Training the Trainers in Microsurgery: A Success Story from Vietnam’s Hanoi National Hospital of Odonto-stomatology

Abstract

Background: Microsurgery is a highly specialized skill that requires advanced training. This is a recount of the 12-year development of Hanoi National Hospital of Odonto-Stomatology (NHOS) from a basic plastic surgery unit to a high-volume, subspecialized reconstructive center. Methods: We present a 12-year retrospective account of the development of NHOS with a brief summary of microsurgical reconstructive outcomes. Results: From 2008 to 2020, NHOS has performed 665 microsurgical flaps for reconstruction of various maxillomandibular defects. In the pioneering stage (2008-2011), without surgical microscopes, all five free flaps failed. After acquiring a microscope and mentoring from Hanoi's 108 Military Hospital, mandibular bone defect reconstruction with free fibula flaps had 85% success rate. In the growth stage (2012-2015), reconstruction advanced toward more complex defects requiring soft tissue, with a 98.7% success rate. The maturation stage (2016-2020) focused on refinement of reconstructive service to provide subspecialized care for malignant head and neck cancer patients with help from Taiwan's E-Da Hospital and Operation Smile's charity program. The charity mission trips were structured to facilitate good quality teaching rather than hit a quantitative goal of the number of surgeries done. And with a success rate of 99.4%, we have begun further education of the plastic surgery community in Vietnam. Conclusions: Our rapid 12-year maturation into a high-volume, subspecialized microsurgical center is the embodiment of the generous efforts of many international friends who invested their time and expertise. And we highly recommend charity mission trips to adopt the “training the trainers” concept to maximize lasting, local impact.

Bidirectional needs assessment of otolaryngology–head and neck surgery short‐term surgical trips to Ethiopia and Kenya

“…Although the equipment is key, it is only one component of infrastructure that supports specialized surgical practice, and other elements are outside the scope of this discussion. [19][20][21] Our data highlighted discrepancies in expectations relating to trip emerging avenue to explore. 22,23 It was clear that both HIC and LMIC otolaryngologists prioritize the model of "training the trainer" to foster long-term sustainability.…”

“…Although the equipment is key, it is only one component of infrastructure that supports specialized surgical practice, and other elements are outside the scope of this discussion. 19 , 20 , 21 …”

“…Following this example, a greater emphasis on concerted donation efforts is an approach that can be adopted by otolaryngology surgical trips to address the need for advanced surgical training. Although the equipment is key, it is only one component of infrastructure that supports specialized surgical practice, and other elements are outside the scope of this discussion 19–21 …”