After being utilised in sectors such as orthopaedics and plastic surgery, microdebrider is one of the most beneficial technological advancements to be introduced to rhinology. In recent decades, it has been utilised in nasal and endoscopic sinus procedures including tonsillectomies. Surgery with a microdebrider is shorter, more precise, and less traumatic for the patient.

Three essential elements of a microdebrider

The microdebrider is a hollow-tubed, tubular tool. As the blades travel back and forth at the tip of the tube, they cut through the tissue that must be removed. The smaller the sliced bits will be, the faster the blades travel. When blades move more slowly, larger bits are being sliced. The sliced tissues are of sufficient size for use in histopathology, etc. Integrated inside the blade is a suction mechanism that continuously pulls the tissue to be sliced and removed from the surgical site.

Major Components of Microdebrider

The microdebrider is composed of three major components.

The blade:

It is a hollow, serrated, or smooth metal tube with a suction port. The suction operation draws tissue to the blade's opening, where it is then severed. The configuration of the blades permits tissue to be sliced and simultaneously removed by suction. There are numerous sizes of blades. They are non-reusable and must be changed after each use. Variable speeds are available for forward, reverse, and oscillating blade rotation.

Recent upgradation in blades includes a cautery function and longer blades. Bipolar blades, for example, aid simultaneously in cauterization and coagulation. The benefit is less blood loss and a more sanitary and effective surgical procedure. These blades can essentially do all three jobs, namely cutting, suction, and cauterization/coagulation.Longer blades facilitate the penetration of deeper lesions and tissues.

Handpiece:

The handpiece holds and controls the blade and suction operation to provide speedy and simultaneous removal of debris and to improve the surgeon's visibility for the remainder of the procedure. The handpiece may accommodate blades of various sizes and shapes. The vacuum hose is connected to the handpiece.

Console (controlled by a foot pedal)  

The surgeon controls the speed and direction of the revolving blade using a foot pedal, and the parameters are shown on a console.

The most frequently employed surgical equipment for sinus surgery are:

• Cannulas
• Razors and Chisels
• Curettes
• Elevators
• Forceps
• Hooks
• Axes and Blades
• Needles and Needle Holders
• Osteotomes
• Probes
• Punches and Rongeurs
• Manual and fibre optic Retractors
• Traditional and supercut scissors
• Speculums
• Vacuum Tubes
• Trocars

Before microdebriders, sinus surgery was performed with curettes and forceps. The extraction of bone and tissue from the nasal and sinus cavities was mainly performed manually. Occasionally, power drills are also employed. Depending on the situation, surgeons continue to utilise a combination of curettes, microdebriders, and forceps.

What are the benefits of employing a microdebrider?

Microdebriders have numerous benefits:

Minimum surgery time 

 A microdebrider does not lessen the risk of bleeding, but constant suction clears the surgical site and keeps the surgeon's field of vision unobstructed during the procedure. This means the surgeon loses less time switching instruments, resulting in a more time-efficient operation overall. If cauterization is incorporated into the device, blood loss is reduced and surgical time is shortened.

Numerous suggestions for enhanced access and precision

Depending on the sort of surgery being carried out, many types of tips may be employed. For instance, pre-bent tips facilitate entry to tough surgical sites (like in paranasal sinuses). Some tips, such as the Straight shot M4, allow for 360-degree rotation, allowing for more precise approaches to the tissue to be removed.

Adjustable Knives for enhanced precision

Multiple types of blades can be utilised. Straight-edged blades are more accurate and less painful than other types of blades. While serrated blades offer the surgeon a greater grip. Altering the speed of the blades allows for greater precision during cutting as well as bone cutting.

Compared to conventional instruments, microdebriders, and blades are more expensive. However, when properly trained and utilised with care, microdebriders result in shorter, more precise, and less stressful surgical procedures for the patient.

The most often used microdebriders are the Medtronic Xomed XPS 2000, Medtronic Xomed XPS 3000, and the Medtronic Straight shot M4 and M5 microdebriders. Other well-known manufacturers include Olympus, Stryker, Naugra, Karl Storz, Brainlab, Smith & Nephew, etc.