Ex Vivo Rabbit: A Novel High-Fidelity Training Model for Microsurgical and Supermicrosurgical Training

Area of Science:

• Biomedical Engineering
• Surgical Training
• Veterinary Anatomy

Background:

• Microsurgical and supermicrosurgical skills are critical for reconstructive surgeons.
• Current in-vivo training models present challenges including limited availability, high costs, and ethical conflicts.
• Existing ex-vivo models often lack the complexity and versatility required for advanced skill development.

Purpose of the Study:

• To evaluate the ex-vivo rabbit as a high-fidelity, inert training model for microsurgery.
• To compare the vascular pedicle characteristics of the ex-vivo rabbit to common vessels used in reconstructive surgery.
• To propose a progressive training regimen utilizing the ex-vivo rabbit model.

Main Methods:

• Ten ex-vivo rabbit dissections were performed.
• Microscopic analysis of the caliber and length of major vascular pedicles was conducted.
• Vascular dimensions were compared to those of typical flaps and recipient vessels in reconstructive surgery.

Main Results:

• The ex-vivo rabbit possesses a range of vascular pedicle calibers (0.4 mm to 2.8 mm), including the internal mammary, iliolumbar artery, brachial, renal, femoral, common carotid, and aorta.
• These vessels accommodate progressive difficulty and diverse microsurgical techniques such as various anastomoses, neurorrhaphies, nerve transfers, and free flap procedures.
• The model allows for practice with vessels of differing sizes.

Conclusions:

• The ex-vivo rabbit is a viable and advantageous alternative to traditional in-vivo and ex-vivo microsurgical training models.
• It overcomes the limitations of in-vivo models by being accessible, inexpensive, and inert.
• It surpasses classic ex-vivo models by offering a broad spectrum of vessel sizes for practicing advanced reconstructive surgery techniques.