Alternative model for teaching microsurgery

Abstract

Animals have been widely used as a training model for teaching microsurgery. However, unlimited access to the animal laboratory is not always possible, and increased scrutiny of the ethical use of laboratory animals is a major factor to consider when teaching microsurgery. In such situations, an alternative method is required for microsurgical training techniques, such as medical grading tubes, and surgical gloves. These alternative teaching tools provide an ideal training model and present an alternative for teaching microsurgical techniques. They are readily available and abundant in the laboratory. In addition, these alternative tools can be used to provide initial training before entering the clinical setting. A practice card designed from surgical gloves and medical grading tube was used to practice simple sutures. The training progressed to a more difficult level, using medical-grade tubing for end-to-end anastomosis, end-to-side anastomosis, side-to-side anastomosis, and free graft placement. This alternative proved challenging for the trainees, but improved hand coordination was observed. The alternative models familiarized trainees with the instruments and with developing a surgical approach before moving on to more clinical settings. The use of surgical gloves and medical grading tubes resulted in a significant reduction in the numbers of laboratory animals used for teaching microsurgery, as well as reduced cost.

Validation of microsurgical models in microsurgery training and competence: A review

“…correct suture placement, various methods of knot tying, forehand and backhand methods, end-to-end anastomosis, end-side anastomosis, side-to side anastomosis, inequal diameters and free graft placement. 24,25 Usón and Calles 26 showed in their study of 200 surgeons that very good progression was achieved from the Validation of Microsurgical Modelssecond to the third day regarding suturing technique and significant decrease in the number of animals that died as better anastomoses were performed. This study showed that Practice Cardboards demonstrate good construct validity and contributes to significant cost reduction due to less number of animals required.…”

Quality assessment of a new surgical simulator for neuroendoscopic training

“…2,4,5,7,8,[10][11][12][14][15][16][22][23][24] Unfortunately, financial, technical, and operational obstacles more often limit their application. Thus, anatomical models built from a myriad of materials 2,14,16,24 and using computational and artistic techniques 12 have become an interesting option in simulating endoscopic procedures with good accuracy at reasonable costs.…”

Microsurgical training course for clinicians and scientists at a German University hospital: A 10‐year experience

“…9,11,12 However, living animal models are still needed and justified to simulate the clinical situation, once the participants have reached a high level of tissue control and security in performing vascular anastomoses. 2,13,14 We follow a stepwise training program, 15 starting with nonliving models where participants gain experiences in the use of optical aids, microsurgical instruments and techniques, and tissue manipulation, which reduces the number of required animals substantially.…”