Validation of microsurgical models in microsurgery training and competence: A review

Chan, Woan-Yi; Matteucci, Paolo; Southern, Stephen

doi:10.1002/micr.20393

Cited by 126 publications

(125 citation statements)

References 68 publications

(47 reference statements)

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“…Usually, fat animals were used for training because it is believed that they have bigger vessels 15,16 , but in our data, there is no correlation between arterial diameter and weight. Showing a no advantage in using fatter rats, since they are older and it could affect the results of a researcher.…”

Section: ■ Discussionmentioning

confidence: 55%

Continuous versus interrupted suture technique in microvascular anastomosis in rats

et al. 2017

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Continuous versus interrupted suture technique in microvascular anastomosis in rats 1 1-Experimental SurgeryActa Cir Bras. 2017;32(9):691-696 AbstractPurpose: To compare the continuous and interrupted suture technique on femoral artery on rats after vessel repair and 14 days after. Methods: Twenty rats were operated randomly divided into two group matched according to the suture technique used: interrupted or continuous. We performed a femoral anastomosis on the right femoral artery. We analyzed weight, arterial caliber, anastomosis time and patency after vessel repair and 14 days after. Results: There was no significant difference between groups in the weight (p=0.64), diameter of the femoral artery (p=0.95) and patency (p=1.00). The time spent in the anastomosis was 451 seconds in the continuous group and 718 seconds in the interrupted group, presenting significant difference (p<0.01). Conclusion:The continuous suture technique shows a similar patency rates than interrupted technique, however with a shorter time to perform the anastomosis.

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Section: ■ Discussionmentioning

confidence: 55%

Continuous versus interrupted suture technique in microvascular anastomosis in rats

et al. 2017

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“…Algunos de estos aspectos son la necesidad de tiempo, paciencia, motivación, tolerancia a la frustración y recursos entre otros 4,13,[27][28][29][30][31] . Si bien existen algunas publicaciones al respecto, aún no se ha desarrollado un currículo válido de entrenamiento para los especialistas que necesitan usar técnicas microquirúrgicas en su práctica diaria 29,[32][33][34][35][36] . Entre los diferentes esquemas de entrenamiento propuestos, está la simple exposición directa a procedimientos microquirúrgicos, sin embargo, esta opción, además de ser riesgosa para los pacientes, se reserva sólo a centros con alto volumen microquirúrgico.…”

Section: Discussionunclassified

“…Así, se ha sugerido que el entrenamiento microquirúrgico debe empezar en el laboratorio y una vez dominadas las habilidades básicas de microcirugía, dar el paso a la microcirugía clínica. Sin embargo, aún no se ha estandarizado el entrenamiento en el laboratorio, ni la forma de evaluarlo 28,35,37,38 . Si bien creemos que se debe trabajar en este punto, nos parece que la mejor opción es adaptarse a las condiciones locales para lograr adquirir las destrezas básicas de microcirugía.…”

Section: Discussionunclassified

Entrenamiento microquirúrgico básico para realizar un modelo animal de alotrasplante compuesto vascularizado

et al. 2013

Rev Chil Cir

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Basic microsurgical training for a vascularized composite allotransplantation animal model Introduction: Rat hind limb transplantation is a complex animal model of vascularized composite allotransplantation (VCA). A basic microsurgical training is required prior to the implementation of this model. Aim: To propose a training program for the acquisition of basic skills to perform a microsurgical VCA model. Animals and Methods: The training program was conducted in two stages. First, at the dry lab, basic suturing skills with 9-0 to 11-0 nylon sutures were practiced, reproduced from surgical videos performed by experts. In a second stage, at the wet lab using 13 Lewis rats, 6 hind limb microsurgical dissections were performed and the important steps for transplantation were identified: 10 end to end femoral artery anastomoses with 10-0 nylon interrupted suture; 10 end to end femoral vein anastomoses with 10-0 nylon suture; 3 femoral vein interposition in the femoral artery; 6 end to end sciatic nerve neurorrhaphy; 4 femur osteosynthesis with 21g needle and wire cerclage. Anastomotic patency rate and anastomotic surgical time were recorded. Results: Arterial and venous patency rate was 100 and 90% respectively. Surgical time decreased from 49 to 24 minutes on arterial anastomoses and from 55 to 25 minutes on venous anastomoses after completion

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“…The SAMS model assesses four areas: dexterity, visuospatial ability, operative flow, and judgment, and was formulated from other previously validated assessment tools including the Imperial College Surgical Assessment Device and the Observed Structured Assessment of Technical Skills. [2][3][4][5] This model was designed to assess technical skills during conventional microsurgery, and has been validated in a recent series at the authors' home institution. 6 Robotically assisted microsurgery or telemicrosurgery is defined as a microsurgical technique that uses robotic telemanipulators to control an effector component that enhances the precision of surgical movements.…”

Section: Introductionmentioning

confidence: 99%

Robotic Microsurgical Training and Evaluation

Selber

Alrasheed

2014

Seminars in Plastic Surgery

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Robotic surgery has expanded rapidly over the past two decades and is in widespread use among the surgical subspecialties. Clinical applications in plastic surgery have emerged gradually over the last few years. One of the promising applications is robotic-assisted microvascular anastomosis. Here the authors first describe a process by which an assessment instrument they developed called the Structured Assessment of Robotic Microsurgical Skills (SARMS) was validated. The instrument combines the previously validated Structured Assessment of Microsurgical Skills (SAMS) with other skill domains in robotic surgery. Interrater reliability for the SARMS instrument was excellent for all skill areas among four expert, blinded evaluators. They then present a process by which the learning curve for robotic-assisted microvascular anastomoses was measured and plotted. Ten study participants performed five robotic microanastomoses each that were recorded, deidentified and scored. Trends in SARMS scores were plotted. All skill areas and overall performance improved significantly for each participant over the five microanastomotic sessions, and operative time decreased for all participants. The results showed an initial steep ascent in technical skill acquisition followed by more gradual improvement, and a steady decrease in operative times for the cohort. Participants at all levels of training, ranging from minimal microsurgical experience to expert microsurgeons gained proficiency over the course of five robotic sessions.

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Validation of microsurgical models in microsurgery training and competence: A review

Cited by 126 publications

References 68 publications

Continuous versus interrupted suture technique in microvascular anastomosis in rats

Continuous versus interrupted suture technique in microvascular anastomosis in rats

Entrenamiento microquirúrgico básico para realizar un modelo animal de alotrasplante compuesto vascularizado

Robotic Microsurgical Training and Evaluation

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