What About The Microdebrider?
A microdebrider is a type of hand-held surgical cutting tool with a rotary tip, often used for ear, nose and throat procedures. The microdebrider is usually employed to shave bone or other tissues. The device is connected to suction to help clear blood and excess tissue from the site, and it is usually equipped with a control switch operated by foot pedal.
Roots of the technology
Modern microdebrider technology grew from the early rotary vacuum shaver developed by Urban in the 1960s to remove growths such as acoustic neuromas. Although this type of device found little use at the time, rotary vacuum shavers were later adopted for use in orthopedic surgery, and by the 1990s had been reintroduced into the field of otolaryngology in the form of a microdebrider for use in sinus surgery, tonsillectomy, turbinoplasty and adenoidectomy.
Where are microdebriders being used?
The microdebrider is often used by orthopedic surgeons to shave tissue in joints. Cosmetic surgeons also use them for liposuction and to treat conditions such as gynecomastia. Surgeons also use endoscopic debridement to treat some forms of obstructing laryngotracheal carcinoma. Still, the most common use of these tools today is for otolaryngology procedures.
The components of a microdebrider
A microdebrider has three main components– The console, handpiece and blade (or bit). The console is the electronic center of the device, and is usually controlled through a switch actuated by a foot pedal. The console allows the operator to set the direction and velocity of the blade as it rotates; the blade or bit can spin in forward or reverse directions, or it can oscillate between settings according to the requirements of the operator.
As implied by its name, the handpiece allows the operator to position and control the blade. The handpiece features an integral cannula for suction, and it is connected to suction tubing. The blade, sometimes called a bit, consists of a hollow tube to permit suction, and has either serrated or smooth edges for cutting or shaving tissue.
The hollow design of the blade allows for removal of tissue during the cutting process. The blade is disposable, and is intended for single use. Since the blades are rigid and their standard diameters range from 5 to 7mm, microdebriders are used together with a suspension laryngoscope or rigid bronchoscope.
How a microdebrider works
The microdebrider uses suction to pull tissue forward into the mouth of the blade, where it is cut. Constant or intermittent suction keeps the site clear of blood and already-cut tissue, so the surgeon enjoys better visibility of the work surface. The handpiece allows an operator to control the tool with a single hand, so the other hand is free.
A microdebrider works so efficiently that the only known risk is a possibility that the operator may overuse the tool, leading to the unintended resection of healthy tissue and possibly resulting in injury to the patient. Still, the risk can be minimized simply by always maintaining good visualization of the work site, and by avoiding too-high suction pressure, since over-suction can bring too much tissue into contact with the blade.