A non-living, effective model for microvascular training

Camargo, Cristina Pires; Silva, Daniel Imbassahy de Sa Bittencourt de Camara e; Maluf, Fauze; Morais-Besteiro, Julio; Gemperli, Rolf

doi:10.1590/s0102-865020170120000010

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Despite all these advantages, there are limiting factors such as the 3R principle, ethics, or the association with legal problems in some countries, which results in microsurgical models in synthetic material being offered to replace the above (24)(25)(26) . Far from opposing this idea, we consider that any experimental program should start with synthetic models and end with live animal models, since they are the ones that most closely resemble human surgery and represent an essential step that gives the surgeon confidence and technical skill (4,10,27) .…”

Section: Discussionmentioning

confidence: 99%

Towards a standardized initial training program in experimental microsurgery for pediatric surgeons

Velayos¹,

Estefanía-Fernández²,

Serrano³

et al. 2023

Cir Pediatr

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Objective. To describe a basic training program in microsurgery and to analyze the learning curve through the process, including improvement in operating times and functional outcome.Materials and methods. Our learning program included basic, transitional, and experimental models. The experimental model included tail vein cannulation, intestinal resection and anastomosis, dissection, division and anastomosis of the cava and aorta. Wistar rats (66.7% male; 406.9 ± 38.9 grams) were used. The program adhered to the 3R principle and obtained animal welfare committee approval.Results. Mean tail vein cannulation time was 2.4 ± 1.2 minutes. Mean intestinal resection and jejunocolic anastomosis time was 14.8 ± 2.7 minutes and 10.4 ± 3 minutes, respectively. All anastomoses were functionally valid. Mean vessel dissection time was 22.9 ± 7.7 minutes, aortic artery anastomosis was 17.2 ± 7.1 minutes, and vena cava anastomosis was 25.9 ± 7.3 minutes. 66.7% of vena cava anastomoses were functionally valid vs. 88.9% for the aorta. The time required for all procedures decreased after the third attempt, except for vena cava anastomoses, which remained similar in all 9 procedures. Conclusions. Our model demonstrated that the procedures were suitable for trainer progression in terms of surgical time and functional outcome. Microsurgical training would benefit from standardized programs to optimize results.

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Section: Discussionmentioning

confidence: 99%

Towards a standardized initial training program in experimental microsurgery for pediatric surgeons

Velayos¹,

Estefanía-Fernández²,

Serrano³

et al. 2023

Cir Pediatr

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“…Frente a todas estas virtudes, existen cuestiones limitantes como, el principio de las 3R, la ética o la asociación con problemas legales en algunos países, resultando que los modelos de microcirugía en material sintético se ofrezcan para sustituir a los anteriores (24)(25)(26) . Lejos de oponernos a esta idea, consideramos que todo programa de experimentación debería empezar por modelos en material sintético para terminar con modelos de animales vivos, ya que son los que más se asemejan a la cirugía humana y suponen un paso esencial que aporta seguridad y destreza técnica al cirujano (4,10,27) .…”

Section: Procedimiento / Medicionesunclassified

Hacia un programa inicial de formación estandarizado en microcirugía experimental para cirujanos pediátricos

Velayos¹,

Estefanía-Fernández²,

Serrano³

et al. 2023

Cir Pediatr

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ResumenObjetivo. Describimos un programa de formación básica en microcirugía y analizamos la curva de aprendizaje a través del proceso, incluyendo la mejora en los tiempos operatorios y en el resultado funcional del procedimiento.Material y métodos. Nuestro programa de aprendizaje incluye modelos básicos, de transición y experimentales. Dentro del modelo experimental se incluyeron: canulación de la vena de la cola, resección y anastomosis intestinal, disección, sección y anastomosis de la cava y la aorta. Se emplearon ratas Wistar (66,7% machos; 406,9 ± 38,9 gramos), el programa se adhirió al principio de las 3R y obtuvo la aprobación del comité de bienestar animal.Resultados. l tiempo medio de canulación de la vena de la cola fue de 2.4 ± 1,2 minutos. El tiempo medio de resección intestinal y anastomosis yeyunocólica de 14.8 ± 2,7 minutos y 10.4 ± 3 minutos, respectivamente. Todas las anastomosis fueron funcionalmente válidas. El tiempo

