A simple, novel technique to create silicone vessels for microsurgical training

Abstract

Background and objectivesEffective microsurgical training necessitates dedicated practice, prompting the development of simulation models that mitigate the hygiene risks, regulatory challenges, and storage difficulties associated with conventional biological models. This study aims to evaluate the preferences of microsurgeons and medical students regarding self-made silicone simulation vessels, comparing them to standard biological models. MethodsA three-part jig, comprising of a two-part metal clamp component and a transparent acrylic block with 4x4 channels, was designed. This assembly produced 16 vessels with a 1 ​mm inner diameter. Liquid silicone (Ecoflex 00–30), readily accessible from online distributors, was injected into the channels using a syringe. After tightening the clamp component and inserting 16 1 ​mm k-wires, the vessels were left to set for approximately 24 ​h 20 medical students with no prior microsurgical experience and 10 microsurgery-trained surgeons then evaluated these silicone vessels against a commonly used biological model (chicken brachial artery for surgeons or chicken aorta for students). Participants were then surveyed about their preference for a specific model for frequent practice using a 10-point Likert scale. Results and conclusionIn assessing ideal microsurgical training models, all participants highlighted the importance of realism. Surgeons’ main practical considerations were hygiene, availability, and setup and storage ease, while medical students were primarily concerned with cost-effectiveness. Both surgeons and medical students perceived the biological model as more realistic, yet less hygienic and harder to set up and store. Conversely, the silicone model, though deemed less realistic, offered advantages in hygiene, availability, cost-effectiveness, and setup and storage simplicity. The silicone model emerged as the overall favorite amongst all participants for frequent practice. Silicone vessels may serve as a complementary adjunct to biological models, allowing surgeons-in-training to practice their skills outside of the operating room and lab settings.