Training in Microvascular Surgery Using a Chicken Wing Artery

Hino, Akihiko

doi:10.1227/01.neu.0000065174.83840.62

Cited by 176 publications

(91 citation statements)

References 9 publications

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“…This knot was made between the needle end of the suture and the preceding external suture loop. The other technique entailed both poles of the arteriotomies connected by separate microsutures with the [6][7][8][9][10][11][12] for human placental artery vs 12 [8][9][10][11][12][13][14][15] for M 4 .) The 1.8-mm diameter human placental artery most closely approximates the STA, although the thickness and amount of reticular fibers is statistically significantly different (p < 0.01 and p < 0.01, respectively); however, in practice such differences are not apparent during surgical procedures.…”

Section: Side-to-side and End-to-end Bypass Modelsmentioning

confidence: 99%

“…With scores ranging from 1 to 20, most of the trained (16 of 17; 94%) and untrained (12 of 13; 92%) participants (total 28 of 30; 93%) scored the ability of the training model to replicate real bypass surgery within the interval from "more than somewhat" (score 13) to "very well" (score 20), and 1 of 17 (6%) of the trained and 1 of 13 (8%) of the untrained (total 2 of 30; 7%) participants scored the training as "somewhat" replicating real surgery (a score within the interval of [8][9][10][11][12]. Differences in scores between the 2 groups show a trend toward significance (p = 0.06).…”

Section: Face and Content Validitymentioning

confidence: 99%

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Low-flow and high-flow neurosurgical bypass and anastomosis training models using human and bovine placental vessels: a histological analysis and validation study

Belykh

Lei

Safavi–Abbasi

et al. 2016

JNS

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N eurosurgical vascular cases often require complex microvascular bypass techniques, such as those used in operative corrections for moyamoya disease, 7,26,32 cerebral aneurysms, 9,13,14,19 and intracranial tumors. 30,31 Therefore, simple and accessible models for microvascular anastomosis training are increasingly essential for providing a means for refining and preserving skills. Several models, including chicken wings, 12,17 turkey wings, 1 rats, 15 human cadavers, 24,29 and plastic tubing, 22 have been proposed. However, these models are still less than ideal for various reasons, such as vessel diameter diversity, cost-effectiveness, artifacts due to storage (e.g., Low-flow and high-flow neurosurgical bypass and anastomosis training models using human and bovine placental vessels: a histological analysis and validation study obJective Microvascular anastomosis is a basic neurosurgical technique that should be mastered in the laboratory. Human and bovine placentas have been proposed as convenient surgical practice models; however, the histologic characteristics of these tissues have not been compared with human cerebral vessels, and the models have not been validated as simulation training models. In this study, the authors assessed the construct, face, and content validities of microvascular bypass simulation models that used human and bovine placental vessels. methods The characteristics of vessel segments from 30 human and 10 bovine placentas were assessed anatomically and histologically. Microvascular bypasses were performed on the placenta models according to a delineated training module by "trained" participants (10 practicing neurosurgeons and 7 residents with microsurgical experience) and "untrained" participants (10 medical students and 3 residents without experience). Anastomosis performance and impressions of the model were assessed using the Northwestern Objective Microanastomosis Assessment Tool (NOMAT) scale and a posttraining survey. results Human placental arteries were found to approximate the M 2 -M 4 cerebral and superficial temporal arteries, and bovine placental veins were found to approximate the internal carotid and radial arteries. The mean NOMAT performance score was 37.2 ± 7.0 in the untrained group versus 62.7 ± 6.1 in the trained group (p < 0.01; construct validity). A 50% probability of allocation to either group corresponded to 50 NOMAT points. In the posttraining survey, 16 of 17 of the trained participants (94%) scored the model's replication of real bypass surgery as high, and 16 of 17 (94%) scored the difficulty as "the same" (face validity). All participants, 30 of 30 (100%), answered positively to questions regarding the ability of the model to improve microsurgical technique (content validity). coNclusioNs Human placental arteries and bovine placental veins are convenient, anatomically relevant, and beneficial models for microneurosurgical training. Microanastomosis simulation using these models has high face, content, and construct validities. A NOMAT score of more than 5...

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Section: Side-to-side and End-to-end Bypass Modelsmentioning

confidence: 99%

Section: Face and Content Validitymentioning

confidence: 99%

Low-flow and high-flow neurosurgical bypass and anastomosis training models using human and bovine placental vessels: a histological analysis and validation study

Belykh

Lei

Safavi–Abbasi

et al. 2016

JNS

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“…Hino described a training exercise for microarterial anastomosis using a chicken wing artery 12 . These methods proved to be useful for learning microsurgical techniques and several advantages can be noted, including low cost and easiness to handle.…”

Section: Discussionmentioning

confidence: 99%

Microsurgical training model with nonliving swine head. Alternative for neurosurgical education

et al. 2014

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PURPOSE: This paper proposes a practical model of microneurosurgical training using a nonliving swine head. METHODS:Fresh porcine heads were obtained from butchery and dissected at our Laboratory of Microsurgery. Brain and skull base surgery were trained under microscopic magnification. RESULTS:Several neurosurgical procedures could be simulated in the nonliving pig model, including transcallosal approach to the lateral ventricle, lateral sulcus and middle fossa dissection, and posterior fossa surgery. CONCLUSION:The swine model perfectly simulates standard microneurosurgical procedures, and is a useful tool for developing and refining surgical skills.

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“…These include living animals 1,2 , human cadaveric specimens 3 , inert models 4,5 and non-living animal models [6][7][8][9] .The Living animal models, specifically those using rats have been extensively used in the teaching of microsurgery 1,2 ; and they are considered the current gold standard of training. In spite of their remarkable instructive value, when an intensive or prolonged training is required; economical and ethical concerns can hinder their practical usage.…”

Section: Introductionmentioning

confidence: 99%

Step By Step: Microsurgical training method combining two nonliving animal models

Couceiro

Castro

Tien

et al. 2015

JoVE

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The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly laboratory rats. This method although extremely valuable can be economically demanding both for the surgeon and the sponsoring institution; it also requires special training facilities that may not always be available or accessible. Furthermore ethical concerns can limit the use of living animals for training purposes. Alternative training methods, such as inert tubes and gloves have not gained popularity among surgeons since they do not offer an experience similar to that of a clinical situation. Non-living animal models include the use of chicken thighs and wings; they offer a practice experience that resembles a clinical situation to a considerable extent. This type of training is relatively cheap and easily available. The microscope and instruments required can be acquired over the internet, and the chicken pieces can be bought at the local supermarket.This approach allows a motivated trainee to rehearse different types of surgical techniques several times at a reasonable expense, helping to develop or maintain his surgical expertise if more complex facilities are not available. On the current manuscript we describe how to setup a small practice station, how to dissect the specimens, and how to practice both with the chicken thighs and with the chicken wings in a progressive fashion. This approach takes advantage on the versatility of the chicken thigh model and the small size of the chicken wing Brachial artery. Video LinkThe video component of this article can be found at

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Training in Microvascular Surgery Using a Chicken Wing Artery

Abstract: This exercise is useful not only for young surgeons who wish to learn microsurgical techniques but also for more experienced surgeons who need to maintain or improve their skills.

Cited by 176 publications

References 9 publications

Low-flow and high-flow neurosurgical bypass and anastomosis training models using human and bovine placental vessels: a histological analysis and validation study

Low-flow and high-flow neurosurgical bypass and anastomosis training models using human and bovine placental vessels: a histological analysis and validation study

Microsurgical training model with nonliving swine head. Alternative for neurosurgical education

Step By Step: Microsurgical training method combining two nonliving animal models

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