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“…In this context, current experimental research works according to the ethical principles of the 3 R's -replacement, reduction, refinement -translated into research tests that replace animals with inanimate tools and technologies, (10,11) or that reduce the number of animals tested by the refinement of the technique. (12) The chicken egg symbolizes these principles in reality: a material of low cost, easy to acquire and similar to the human tissues; characteristics already used in simulations in other specialties and potential for ophthalmology. (12,13) The egg is composed of the yolk and albumen, similar to the vitreous humor, covered by membranes, cuticle and a calcified layer.…”

Section: Introductionmentioning

confidence: 99%

“…(12) The chicken egg symbolizes these principles in reality: a material of low cost, easy to acquire and similar to the human tissues; characteristics already used in simulations in other specialties and potential for ophthalmology. (12,13) The egg is composed of the yolk and albumen, similar to the vitreous humor, covered by membranes, cuticle and a calcified layer. (1,3) The composition of the membranes consists of collagen and glycoproteins, which form a film similar to the human cornea which may be used to simulate the sclerocorneal tissue of the human eye, possibly useful to simulate sutures of ophthalmic microsurgery.…”

Section: Introductionmentioning

confidence: 99%

What came first: the egg or the microsurgery training? An ophthalmic model for developing basic skills in microsurgery

Bentes¹,

Costa²,

Pimentel³

et al. 2022

Revista Brasileira De Oftalmologia

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Purpose: To describe a new accessible model of ophthalmological training using chicken eggs.Methods: With the aid of a spherical drill, the external calcified layer and the cuticle of the chicken eggshell were removed in a 2cm diameter circle. Using a video-magnification system, the film was dissected and cut to approximately 1.5 cm diameters. The film was removed and repositioned to make interrupted 12-0 nylon microsutures. The parameters analyzed were: cost, facility of acquisition and handling, time for making the model and the microsutures and number of possible uses.Results: In all simulators, it was possible to carry out separated and equidistant micro-sutures in the egg membrane, without the need for reintervention. Conclusion:The new chicken-egg model for ophthalmic surgery training is low-cost, easy to acquire and handle, and viable for the development of basic microsurgery skills. RESUMOObjetivo: Descrever um novo modelo acessível de treinamento oftalmológico com ovo de galinha.Métodos: Com o auxílio de uma broca esférica, a camada calcificada externa e a cutícula da casca do ovo de galinha foram retiradas em um círculo 2 cm de diâmetro. Mediante um sistema de videomagnificação, a película foi dissecada e cortada em formato aproximado de 1,5 cm de diâmetro. A película foi removida e reposicionada para a confecção de microssuturas interrompidas com nylon 12-0. Os parâmetros analisados foram: custo, facilidade de aquisição e manuseio, tempo para confecção do modelo e para a confecção das microssuturas e número de utilizações possíveis.Resultados: Em todos os simuladores foi possível realizar microssuturas separadas e equidistantes na membrana do ovo, sem necessidade de reintervenção.Conclusão: O novo modelo com ovo de galinha para o treinamento de cirurgia oftalmológica é de baixo custo, fácil aquisição e manuseio, além de ser viável no desenvolvimento de habilidades básicas em microcirurgia.

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A non-living, effective model for microvascular training

Abstract: This study suggested a feasible non-animal model for microsurgical training process for beginners and intermediate trainees.

Cited by 5 publications

References 14 publications

Towards a standardized initial training program in experimental microsurgery for pediatric surgeons

Towards a standardized initial training program in experimental microsurgery for pediatric surgeons

Hacia un programa inicial de formación estandarizado en microcirugía experimental para cirujanos pediátricos

What came first: the egg or the microsurgery training? An ophthalmic model for developing basic skills in microsurgery

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