Once his dual qualifications in medicine and dentistry had been completed at Bart’s and The London Schools of Medicine and Dentistry, Professor Andi undertook his basic surgical training in Essex. He then went back to the London Deanery Higher Surgical Training Programme in Oral and Maxillofacial surgery at The Royal London Hospital, St Bartholomew’s Hospital, Luton and Dunstable Hospital, University College London and Guy’s and St Thomas’ Hospital.

He was ranked first among the highest level maxillofacial, ENT, and plastic surgeons in the UK by the joint committee for Higher Surgical Training following the reception of his FRCS award. This allowed Professor Andi to successfully complete a highly competitive Advanced Head and Neck Interface Training Fellowship at Guy’s Hospital. He did this in conjunction with a Fellowship of The Higher Education Academy award.

Professor Andi’s areas of interest include augmented reality, robotic surgery, and 3D virtual surgical planning, for which he was award the prestigious Norman Rowe Clinical Prize by the British Association of Oral and Maxillo-Facial Surgeons (2012). Among his interests and research, Professor Andi has also been published and has written original software on a variety of platforms which were user-friendly tools to collect data on clinical and outcomes research.

Other awards Professor Andi has been the recipient of the J.N. Kidd award from the Institute of Reconstructive Sciences (2016), a Clinical Excellence Award from St George's University Hospitals NHS Foundation Trust (2015), the Annual College Prize in Clinical Dentistry awarded by the University of London (1997), and many more in between.

Carrying out pioneering research at St George's, University of London Medical School and Cranfield University Centre for Digital Engineering, Professor Andi was appointed as a Visiting Professor in 2020. 

Professor Andi has held former roles as lead clinician of the St George’s and Royal Marsden Head & Neck Cancer MDT, regional professional advisor to the Royal College of Surgeons of England and President of The Institute of Reconstructive Sciences.

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