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Abstract
Purpose:Surgical simulation of microvascular anastomosis has become increasingly popular. There are several living and silicone models available. Current silicone models fail to accurately reproduce a vessel’s loose adventitial layer, which may lead to the development of improper microsurgical technique. Our purpose is to create a realistic 3-dimensional microsurgical simulator that incorporates an adventitial vessel layer for higher fidelity manipulation of vessels.Methods:A microvascular anastomosis simulator was manufactured using metal moulds and inorganic materials. Synthetic tubing was created with a metal cylinder, 1.65 mm in diameter, painted with 2 sequential layers of silicon with a shore hardness of 2A. Silicone was allowed to fully cure in-between layers. Vessel adventitia was created with a 100-micron polyester mesh adhered to the silicone vessel exterior. Once dry, the synthetic tube is removed from the metal cylinder is then clipped to reveal the inner lumen. Both Resident and attending physicians evaluated the model with and without the adventitial layer and completed a questionnaire.Results:Grasping and manipulation of the vessel were scored on Average score 4.5 and 3 out of 5, with adventitia and without, respectively (P = .00906). Usefulness as a teaching tool was scored on average 4.9 and 4.2, with adventitia and without, respectively (P = .0232). The analysis included: simulation realism, educational utility, and overall satisfaction. Responses in all domains were favourable, suggesting the utility of this model.Conclusion:We created a realistic, high fidelity microvascular anastomosis simulator that is low cost and easily reproducible. Initial feedback is encouraging regarding realism, educational utility, and overall usefulness. Further validation is required to assess its effectiveness in resident education and skill transfer to the operating room.
Highlights
As part of any plastic surgery training program, microsurgery is a core pillar among the fund of knowledge that must be learned and applied
Benefits of surgical simulation include reduced time spent in the operating room teaching basics, maximizing the benefit from actual cases, ensuring adequate case volume, skill transfer from the simulator to the operating room, and improved patient outcomes.[3,4]
Microsurgical simulation has become increasingly popular among training programs for these reasons
Summary
As part of any plastic surgery training program, microsurgery is a core pillar among the fund of knowledge that must be learned and applied. Access to the information behind the theory of microsurgery is in abundance. Access to clinical application of these theories has become increasingly more challenging, that is the combination of an ever-reducing allocation of time in workplace training with a highly demanding skill that has high stakes in the case of error has led to the establishment of simulation as an integral part of microsurgical training.[1,2] Surgical simulators aim to improve operative skills and patients’ safety by allowing trainees to recreate tasks modelled before and after surgical procedures. Benefits of surgical simulation include reduced time spent in the operating room teaching basics, maximizing the benefit from actual cases, ensuring adequate case volume, skill transfer from the simulator to the operating room, and improved patient outcomes.[3,4] Microsurgical simulation has become increasingly popular among training programs for these reasons
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