Synthetic Latex Conduits as an Aid for Microsurgical Training

Abstract

Sir: We read with interest the article on a novel technique to aid microsurgical training.1 We would like to compliment the authors on the method they describe. The cornerstone of microsurgical training involves anastomoses in live models in a laboratory or clinical setting. Stringent ethical issues and increasing expenses in running animal laboratories make access difficult for regular and sustained training.2 The development of alternative models that allow for realistic and effective practice is of increasing importance. We propose a simple innovation that has negligible cost, is readily accessible, and has been used successfully in our unit to enable the instruction of trainees in anastomotic techniques using the microscope. To obtain as realistic a “vessel” as possible, we cut the rolled rim/sleeve of nonsterile latex gloves. Transecting these at different levels reveals a hollow conduit of variable diameter and wall thickness (Fig. 1). The pliable nature and thin wall of the latex in such gloves allows for the accurate simulation of authentic vessels with the realistic passage of suture material ranging from 8-0 to 11-0 nylon (Fig. 2). After completion of the anastomosis, the ends can be opened perpendicular to the suture line and the sutures inspected individually for accuracy of placement.Fig. 1.: Hollow conduit of variable diameter and wall thickness.Fig. 2.: Accurate simulation of authentic vessels with realistic passage of sutures ranging from 8-0 to 11-0 nylon.The use of latex glove material in microsurgical training has previously been described.3 The technique that we propose has the advantage of increased authenticity and accessibility in that an intact “tube” is readily available without the need for further fabrication as described in the article by Kamath and Kamath.1 Gloves with rolled sleeve ends are used in most hospitals, do not require any further special preparation, and are of low cost. We hope that our idea proves useful to both trainees and trainers in practicing or teaching anastomotic technique on a regular basis. Shakeel Dustagheer, M.R.C.S. Alastair P. Brown, F.R.C.S.(Plast.) Northern Ireland Plastic and Maxillofacial Service Ulster Hospital Belfast, Ireland