Shopping for loupes--what really matters?

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My program is encouraging us to start shopping for loupes toward the end of intern year. We had someone in a week or so ago from DFV and Surgitel to show product and fit people. I have a friend that went with Zeiss. I am going to be at the ACS meeting in October and was thinking of taking advantage of one of the deals they usually put together for that meeting.

If you were buying loupes now, what would be the critical factors for you? I don't need a prescription in the lenses, and I am not going to get the DFV ones just because they are 'traditional'. I have heard the Surgitel ones have a better angle so you can stand with your neck straighter, potentially preventing surgical kyphosis. It seems most practical to get 2.5x telescopes.

I know there are some older threads on this, but since the technology seems to be changing, I thought it was worth starting a new one. I have asked around at my program, but everyone seems to have different opinions. Thanks in advance for your thoughts and advice!

Treg

Originally Posted by Treg

...If you were buying loupes now, what would be the critical factors for you? ...I have heard the Surgitel ones have a better angle so you can stand with your neck straighter, potentially preventing surgical kyphosis. It seems most practical to get 2.5x telescopes.

I know there are some older threads on this, but since the technology seems to be changing...

Starting from the end and working backwards. Despite what the sales reps may tell you and how fancy the new boxes/cases may look, technology hasn't really changed all that much.

I own both DFV & surgitels. These are consideration you should think about, IMHO.

First, what do you think you will ultimately be practicing? Yes, your mind will change multiple times, etc... but give yourself some options. If you think you will be doing fine work, i.e. vascular, CV, liver/kidney transplant, pedes, etc... consider 3.5x wide fields. Otherwise (i.e. MIS/laparoscopy bound/breast surgery) stick with 2.5 standard.

Second, weight and angle are serious consideration. DFV offers very little in alteration of angle.

Finally, how they fit and or are padded should be considered.

The first, second, third above are not in a particular order of importance. Only you can decide what order of importance to apply to each.

I have surgical acuity ones which I love. The DFV's with the black frames didn't fit me well at all. I'm a person who fiddles around with stuff, so the Surgitel flipdowns were just asking for trouble for me.

As to what to look for:
Fit is probably the most important. I may wear my loupes for a 10 hour case. If they don't fit right, it's a disaster. Since you can't justreach up to shift them around whenever they are irritating you, this is key.
I would recommend going to the ACS and going to all the booths and trying them on as quickly as you can one after another. That way you can see what you think in person. Optics wise, I think they are pretty close. I think DFVs probably have the narrowest width of vision though in the standard fields. (at least that what it seemed to me). The extended fields were just too heavy for me to be comfortable though. I liked the Surgitels, but really wanted TTL (through the lens) scopes so they would always be right and couldn't get banged out of alignment.

Also, get the longest focal length you can tolerate while making sure they are still ok when you are sitting, if you are trying to avoid bending over. Especially as a resident, you will sometimes be further away from the surgical field than you would like and it's nice to have the longer focal length so you can still look through them.

good comments- gotta get what works for YOU.

The ACS is coming up and represents the best shot at trying them all on- I probably will go to get another pair (and my new custom instruments!!!!)

a word of advice as I sit here with a heating pad on my neck. do not get 3.5x unless you are gonna be actually sewing, they really hinder your ability to first assist and have a good enough depth without destroying your neck.
i try to wear my 2.5x on cases when I know the staff isnt gonna give much up.

I'm a first year resident in an integrated cardiothoraic program. There are big discussion btw residents. Somebody told me to stay with the 2.5 for the first 2 years, somebody told me to go directly to the 3.5. What do you think?

i own design for visions 2.5x and 4.5x. i rarely use the 4.5 xs. the problem is the weight and propensity to slide down even with the nerd strap. it is a different game to try them on at the vendor's table for 2 min vs 3 hrs in a case. I wear the big ones only for vasectomy reversals when I don't use the microscope and some short pediatric cases. My take is buy the 2.5X and buy higher power loupes on the hospital budget. find some way to make them a vital part of your practice and make somebody else pay for them. deduct the cost.

Originally Posted by importedsurgeon

I'm a first year resident in an integrated cardiothoraic program. There are big discussion btw residents. Somebody told me to stay with the 2.5 for the first 2 years, somebody told me to go directly to the 3.5. What do you think?

I would only go for one set during residency. I would not recommend getting used to lower power and then moving up after two years. IMHO, you need one set to train with and get comfortable with during residency.

Given your residency is CT/CV, I suggest 3.5 expanded fields. The surgitels are nice at ~3.5x. The DFV 3.5x expanded fields can be somewhat large and heavy in comparison.

bump...

anyone with experience using loupes with built-in headlights?

also for 3.5x expanded field loupes, whats the word these days on which one is best... (starting vascular fellowship soon so thinking about it 3.5x)

Originally Posted by maverick_pkg

bump...

anyone with experience using loupes with built-in headlights?

Yes. They blow.

you don't need 3.5 for vascular. 2.5x is enough for practically everything.

I've yet to find a portable headlight that works as well as the traditional kind.

I am a CT surgeon. Have been using DFV 3.5 expanded fields for few years. Owned few other before. DFV the best ones, by far

thanks guys

Neuro here. I love my DFV 3.5xf. I have the traditional Yoeman frame. My co-residents vary, some have the nike and some have a wire glasses frame that are lighter.