Training Model for Microvascular Anastomosis

Tellioğlu, Ali Teoman; Eker, Esabil; Cimen, Kadir; Cömert, Ayhan; Karaeminogullari, Gokhan; Tekdemi̇r, İbrahi̇m

doi:10.1097/scs.0b013e3181843ade

Cited by 14 publications

(10 citation statements)

References 8 publications

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“…The second group includes cadaver models and chicken wing arteries. 11,12 These models are more convenient than living animal models and can be used without anesthetic procedures. They are more analogous to human tissues than surgical gloves, silicone tubes, and beads.…”

Section: Discussionmentioning

confidence: 99%

Microsurgical Training with Porcine Thigh Infusion Model

Nam

Shin

Kim

et al. 2013

J reconstr Microsurg

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We herein present our experience with microsurgical training using a porcine thigh infusion model, which resembles living animal models. The main femoral artery was cannulated with a 24G angioneedle and fixed with 4-0 black silk sutures. Microanastomoses were performed on the femoral vessels of porcine thighs using end-to-end and end-to-side techniques. During the microanastomoses, dyed 0.9% isotonic sodium chloride was infused at 200 to 850 mL/min using an infusion pump. No anastomosis site leakage was observed and the patency of the anastomosis site was maintained. We consider the porcine thigh infusion model to be appropriate for the beginner trainee because the large vessel size enables him or her to practice. In addition, our model provides a circulation environment similar to the in vivo human environment. We believe that our model is more convenient than living animal models and more accurate than models that do not provide a circulation environment.

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Section: Discussionmentioning

confidence: 99%

Microsurgical Training with Porcine Thigh Infusion Model

Nam

Shin

Kim

et al. 2013

J reconstr Microsurg

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“…The first involves the development of appropriate vascular substitutes. Gauze fibers,[8] silicone tubes,[14] synthetic vessels created from polyvinyl chloride[20] or polyurethane,[15] cadaveric materials,[11921] and living and extracted animal vessels[610] have been reported as useful materials for training in anastomosis. Artificially pulsatile or perfused arteries in models have recently been reported to create relatively realistic situations.…”

Section: Discussionmentioning

confidence: 99%

A new polyvinyl alcohol hydrogel vascular model (KEZLEX) for microvascular anastomosis training

Mutoh

Ishikawa²,

Ono³

et al. 2010

Surg Neurol Int

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Background:Microvascular anastomosis is a challenging neurosurgical technique that requires extensive training for one to master it. We developed a new vascular model (KEZLEX, Ono and Co., Ltd., Tokyo, Japan) as a non-animal, realistic tool for practicing microvascular anastomosis under realistic circumstances.Methods:The model was manufactured from polyvinyl alcohol hydrogel to provide 1.0–3.0 mm diameter (available for 0.5-mm pitch), 6–8 cm long tubes that have qualitatively similar surface characteristics, visibility, and stiffness to human donor and recipient arteries for various bypass surgeries based on three-dimensional computed tomography/magnetic resonance imaging scanning data reconstruction using visible human data set and vessel casts.Results:Trainees can acquire basic microsuturing techniques for end-to-end, end-to-side, and side-to-side anastomoses with handling similar to that for real arteries. To practice standard deep bypass techniques under realistic circumstances, the substitute vessel can be fixed to specific locations of a commercially available brain model with pins.Conclusion:Our vascular prosthesis model is simple and easy to set up for repeated practice, and will contribute to facilitate “off-the-job” training by trainees.

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“…Success of microvascular anastomosis is related to the following factors: (1) exposition of adventitia and media; (2) choice of suture material; (3) suturing technique; (4) elimination of luminal occlusion linked to inversion, stenosis, thrombosis, and intimal thickening; (5) freeing the lumen from foreign material and atraumatic meticulous handing. [11][12][13] The conventional technique of microvascular anastomosis with sutures only is well established. However, the passage of the suture needle through the vessel wall and the presence of suture material cause inflammation and increase the risk of thrombosis.…”

Section: Discussionmentioning

confidence: 99%

2-Octylcyanoacrylate-Assisted Microvascular Anastomosis in Rat Orthotopic Small Bowel Transplantation

Zhu¹,

Wei²,

Li³

2010

J reconstr Microsurg

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The purpose of this study was to investigate the potential advantages of 2-octylcyanoacrylate-assisted end-to-side arterial anastomosis over continuous suture-only anastomosis in the rat orthotopic small bowel transplantation (OSBT) model. OSBT was performed in 80 Sprague-Dawley rats, and they were divided into two groups. Group 1 was the study group (n = 40), using 2-octylcyanoacrylate-assisted end-to-side arterial anastomosis. Group 2 was the control group (n = 40), using a running 9-0 prolene suture only. The operation time and degree of leakage were observed. After sacrifice on postoperative days 90, histology and electron scanning microscope of arterial anastomosis were measured. The suture time and recovery time in group 1 were significantly shorter than that in group 2. First-degree leakage was observed mostly in group 1, and second-degree leakage was common in group 2. No difference was found between the two techniques considering the graft intestinal histological changes. Under electron scanning microscopy, the anastomoses of the two groups displayed no obvious difference. In conclusion, due to superior speed of operation and no toxicity to vessel wall, 2-octylcyanoacrylate-assisted end-to-side arterial anastomosis might be a quick and safe method that is much easier to apply in rat OSBT.

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Training Model for Microvascular Anastomosis

Cited by 14 publications

References 8 publications

Microsurgical Training with Porcine Thigh Infusion Model

Microsurgical Training with Porcine Thigh Infusion Model

A new polyvinyl alcohol hydrogel vascular model (KEZLEX) for microvascular anastomosis training

2-Octylcyanoacrylate-Assisted Microvascular Anastomosis in Rat Orthotopic Small Bowel Transplantation

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