An alternative method of magnification for microvascular anastomosis was analyzed using an ordinary video camera and compared with the traditional method under microscope. For this study 20 rats were divided in two groups of 10 each: control group (microscope-assisted [M]) and experimental group (video-assisted [V]). Magnification was accomplished by a surgical microscope in group M, whereas a video system composed of low-cost camera, audiovisual cable, and analogue television in group V. In both groups, the right femoral artery was severed and sutured with interrupted simple stitches. The criteria examined were: patency, vessel diameter, amount of sutures, anastomosis time, and histologic features. There were no differences between both groups in patency rate and vessel diameter. The video-assisted microanastomosis is a time-consuming procedure as compared with the microscope-assisted anastomosis, to a certain extent due to lack of stereoscopic image and technical inability with the video system as well. There was a smaller quantity of sutures in group V. Higher foreign body tissue reaction was found in group M, consequent to greater amount of suture material. In conclusion, video-assisted microanastomosis is possible with the present video system but is not as safe as conventional microanastomosis.
Vascular anastomoses are common procedures and are performed by most surgeons. Training is primarily conducted in human beings, which violates current ethical principles. This is because current training models are expensive and in short supply. This study was designed to investigate the feasibility of three vegetable models of vascular anastomosis. Five units each of scallions, green beans, and yardlong beans were used. An end-to-end anastomosis was attempted with each specimen. Anastomoses were only successful in green beans and yardlong beans. Since they are narrower, the yardlong beans are the most similar to human vessels.Keywords: surgery; medical education; training; training by simulation. ResumoAnastomoses vasculares são procedimentos comuns realizados por grande parte dos cirurgiões e cujo treinamento ocorre principalmente em seres humanos, contrariando os princípios éticos vigentes. Esse fato se deve, sobretudo, à carência e ao alto custo relacionados aos atuais modelos de treinamento. Assim, este estudo visa avaliar a viabilidade de três vegetais para a realização de anastomoses vasculares. Foram utilizadas cinco unidades de cebolinha, vagem e feijão-verde. Em cada uma tentou-se realizar uma anastomose término-terminal. Conseguiu-se a realização da anastomose apenas na vagem e no
Background. Smartphone cameras are continuously improving. The present study aimed to evaluate the possibility of using smartphones' magnification system to perform microanastomosis in rats. Methods. Fifteen rats were randomly divided into 3 groups, according to the magnification system used: Microscope, iPhone 7 smartphone, and Galaxy S7 smartphone. In the microscope group, a DFVasconcelos microsurgery microscope was used. In both smartphone groups, the magnifications systems were connected to a 55-inch television through the mirror function. Animals in both groups underwent femoral artery anastomosis in the right forepaw and femoral nerve neurorrhaphy in the left hindleg. The body weight, arterial and nerve caliber, and anastomosis time and patency were immediately analyzed. Results. No significant differences were observed between the groups regarding body weight, arterial, or nerve caliber. The smartphones did not provide a sufficient quality of image for an adequate identification of the arterial walls. Therefore, neither arterial anastomosis nor neurorrhaphy could be completed, even after 3 hours of surgery. The first steps toward anastomosis or raffia were performed with difficulty. Conclusion. The current video resolution and lack of stereoscopic image of available smartphones is not sufficient to perform video-assisted anastomosis of femoral arteries or nerves.
OBJECTIVE: To analyze the possible effects of low-intensity ultrasound on induced tibia fracture of rats in a dose commonly used in physical therapy treatments. METHODS: Twenty male Wistar rats were divided into two groups with 10 animals each. In the ultrasound group (USG), the animals were submitted to bone fracture and treatment with therapeutic ultrasound (TUS). Ultrasonic parameters are: frequency of 1.0 MHz, intensity of 0.2 W/cm2, pulsed mode at 20%, applied in stationary form during 10 minutes on the fracture region, for five weeks. The control group (CG) was submitted to bone fracture but not treated with ultrasound. RESULTS: The radiographies showed better consolidation in USG compared to CG. The statistical tests for alkaline phosphatase and serum calcium did not show significant difference between groups. CONCLUSION: According to this study, TUS, applied with these parameters (not commonly used for bone therapy) accelerates bone healing, confirmed by radiography, yet the biochemical analysis was not conclusive. One reason for this inconsistency may have been some inadequacy of the biochemical protocol, currently under investigation. Level of Evidence II, Prospective comparative study.
It is possible to perform a peripheral neurorrhaphy in rats through video system magnification, but with a longer surgical time.
Background Microsurgery training is critical to the practice of microvascular procedures in many surgical areas. However, even simple procedures require different levels of complex skills. Therefore, simulation-based surgical training, mainly in the area of vascular anastomosis, is of great importance. In this paper, we present a new microsurgery training model for the development of basic to advanced microsurgical skills. Methods Porcine kidneys were purchased from a legal butchery slaughterhouse. First, kidneys were washed with water to remove blood and clots inside vessels. Then, dissection was performed throughout the vascular pedicle from the renal arteries to the segmentary branches. Finally, the longitudinal sectioning of the kidney parenchyma was performed to expose the vessels necessary for training. Sixty end-to-end anastomoses were performed. Specific instruments and materials were used to perform anastomoses and dissections with magnification by a video system. We evaluated the diameter of vessels, time to perform anastomosis, and patency of anastomosis. Results There was no great anatomical variation among the porcine kidneys. The total length for dissection training was 25.80 ± 7.44 cm using the arterial and venous vessel. The average time to perform arterial anastomoses was 23.79 ± 4.55 minutes. For vessel diameters of ≤ 3, 4 to 6, and 7 to 10 mm, the average procedure times were 27.68 ± 3.39, 22.92 ± 4.12, and 20.77 ± 3.44 minutes, respectively. Regarding venous anastomosis, the average duration of the procedure was 26.17 ± 4.80 minutes, including durations of 31.61 ± 3.86, 25.66 ± 4.19, and 21.24 ± 3.79 minutes for vessel diameters of ≤ 7, 8 to 10, and >10 mm, respectively. Positive patency was achieved in all surgeries. Conclusion The porcine kidney provides an inexpensive and convenient biological model for modeling microanastomosis with high fidelity to vascular structures.
Purpose: To study the anatomorphometry of the plexus brachialis (PB) of rats under a high-definition video system. Methods: Ten male Wistar rats discarded from other research that did not interfere in the morphology of the animal, respecting the principle of reduction, were used. All animals were submitted to the same protocol. Initially, the cervical region was shaved. The animals were placed in a dorsal position. A single elbow-to-elbow incision was performed and dissection started at the deltopectoral sulcus. The procedures were performed under a video system. To measure the structures, the Image J software was used. Results: All the PB evaluated originated from the C5-T1 spinal nerves. C5 and C6 converged to form the truncus superior, the root of C7 originated the truncus medius, and the confluence of C8 and T1 originated the truncus inferior. It was found the union of C7, C8, and T1 to form truncus inferomedialis instead of separate medial and inferior truncus. C8 (1.31 mm) was the thickest root, the truncus inferior (1.80 mm) and the nerve radialis (1.02 mm), were the thickest. Conclusions: The anatomy of the PB is comparable to humans, admitting variations. The videomagnification system is useful to perform microsurgical dissection.
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