Microsurgical training regimen with nonliving chicken models

Couceiro, José; Özyürekoğlu, Tuna; Sanders, SP; Tien, Huey

doi:10.1002/micr.22060

Cited by 10 publications

(12 citation statements)

References 13 publications

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“…18 Based on this principle, continuous training using this model could help surgeons to shorten their learning curve, use fewer living animals to achieve mastery, and make fewer technical mistakes in the operating room. 19 Multiple models have been described for microvascular anastomosis training including the chicken wing, 20 the turkey wing, 21 and the porcine thigh infusion model 22 among others. These models have the advantage of being convenient, inexpensive, and readily accessible.…”

Section: Discussionmentioning

confidence: 99%

A Novel Ex Vivo Training Model for Acquiring Supermicrosurgical Skills Using a Chicken Leg

Cifuentes

Rodríguez

Yáñez

et al. 2016

J reconstr Microsurg

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Supermicrosurgery is a technique used for dissection and anastomosis of submillimeter diameter vessels. This technique requires precise hand movements and superb eye-hand coordination, making continuous training necessary. Biological in vivo and ex vivo models have been described for this purpose, the latter being more accessible and cost-effective. The aim of this study is to present a new ex vivo training model using a chicken leg. In 28 chicken legs, an anatomical study was performed. An intramuscular perforator vessel was identified and dissected. Arterial diameters of 0.7, 0.5, and 0.3 mm were identified and consistency of the perforator was assessed. In additional 10 chicken legs, 25 submillimeter arteries were anastomosed using this perforator vessel. Five arteries of 0.3 and 10 of 0.5 mm were anastomosed with nylon 11-0 and 12-0 sutures. Intravascular stent (IVaS) technique and open guide (OG) technique were used in 0.5-mm arteries. A total of 10 arteries of 0.7 mm were anastomosed using 10-0 sutures in a conventional fashion. Dissection and anastomosis time were recorded and patency was tested. We were able to identify 0.7 to 0.3 mm diameter arteries in all the specimens and confirm the consistency of the perforator. The median time for dissection was 13.4 minutes. The median time for anastomosis was 32.3 minutes for 0.3-mm arteries, 24.3 minutes for 0.5-mm arteries using IVaS, 29.5 minutes for the OG technique, and 20.9 minutes for the 0.7 mm diameter arteries. All the anastomoses were permeable. Due to its consistent and adequate diameter vessels, this model is adequate for training supermicrosurgical skills.

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Section: Discussionmentioning

confidence: 99%

A Novel Ex Vivo Training Model for Acquiring Supermicrosurgical Skills Using a Chicken Leg

Cifuentes

Rodríguez

Yáñez

et al. 2016

J reconstr Microsurg

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“…[8][9][10][11][12]16 The advantages of using nonliving chicken models relies on having low cost and readily available simulation models for continuous training in the laboratory without ethical or major logistic issues. 13 Even though the chicken muscle is slightly less fibrous than the human muscle, our impression is that it achieves to replicate the feeling of dissecting the intramuscular perforator. The dissection time seems adequate in terms of the length of the pedicle, the size of the vessels and the numerous collaterals.…”

Section: Discussionmentioning

confidence: 99%

“…Following a stepwise training program starting with nonliving models reduces the number of required live animals to achieve microsurgical skills, and should be a previous step toward them. 13 Chicken wings and thighs have been used as ex vivo training models for acquiring skills in microsurgical vascular anastomoses [13][14][15] and have been described as a convenient and cost-effective method for continuous training.…”

Section: Introductionmentioning

confidence: 99%

A Novel Perforator Flap Training Model Using a Chicken Leg

et al. 2016

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Introduction?Living animal models are frequently used for perforator flap dissection training, but no ex vivo models have been described. The aim of this study is to present a novel nonliving model for perforator flap training based on a constant perforator in the chicken leg. Methods?A total of 15 chicken legs were used in this study. Anatomical dissection of the perforator was performed after its identification using ink injection, and in four of these specimens a perforator-based flap was raised. Results?The anatomical dissection revealed a constant intramuscular perforator with a median length of 5.7 cm. Median proximal and distal vessel diameters were 0.93 and 0.4?mm, respectively. The median dissection time was 77.5 minutes. Conclusion?This study introduces a novel, affordable, and reproducible model for the intramuscular dissection of a perforator-based flap using an ex vivo animal model. Its consistent perforator and appropriate-sized vessels make it useful for training.

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“…Recently, various reports have been published on microsurgery training. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] We believe that the following elements are necessary for an effective medical training model: the training must arouse trainees' interest; and it must improve trainees' motivation. Next, trainees can obtain appropriate training before performing the operation on a human.…”

Section: Discussionmentioning

confidence: 99%

Analysis of 10-Year Training Results of Medical Students Using the Microvascular Research Center Training Program

Onoda

Kimata

Sugiyama

et al. 2015

J reconstr Microsurg

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Background In this article, we reviewed the training results of medical students using the Microvascular Research Center Training Program (MRCP), and proposed an ideal microsurgical training program for all individuals by analyzing the training results of medical students who did not have any surgical experience. Methods As of 2015, a total of 29 medical students completed the MRCP. In the most recent 12 medical students, the number of trials performed for each training stage and the number of rats needed to complete the training were recorded. Additionally, we measured the operating time upon finishing stage 5 for the recent six medical students after it became a current program. Results The average operating time upon finishing stage 5 for the recent six medical students was 120 minutes ± 11 minutes (standard deviation [SD]). The average vascular anastomosis time (for the artery and vein) was 52 minutes ± 2 minutes (SD). For the most recent 12 medical students, there was a negative correlation between the number of trials performed in the non-rat stages (stages 1-3) and the number of rats used in the rat stages (stages 4-5). Conclusion Analysis of the training results of medical students suggests that performing microsurgery first on silicon tubes and chicken wings saves animals' lives later during the training program. We believe that any person can learn the technique of microsurgery by performing 7 to 8 hours of training per day over a period of 15 days within this program setting.

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Microsurgical training regimen with nonliving chicken models

Cited by 10 publications

References 13 publications

A Novel Ex Vivo Training Model for Acquiring Supermicrosurgical Skills Using a Chicken Leg

A Novel Ex Vivo Training Model for Acquiring Supermicrosurgical Skills Using a Chicken Leg

A Novel Perforator Flap Training Model Using a Chicken Leg

Analysis of 10-Year Training Results of Medical Students Using the Microvascular Research Center Training Program

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