The Role of Low-Cost Microsurgical Training Models and Experience with Exercises Based on a Bovine Heart

Olijnyk, Leonardo Desessards; Patel, Krunal; Brandão, M. R.F.; Morais, Artur Nobrega Lima de; Carvalho, Rodolfo Figueiredo de; Severino, Antônio Generoso; Mayor, Diana; Silva, Carlos Eduardo da; Stefani, Marco Antônio

doi:10.1016/j.wneu.2019.06.089

Cited by 12 publications

(11 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although this model is specifically designed for microsurgery training, the porcine kidney may be useful for other modalities such as human kidney transplantation training. 3,4 In addition, vascular dissection may be useful for training surgeons performing vascular access and arteriovenous fistula creation. 10,21 Comparing to others nonliving training model such as chicken parts, 13,15,22,23 human placenta 12 and fresh cadaveric' vessels, 24 the kidney's pork is cheap, normally is not used for human consumption and don't have risk of viral transmission.…”

Section: Discussionmentioning

confidence: 99%

“…1 Microsurgery has a long learning curve, and it is a challenging task, especially for young surgeons, because of the need for high dexterity and manual skills. [1][2][3] Even simple procedures require different levels of complex skills. 2,4,5 Until recently, training with more experienced surgeons during surgeries in patients has been the traditional method of gaining skills based on the experience principle.…”

mentioning

confidence: 99%

“…2,4,5 Until recently, training with more experienced surgeons during surgeries in patients has been the traditional method of gaining skills based on the experience principle. 3,6 However, with increasing concerns regarding patient safety, the traditional method of surgical training is being replaced by other forms of learning, mainly to master microsurgical skills. This has led to the adoption of simulation-based surgical training.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Novel Porcine Kidney-Based Microsurgery Training Model for Developing Basic to Advanced Microsurgical Skills

Reis

Teixeira

Santos

et al. 2020

J Reconstr Microsurg

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Novel Porcine Kidney-Based Microsurgery Training Model for Developing Basic to Advanced Microsurgical Skills

Reis

Teixeira

Santos

et al. 2020

J Reconstr Microsurg

View full text Add to dashboard Cite

show abstract

“…Moreover, whilst certain institutions may be early adopters with exposure to digital neurosurgical simulation technologies, others may be unable to gain the required exposure due to organisational financial constraints. In fact, various teams have highlighted that the costs of neurosurgical simulation can be high and hence have developed further methods like app-based communication platforms to reduce costs [26,28,31,61,75,79,113]. Study designs for centres with established track records and budgets for neurosurgical simulation differ from centres with financial constraints undertaking an initial study into its usefulness for their trainees.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance

et al. 2020

View full text Add to dashboard Cite

At a time of significant global unrest and uncertainty surrounding how the delivery of clinical training will unfold over the coming years, we offer a systematic review, meta-analysis, and bibliometric analysis of global studies showing the crucial role simulation will play in training. Our aim was to determine the types of simulators in use, their effectiveness in improving clinical skills, and whether we have reached a point of global acceptance. A PRISMA-guided global systematic review of the neurosurgical simulators available, a meta-analysis of their effectiveness, and an extended analysis of their progressive scholarly acceptance on studies meeting our inclusion criteria of simulation in neurosurgical education were performed. Improvement in procedural knowledge and technical skills was evaluated. Of the identified 7405 studies, 56 studies met the inclusion criteria, collectively reporting 50 simulator types ranging from cadaveric, low-fidelity, and part-task to virtual reality (VR) simulators. In all, 32 studies were included in the meta-analysis, including 7 randomised controlled trials. A random effects, ratio of means effects measure quantified statistically significant improvement in procedural knowledge by 50.2% (ES 0.502; CI 0.355; 0.649, p < 0.001), technical skill including accuracy by 32.5% (ES 0.325; CI − 0.482; − 0.167, p < 0.001), and speed by 25% (ES − 0.25, CI − 0.399; − 0.107, p < 0.001). The initial number of VR studies (n = 91) was approximately double the number of refining studies (n = 45) indicating it is yet to reach progressive scholarly acceptance. There is strong evidence for a beneficial impact of adopting simulation in the improvement of procedural knowledge and technical skill. We show a growing trend towards the adoption of neurosurgical simulators, although we have not fully gained progressive scholarly acceptance for VR-based simulation technologies in neurosurgical education.

show abstract

“…This is especially true during the early stages of the learning curve, with hybrid approaches typically introduced in a step-ladder-type training employing a combination of ex vivo and in vivo models. 1 – 4 …”

Section: Introductionmentioning

confidence: 99%

Three-dimensional Printed Microvascular Clamps: A Safe, Cheap, and Effective Instrumentation for Microsurgery Training

Papavasiliou

Chatzimichail

Pafitanis

2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary: Microsurgical training involves practice in ex vivo models during the early learning curve, and poor instrument handling by the inexperienced microsurgeons can cause damage to microsurgical instrumentation or clamps, which is particularly costly. To address this, we demonstrate the development, design, manufacturing, and application of 3 different types of 3-dimensional printed microvascular clamps in an ex vivo simulation training model. This report provides evidence of a low-cost and easily accessible device that facilitates the process of microsurgical training. The clamps were found to provide advantages akin to normal stainless-steel microvascular clamps in training settings.

show abstract

The Role of Low-Cost Microsurgical Training Models and Experience with Exercises Based on a Bovine Heart

Cited by 12 publications

References 30 publications

Novel Porcine Kidney-Based Microsurgery Training Model for Developing Basic to Advanced Microsurgical Skills

Novel Porcine Kidney-Based Microsurgery Training Model for Developing Basic to Advanced Microsurgical Skills

Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance

Three-dimensional Printed Microvascular Clamps: A Safe, Cheap, and Effective Instrumentation for Microsurgery Training

Contact Info

Product

Resources

About