Various handcrafted artificial vessels: Evaluation of practicality and feasibility for supermicrosurgery training

Supermicrosurgery demands more refined skills compared to traditional microsurgery, necessitating comprehensive training prior to clinical implementation. Despite the existence of various training models, they often fall short in terms of cost, ethical considerations, and infection risk. Our objective was to develop and evaluate novel training models for supermicrosurgery that are cost-effective, ethical, and risk-free.

We fabricated tubes using polyvinyl alcohol (PVA) liquid glue, polyvinyl acetate resin (PAR) wood glue, and hydrocolloid dressing (HCD), aiming to identify suitable, low-cost candidates for a supermicrosurgery training model. These tubes were anastomosed under a microscope using 10-0 or 11-0 nylon sutures. We assessed the time and cost involved in tube fabrication, their diameters, and the overall feasibility of the models.

The average time and cost to fabricate a 15-mm-long luminal tube were 33.5 min and 0.02 USD for the PVA group, 23 min and 0.02 USD for the PAR group, and 63 s and 0.40 USD for the HCD group, respectively. The average diameter of the tubes was 0.49, 0.58, and 1.55 mm in the PVA, PAR, and HCD groups, respectively. The PVA and PAR tubes, with their transparent and thin walls, facilitated easier evaluation of anastomosis patency compared to the HCD tubes.

We successfully used non-living materials to develop new supermicrosurgery training models, characterized by their low cost, absence of ethical concerns, and elimination of infection risk. The PAR and PVA tubes, in particular, are suitable for resident training in supermicrosurgery.