Apprentissage des techniques microchirurgicales vasculaires sur un modèle animal

Mathon, Bertrand

doi:10.1016/j.neuchi.2014.02.011

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…Training conducted on laboratory animals has high indicators of face and constructive validity [ 8 ]. Working with animal vessels allows feasible rehearsal of the main stage of reconstructive vascular brain surgeries, the direct microanastomosis [ 55 ]. The presence of natural blood flow, the potential for thrombosis, and relative similarity of live animal tissues to human allow trainees to practice technique with great viability and realism.…”

Section: “Wet” Training Using Live Modelsmentioning

confidence: 99%

Microvascular Anastomosis Training in Neurosurgery: A Review

Byvaltsev

Akshulakov²,

Polkin

et al. 2018

Minimally Invasive Surgery

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Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques. In this text we will briefly discuss the history of microvascular surgery, review current literature on simulation models with the emphasis on their merits and shortcomings, and describe the views and opinions on the future of the microvascular training in neurosurgery. In “dry” microsurgical training, various models created from artificial materials that simulate biological tissues are used. The next stage in training more experienced surgeons is to work with nonliving tissue models. Microvascular training using live models is considered to be the most relevant due to presence of the blood flow. Training on laboratory animals has high indicators of face and constructive validity. One of the future directions in the development of microsurgical techniques is the use of robotic systems. Robotic systems may play a role in teaching future generations of microsurgeons. Modern technologies allow access to highly accurate learning environments that are extremely similar to real environment. Additionally, assessment of microsurgical skills should become a fundamental part of the current evaluation of competence within a microneurosurgical training program. Such an assessment tool could be utilized to ensure a constant level of surgical competence within the recertification process. It is important that this evaluation be based on validated models.

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Section: “Wet” Training Using Live Modelsmentioning

confidence: 99%

Microvascular Anastomosis Training in Neurosurgery: A Review

Byvaltsev

Akshulakov²,

Polkin

et al. 2018

Minimally Invasive Surgery

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“…One of the main steps during training is the preparation of the vessel that receives the anastomosis. Simultaneously, proper manipulation of the adventitial layer of the vessels, particularly arteries, is essential, which must be released to avoid anastomotic failure, as well as being useful for vessel movement during dissection and suturing 15 .…”

Section: Introductionmentioning

confidence: 99%

Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery

NETO¹,

Neto

Secanho

et al. 2021

Acta Cir. Bras.

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Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusion: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.

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Model of Arteriovenous Malformation Created in Human Placenta for Training in Vascular Microneurosurgery

Jiménez,

Salvagni,

Biondi-Soares

et al. 2024

Operative Neurosurgery

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BACKGROUND AND OBJECTIVE: Arteriovenous malformations (AVMs) are congenital lesions, and because of their structure, complexity, flow, size, and location organization, they are lesions that require extensive anatomic knowledge and mastery of microsurgical skills and techniques. Human placentas as a training model for AVM surgery are promising alternatives. This article aims to describe the technique for forming an AVM-type lesion in human placentas and its usefulness in the training of microsurgical treatment techniques. METHODS: In this study, 15 fresh human placental models were treated. A nidus was created using synthetic material, and dynamic flow was evaluated with intravascular injection of Indocyanine Green. The catheter system was connected to a continuous flow infusion pump. For simulation purposes, 4 vascular neurosurgeons and 4 vascular neurosurgery fellows used the same techniques and instruments used in real surgery to simulate the resection of AVM lesions. Subjective assessments were conducted, evaluating the validity and structured content on a 5-point Likert scale. Evaluation criteria included the execution of technical maneuvers and the model's expression and structural aspects. RESULTS: We describe the step-by-step creation of an AVM in a placental biological model for the performance of vascular microsurgery training in the laboratory. We created in the human placenta a lesion with the characteristics of an AVM for microsurgical training in the laboratory, which presents key features realistic to a real AVM, such as 1 or more feeder arteries, nidus (synthetic), draining vein(s), continuous and pulsatile flow, and 3-dimensional configuration. Furthermore, it demonstrates the applicability of microsurgical techniques to the model compared with performing surgery on a patient. CONCLUSION: Considering it an effective method for laboratory training, the creation of arteriovenous malformations in human placentas enables students to replicate, comprehend the structure, and master microsurgical techniques in a realistic model.

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Apprentissage des techniques microchirurgicales vasculaires sur un modèle animal

Cited by 3 publications

References 24 publications

Microvascular Anastomosis Training in Neurosurgery: A Review

Microvascular Anastomosis Training in Neurosurgery: A Review

Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery

Model of Arteriovenous Malformation Created in Human Placenta for Training in Vascular Microneurosurgery

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