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Is there good simulation basic training for end-to-side vascular microanastomoses?

Franck Marie P Leclère1, Mario Trelles, Gregory A Lewbart

  • 1Department of Plastic and Hand Surgery, Inselspital Bern, University of Bern, Freiburgstrasse, Bern, Switzerland. franckleclere@yahoo.fr

Aesthetic Plastic Surgery
|February 12, 2013
PubMed
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Earthworms provide a cost-effective and ethical model for microsurgical training, significantly reducing anastomosis time and improving dexterity. This model overcomes limitations of traditional animal models for practicing microvascular anastomosis.

Area of Science:

  • Biomedical Engineering
  • Surgical Training
  • Veterinary Science

Background:

  • Microvascular anastomosis is crucial for free tissue transfers, requiring extensive laboratory training.
  • Traditional animal models present challenges including ethical concerns, high costs, complex anesthesia, and preparation time.
  • Limitations of current models include weekend laboratory closures and significant time investment.

Purpose of the Study:

  • To identify and evaluate an animal model that circumvents the limitations of traditional methods for microsurgical training.
  • To assess the efficacy of earthworms as a model for practicing end-to-side vascular microanastomosis.
  • To determine the impact of training duration and vessel size on anastomosis time and skill acquisition.

Main Methods:

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  • Utilized 91 earthworms for 150 microsurgical training exercises simulating end-to-side vascular microanastomosis over ten 7-day periods.
  • Training included simulations on vessel diameters >1.5 mm, 1.0-1.5 mm, and <1.0 mm.
  • A linear model analyzed trends in anastomosis time based on training weeks and animal size.

    • Main Results:

    • Significant improvement in anastomosis time and dexterity was observed over the training period (p<0.001).
    • Mean anastomosis time decreased by 42.5% for vessels >1.5 mm, 43.2% for 1.0-1.5 mm, and 40.9% for <1.0 mm.
    • Dexterity and speed of knot execution significantly improved with training.

    Conclusions:

    • Earthworms serve as a reliable and advantageous experimental model for microsurgical training in end-to-side microanastomosis.
    • The earthworm model effectively addresses ethical, cost, and time constraints associated with traditional training methods.
    • The use of earthworms for microsurgical training is predicted to increase significantly in the future.