Video‐assisted versus conventional microsurgical training: A comparative study in the rat model

Abstract

Recent technical development has led to remarkable performances in video-guided surgical procedures. A video-endoscopic system (VES) is evaluated as an alternative magnifying solution for microsurgical procedures and compared to table-top microscopes in terms of technical and surgical aspects. Six surgical residents without microsurgical experience, alternating both systems, performed each 12 aortic end-to-end anastomoses on Sprague-Dawley rats using the triangulation technique. All anastomoses underwent quality review, total and single suture time, suture spacing, vessel bite, vessel overlapping and wall penetration were evaluated and graded. Overall anastomosis quality score was 52.28 (out of a maximum of 140) using the microscope and 42.7 using the VES. Despite significant differences in total anastomosis time, the learning curves are similar for the two systems and no major differences were noted in terms of overall anastomosis quality. Video-assisted microsurgery can become a useful instrument for microsurgery training.

A Low-Cost High-Definition Video System for Microsurgical Hindlimb Replantation in Rats

“…15 This is possibly due to the high quality of microscopes, improvements in instrument design, and improvements in surgical skills. [6][7][8][9][10][11] Training requires devotion and a proper laboratory for practice. However, the high cost of implementing an adequate microsurgery laboratory limits the number of trained microsurgeons worldwide.…”

“…[3][4][5][6][7][8][9][10] For 20 to 30 years, microscope technology has remained virtually the same, 6 while the imaging and magnification of the video system has progressively been improving alongside diminishing cost with the rise of new technologies. [8][9][10] The main limitation of the video-assisted system is the lack of a stereoscopic view, [8][9][10] although, as with laparoscopic surgery, [3][4][5][6][7] the information on spatial depth can be derived from secondary spatial depth cues and from experience. 16 New technologies such as three-dimensional (3D) cameras and 4K televisions will certainly remove this limitation.…”

“…Previous studies have used animals with similar characteristics to ours. [3][4][5][6][7][8][9][10] The vascular patency and survival rates of the animals in both groups were lower in T2 than in T1, but with no statistically significant differences observed. Such a decrease happened with a larger proportion than found by other authors, 12,13 although we were unable to explain this.…”

“…11 Conversely, the microscope adds to the stereoscopic effect through using binocular lenses. [3][4][5][6][7][8][9][10] A literature review of the use of video systems for magnification has suggested that so far this novel magnification system has only been used to perform arterial anastomoses. One of the most important applications of vascular microsurgery is replanting amputated limbs and organs.…”

Experiences with basic microsurgical training programs and skill assessment methods at the University of Debrecen, Hungary

“…There is a huge demand on effective microsurgical training that provides necessary skill for using the microsurgical technique successfully in the clinical practice. Numerous educational methods are known, based on special local traditions and masters in Austria, Belgium, Brazil, Canada, China, France, Germany, Hungary, Italy, Japan, Korea, Poland, Romania, Spain, Sweden, UK and the USA, among others [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] . The necessity of the evaluation of training and the importance of the objective skill assessment methods have been developed together with the programs.…”