From Loupes to Loops

biteme988
Sep 1, 2024
3 min read

Whether you're tying suture or tippet, magnification can be handy 🧐.

It's not what you look at that matters, it's what you see. - Henry David Thoreau

Three surgeons at Bridger Veterinary Specialists in Bozeman, MT wearing loupes while tying 0.2 mm (4-0 PDS) suture. As comparison, 4X tippet is 0.18 mm.

“Do you always write your loupe magnification in your surgery report?” I said to the surgeon next to me, with a curious look on my face 🤔.

“Yes. Always.” He said. I think he was a bit confused as to why the hell the anesthesiologist was reading his surgery report. Fair point.

“But why?” I pestered.

“Because it’s how you know you have an experienced surgeon doing the surgery,” he quipped with a grin 😏.

I work with the best surgeons in the world. Seriously, I really do. They can fix things I’ve never seen anyone else fix. These surgeons also happen to be some of the funniest people I’ve ever met. The problem is, sometimes I just can’t tell when they are joking with me and when they are serious.

“Wait, are you serious?” I said, kind of perplexed 🤨.

3.5 x Loupe Magnification

An angler wearing 2x Hat Eyes magnification tying 4x tippet (0.007 in). Product available @ Hurley's Fly Fishing

That led to a conversation about loupes, and the different types of magnification available.

Loupes are kind of like magnifying lens glasses for surgeons. I’ve always had a fascination with them. Perhaps it’s more of a jealousy. I’ve always thought surgeons look so bad ass with them on! And as an anesthesiologist, I have no use for them. Except maybe to use them to tie my flies!

Surgeons and fly tiers aren't the only people who use lenses to magnify their field of view. Lenses first appeared around 2600 B.C. in Egypt (1). And the first surgical loupes are from 1876 when a German ophthalmologist used a pair of convex lenses with a light source mounted on a headband (2).

A surgeon at Bridger Veterinary Specialists uses loupes with a light attached to visualize and remove a mass in a dog's airway. He was having a hard time breathing when he presented to the hospital. The emergency team was able to safely anesthetize and intubate him (pass a tube down his trachea) so he could undergo surgery.

What we see depends on mostly what we look for. - John Lubbock

So here's what this rookie angler and non-surgeon thinks... if you need magnification to do the things you love, wear them with pride. If the surgeon who's doing your dog's surgery wears 3.5x loupe magnification, you're probably in great hands. You sure are where I work.

Just whatever you do, keep tying that tippet, casting that line, and chasing those dreams.

Stay wild and free!

Winston & Ashley

P.S. - If you are wondering what type of surgery the surgeons are working on in the top photo, it is for an emergency surgery for a tracheal resection and anastomosis. A part of the dog's trachea (windpipe) was narrowed. This caused a life-threatening airway obstruction. Our awesome surgeons, emergency room doctors and fantastic nurses were able to spring into action and save this dog's life by placing an endotracheal tube into his airway, and then take him into the operating room to remove the damaged narrow aspect of the trachea. After removing the narrowed and damaged part of the trachea, they connected the healthy parts together.

Thanks to the amazing team at Bridger Veterinary Specialists in Bozeman, Montana, this dog walked out (actually I think he ran out) of the hospital the next day.

Pre-operative radiographs (X-rays)

Post-operative radiographs (X-rays)

References:

1. Enoch JM. First known lenses originating in Egypt about 4600 years ago. The unique optical properties of these lenses in the context of the known technologies of the time. Doc Ophthalmol. 1999;99:303–314. doi: 10.1023/A:1002747025372. [PubMed] [CrossRef] [Google Scholar]

2. http://admetecvision.wordpress.com/2011/08/18/a-short-history-of-surgical-loupes/. Accessed on 13-10-2013 at 16:56

3. McClelland E, Marzouk S, Coyle P, Tatla T. Optical Loupes: A Useful Tool for the Oncall Otorhinolaryngologist-Our Experience. Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):137-141. doi: 10.1007/s12070-017-1158-6. Epub 2017 Aug 2. PMID: 31741948; PMCID: PMC6848595.