Abstract
Clinical microsurgery has been introduced in many fields, while experimental microsurgery has the cross-disciplinary features of the sciences and techniques for growth of medicine, pharmacology, veterinary, engineering etc. Training protocol, proposing a new name as Translational Microsurgery, was introduced. Reconstructive skills of hepatic artery in pediatric living donor liver transplantation were summarized. Ex vivo training protocol using artificial blood vessel for surgeons was proposed. Clinical microsurgery requires anastomosis with delicate arteries and limited field of view. Our training protocol revealed that the relation between the score and speed was seen, while not all the surgeons with enough experience got high score. This training led to muster clinical skills and to apply excellent experimental works. Our microsurgical training protocol has been planned from the points of clinical setting. Training for vascular anastomosis led to rodent transplantation models. These models were used for immunology and immunosuppressant research. Microsurgical techniques led to master catheter technique and to inject various drugs or gene vectors.
Highlights
Clinical microsurgery is a technique for working on microscopic areas under a stereomicroscope or loupe
It is worth while saying that microsurgical techniques necessary to perform procedures in humans are same as that in mice or rats
It is possible to see the technical level by sacrificing the rat about 7 days after this surgical procedure and observing the anastomosis area (Figure 4A)
Summary
Clinical microsurgery is a technique for working on microscopic areas under a stereomicroscope or loupe. Many rat organ transplantation models had been developed, and the International Society for Experimental Microsurgery (ISEM) was established in 1991 by Sun Lee, who had disseminated experimental microsurgical technique[2,3]. The goal of this society is to disseminate research on experimental microsurgery around the world, and the society is characterized by its extremely varied cross-section across fields such as medicine, pharmacology, and veterinary medicine. Translational technique training from the view point of clinical transplantation Experimental producers were conducted according to the guidelines of the Animal Care Committee of Keio University. In microsurgery in living donor liver transplantations, anastomosis is performed in a severely limited field of view and has difficulty as in brain surgery. After stitching the anterior surface with knotted sutures and pulling up the support thread for each side (Figure 3C), flip over and suture (Figure 3D)
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