Surgeon's world-first invention will help cut risk during breast reconstructions

An award-winning surgeon at Morriston Hospital has scored a world first by inventing a surgical instrument designed to improve patient safety.

Consultant plastic surgeon Muhammad Umair Javed (pictured above) created a microsurgery dissector, for use during breast reconstructions.

Now in the prototype stage, the dissector has smooth, blunted edges, allowing surgeons to separate, or dissect, blood vessels without the risk of accidentally cutting them.

Breast reconstruction is a microsurgical procedure used mostly, but not exclusively, following breast cancer.

Certain types of breast reconstructions involve taking excess tissue – skin, fat and, sometimes muscle – from another part of the body, such as the lower tummy. This is then formed into a breast shape.

The tissue needs a good blood supply, or it will die. So, the surgeon will leave the tissue attached to its original blood vessels and then connect these to the vessels in the chest wall.

The vessels have to be carefully harvested and separated. It’s such a delicate procedure that surgeons usually undertake it using a microscope or surgical loupes – magnifying lenses.

“When we dissect the vessels we use microsurgery instruments,” said Mr Javed. “They are very fine instruments for very fine work.

“The microsurgery instruments used globally are generally forceps and scissors. But if you use scissors to separate the blood vessels, which are stuck to each other by connective tissue, there is always a risk you can accidentally damage the vessel.

“You have to be very gentle. But we do not have a blunt microsurgery instrument to do this work. We have to use blunt instruments that are very large and not meant for microsurgery.”

Having identified this gap, Mr Javed’s solution was to design a blunt dissector small enough to be used during microsurgery (pictured right).

The surfaces are smooth, with the tip purposely created to keep a blunt, round shape to ensure blood vessels are not damaged during dissection.

“The design is registered with the Intellectual Property Office,” said Mr Javed. “We haven’t started using it yet. I made three prototypes. I might test one of them in the microsurgery lab.

“The next step will be to make it available in our department, in our microsurgical sets. If anyone else wants to use it, they can as well.”

Mr Javed is based in the Welsh Centre for Burns and Plastic Surgery in Morriston Hospital.

He is the recipient of several national and international awards and prizes, as well as fellowships from world-renowned plastic surgery centres in London, Vancouver and Adelaide.

The microsurgery blunt dissector is not his first foray into inventing. He previously created an abdominal retractor, specifically for use in breast reconstruction, which helps surgeons have a better view of their work.

Mr Javed said the blunt dissector would allow for technical refinement during surgery. “When you’re doing this dissection you want to make things safer and easier,” he added.

“This little instrument is a step in that direction. Nothing like it exists anywhere else in the world.”