In Search of Ideal Low-Cost Blood Vessel Simulators for Microsurgical Education

Microsurgical training is essential but often limited by cost and access. Simulation plays a central role in microsurgical education, where repetition drives skill acquisition. This study evaluated low-cost, accessible materials such as bucatini pasta, konjac noodle, Biomet silicone, Dragon skin silicone, and chicken thigh for their potential use in microsurgical training, aiming to broaden access globally.

Following a preliminary assessment, four materials were selected (bucatini was excluded). Five students and five residents were enrolled. Participants completed a presurvey and then performed anastomoses on each material. Metrics recorded included lumen and vessel diameter, time to complete the task, number of sutures, and patency. A postsurvey was followed. Data were analyzed using Kruskal-Wallis test, Drunn's test (post hoc), and Wilcoxon Rank-Sum test.

The median time to perform an anastomosis was 29 min for students and 10.5 min for residents. Across materials, there were differences in both vessel diameter in the resident and student vessels (P = 0.0026 and 0.0094, respectively) and wall thickness in the student group (P = 0.0048). Before the experiment, 80% of students and 40% of residents anticipated realism. Afterward, 60% of students and all residents agreed that the experience was realistic; all participants found it valuable. The chicken thigh model was rated most enjoyable by 90% of participants.

Low-cost models enabled successful anastomoses across experience levels. These accessible materials offer practical, scalable options to potentially enhance microsurgical education and outreach worldwide.