Operating microscope use increased operative time in cleft palate repair for infants under two years

The use of an operating microscope in cleft palate repair offers improved visualization, enhanced illumination, and ergonomic advantages. However, its clinical adoption remains limited. This study compares surgical efficiency, intraoperative visualization, and complication rates between microscope and surgical loupe use. A prospective, quasi-randomized controlled study was conducted on 40 patients under the age of two years with isolated nonsyndromic secondary incomplete cleft palate. Patients were allocated to either surgical loupe magnification or operating microscope use in an alternating sequence, ensuring balanced distribution between groups. Operative time, intraoperative visualization scores from the surgical team, and postoperative complications were recorded. The mean operative time was significantly longer in the microscope group (76.75 ± 3.7 min) compared to the loupe group (60.91 ± 1.05 min), though this difference decreased over the study period. Visualization scores given by the anesthesiologist and scrub nurse were significantly higher in the microscope, while residents also rated the microscope group higher, though not statistically significant. Complication rates were similar among groups. The operating microscope Improves intraoperative visualization, enhances surgical ergonomics, and provides educational benefits. The initially increased operative time diminishes with experience, indicative of a learning curve. Despite minor limitations, its advantages may justify its routine use in cleft palate repair.