(213) MICROSURGICAL DEVELOPMENT IN FRESH CADAVER - A NEW ERA FOR SURGICAL LEARNING

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Abstract Introduction Microsurgical skills are indispensable for good patient outcomes and a successful surgeon career in male reproductive medicine. The development of these surgical skills is a long hard-earned process with hours of practice and dedication. The learning curve in acquiring microsurgical skills defines the need for training outside the operating room and training models are becoming a crucial step in the progress of the apprentice towards performing live operations. Several surgical simulation techniques are available offering different degrees of realism. One of these techniques is based on learning through fresh cadaver models providing visual and tactile learning closer to real-life anatomy. In this fresh frozenncadaver model, following our preservation protocol, the viability of all the structures of the male reproductive system allowed for microsurgery training with vasovasostomy and other local surgical treatments, with the appearance of a conventional operating room with a genuine patient. Objective Describe the most realistic and innovative simulation model of these applicable educational tools for urological microsurgery using a fresh frozen cadaver. Methods Microsurgical training was performed with 3 microsurgically qualified urologists and 3 trainees in a fresh frozen cadaver. A step-by-step of vasovasostomy surgery and other procedures were performed in the simulation model, from the physical examination to the last stitch in the skin. Results All the reproductive system structures in the fresh frozen cadaver were presented in the same way as in a live patient (Fig. A and B). The texture, the consistency of the anatomic tissues and even the coloring were preserved, enabling urologists in training to perform vasectomy reversals on the model, realistically simulating conventional surgery (Fig. C and D). Conclusions The training of vasectomy reversal on the fresh frozen cadaver, stored at low temperatures and treated with cryopreservatives and antimicrobials provides more realistic learning. The preservation of the cadaver gives it a great physical similarity to a live patient. It also allows the surgeon in training to maintain all the surgery times, from the skin incision to the final suture. A new tool has emerged with strong real-life characteristics for training urologists in microsurgery. Disclosure No.