Evolution of an evidence-based supermicrosurgery simulation training curriculum: A systematic review

Pafitanis, Georgios; Narushima, Mitsunaga; Yamamoto, Takumi; Raveendran, Maria; Veljanoski, Damjan; Ghanem, Ali; Myers, Simon; Koshima, Isao

doi:10.1016/j.bjps.2018.04.005

Cited by 17 publications

(15 citation statements)

References 42 publications

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“…Microsurgical techniques are widely used in several surgical specialties, such as neurosurgery, vascular surgery, ophthalmology, otorhinolaryngology, urology, and hepatobiliary surgery, among others. 1,2 However, in most training centers such techniques are practiced directly in humans due to the high cost involved. The acquisition of microsurgical microscopes is the main limiting factor.…”

Section: Introductionmentioning

confidence: 99%

Can Smartphones Be Used to Perform Video-Assisted Microanastomosis? An Experimental Study

et al. 2019

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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.

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Section: Introductionmentioning

confidence: 99%

Can Smartphones Be Used to Perform Video-Assisted Microanastomosis? An Experimental Study

et al. 2019

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“…It appears that although 3D printing has allowed models to become more accurate in terms of anatomical fidelity, human tissue likeness is an elusive aspect that is yet to be captured. In other areas of surgical simulation training, the difficulty of accurately simulating human tissue is overcome through the use of animal or cadaveric models (Loh et al, 2018) whose tissue properties closely mimic the experience of incising and suturing human tissues (Pafitanis et al, 2018) . However, the use of animal models for cleft palate training is currently unfeasible.…”

Section: Discussionmentioning

confidence: 99%

Simulation-Based Training Models for Cleft Palate Repair: A Systematic Review

Raveendran

2019

The Cleft Palate-Craniofacial Journal

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Objective: Simulation-based training is a relatively new inclusion to surgical training curricula, with promises of achieving increased competency while maximizing patient safety. Cleft palate, which contributes significantly to the global burden of surgically treatable diseases, is a challenging repair to learn due to the high level of skill and dexterity required, delicate oral tissues, and limited space of an infant oral cavity. Simulation training can allow cleft palate education to move from an observational to a competency-based learning. Hence, this systematic review presents the models described in the literature that simulate cleft palate repair. Design: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search of the MEDLINE and Cochrane databases was performed. Qualitative data were extracted, and the models were stratified based on their anatomical fidelity and realism, forming the basis of the curriculum. Results: The database search returned 3261 articles. Twelve articles were considered eligible for inclusion. The anatomical fidelity, human tissue likeness, evidence of improved outcomes, and cost are discussed. Conclusions: Cleft palate is a globally significant birth defect and its repair is a difficult procedure to learn. This review presents the 12 models of cleft palate described in the literature, highlighting the advances and gaps in current cleft palate simulation.

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“…Through this communication we hope to stimulate the evolution of microsurgery training curricula to adapt in technical differences and challenges faced in supermicrosurgery, but also the expansive clinical applications of this specific technique (Pafitanis et al, 2017). There is a need of formal incorporation of submillimeter microsurgical deliberate practice into higher training pathways (Pafitanis et al, 2018).…”

Section: Flow-like Gesturesmentioning

confidence: 97%