Microsurgery is a general term used for surgery requiring an operating microscope or surgical loupes (specialized glasses which magnify the operative field). In the case of laparoscopic procedures (particularly robotically-assisted laparoscopy) the operative field is already magnified 10x, allowing for exceptionally clear 3-dimensional view of even the most minute tissue/organs. Magnification of the operative field allows visualization and repair/reconstruction of extremely small body parts such as blood vessels, nerves, and the fallopian tubes. Because the tissues handled under the microscope/surgical loupes or during robotically-assisted laparoscopy are often extremely small and delicate, barely visible to the naked eye, they must be handled with very fine non-traumatic instruments to prevent organ damage and to optimize the success of surgery. Such instruments include special micro-forceps, micro-needle holders, micro-scissors, and micro-dilators, uniquely designed to handle the smallest body parts in the gentlest manner. Suturing, or stitching, is accomplished using specialized microscopic caliber needles and sutures (threads). Microsurgical sutures typically have a diameter (gauge) which ranges between 7-0 (0.06 mm) to 12-0 (0.001 mm). In the case of tubal ligation reversal, standard suture size range in gauge between 7-0 to 8-0 (self-absorbable sutures). Microsurgical suture needles also come in various sizes with diameters often less than 0.15 mm.
Microsurgery is a subspecialty of surgery which requires extensive additional training and practice. Everything from use of the operative microscope (or surgical loupes), to correct posture during surgery, proper holding of micro-instruments, minimization of trembling, and micro tissue handling and dissection must be taught and rehearsed numerous times. In the case of tubal ligation reversal, this type of extensive training is obtained in accredited fellowship programs sub-specializing in Reproductive Endocrinology and Infertility. Prior to undergoing a tubal ligation reversal, patients should verify that the physician(s) performing the procedure are fellowship-trained and board certified by the American Board of Obstetrics and Gynecology in Reproductive Endocrinology and Infertility.