A Novel Supermicrosurgery Training Model: Exercise for Lymphovenular Anastomosis.

Area of Science:

• Surgical Training
• Microsurgery
• Vascular Surgery

Background:

• Supermicrosurgery, particularly lymphovenular anastomosis (LVA), requires specialized training.
• Current training models often lack realistic lymphatic vessel simulation and dynamic postoperative assessment.

Purpose of the Study:

• To develop a novel, reproducible, and user-friendly animal model for supermicrosurgical training.
• To provide realistic simulation of lymphatic vessels and enable dynamic postoperative observation.

Main Methods:

• Adult male Sprague-Dawley rats underwent supermicrosurgical training on caudal lymphatic vessels (0.3 mm) and veins (0.3-0.8 mm).
• Lymphatic vessels were visualized using methylene blue, and anastomotic patency was assessed postoperatively via melphalan staining and perfusion tests.
• Trainees performed end-to-end and end-to-side LVAs, completing at least 20 anastomoses per session.

Main Results:

• The rat caudal LVA model provided realistic simulation of thin-walled lymphatic vessels, comparable to clinical lymphedema cases.
• The model allowed for dynamic observation of anastomoses and assessment of patency.
• Trainees demonstrated proficiency in LVA techniques, with the model facilitating repeated practice and evaluation.

Conclusions:

• The rat caudal LVA model is a highly reproducible and practical tool for supermicrosurgical training.
• This model overcomes limitations of existing methods by being simple, cost-effective, and clinically relevant.
• It is ideal for advancing LVA skills and preparing surgeons for real-world lymphedema treatment scenarios.