Microsurgical Training of STA-MCA Anastomosis Using a Raw STA Graft

Abstract

The surgical skill of STA-MCA anastomosis has been reported to be trainable through several off-the-job practices, including suturing gauze fibers. We report a new method using a raw STA graft that can be obtained during routine STA-MCA bypass surgery, when preparing an STA stump. The raw STA graft was used to practice end-to-side anastomosis with a silicone tube used to simulate a recipient artery. Using a raw graft allowed the trainee to practice removing the connective tissue from the STA stump, which is good training for blunt dissection using microforceps. A raw graft also provides the trainee with real sensory input when penetrating the vessel wall, which made the practice closer to a real operation, resulting in good pre-operation simulation for training neurosurgeons. A raw STA graft makes a good material for training young neurosurgeons.