Opportunities of microsurgical training using a stereomicroscope and simple instruments

Abstract

Background. Modern neurosurgery requires the surgeon to be skilled in microsurgical techniques to be able to operate efficiency and safety. Maintaining and developing these skills is one of main goal for neurosurgery. Optimal use of simple models for microsurgical techniques. For this purpose, we use an stereomicroscope and simple microinstruments to enable training without interruption from the main activity or at home.Aim. To introduce a microneurosurgery training based on use of stereomicroscope and simple microinstruments that can be used for daily training.Materials and methods. Simple microinstruments and stereomicroscope were used for anastomosis and suturing training. All equipment and tools were purchased on the AliExpress online trading platform. We suture neighboring fibers of the gauze with 9/0-12/0 nylon under fixed and highest magnification. Chicken blood vessels were used as a material for anastomosis training. A long segment of blood vessel from the proximal brachial artery to the distal radial artery was used for anastomosis. End-to-side anastomosis was practiced first, and the training continued with end-to-end anastomosis of the appropriate segments. Also, we used homemade box made of LEGO for training dexterity and maneuverability in the limited and deep field. Progress in changing microsurgical skills was assessed by the duration and quality of suturing and anastomoses.Results. The instruments used for these models were affordable, simple and easy to use. The simple, but the same time effective training, is the suture neighboring fibers of the gauze. Daily training allowed us improve the skills of anastomosis reducing time for anastomosis end-to-side from 40 min to 22 min 40 sec. The same results we noticed using suture neighboring fibers of the gauze, reducing time of exercises by 15 min. This training system is somewhat of a drawback compared to the simulation of a real clinical setting. However, due to the extremely easy accessibility and accessibility, the stereomicroscope and simple instrument allow us to use them for daily training. This resulted in a steep learning curve of the technique.Conclusion. This study suggests an effective and feasible method for microneurosurgical training using stereomicroscope and simple microinstruments. The improvement of our manual skills, marked by constant training, testifies about the necessity of microsurgical training both in the training of neurosurgeons and in the future.