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Updated: May 28, 2026

Step By Step: Microsurgical training method combining two nonliving animal models

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Published on: May 9, 2015

Taking microvascular training through the elevator: institutional experience in structured microsurgical training in

Navneet Kaur^1,2, Vineet Kumar^1,2, Mayur Mantri^1,2

¹Department of plastic & reconstructive surgery, Tata Memorial Hospital, Mumbai, India.

Maxillofacial Plastic and Reconstructive Surgery

|May 27, 2026

Summary

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A new structured microsurgical training program significantly shortened the learning curve for plastic surgery residents in India. This simulation-based approach maintained high patient care standards, demonstrating an effective method for accelerating surgical competency.

Area of Science:

Microsurgery
Plastic Surgery
Surgical Education

Background:

Microsurgery is crucial for oncological reconstructions in plastic surgery.
Traditional Indian training is lengthy (approx. 12 years).
Rising cancer incidence necessitates expedited training.

Purpose of the Study:

To implement and evaluate a structured, accelerated microsurgical training program for plastic surgery residents.
To assess the impact of simulation-based training on resident competency and patient outcomes.

Main Methods:

A four-phase program using Peyton's four-step approach and simulation (latex gloves, silicon tubes, rat models).
Objective assessment via the Microsurgical Anastomosis Rating Scale (MARS10) for progression.
Residents progressed from assisting to independently performing microsurgical procedures.

Keywords:

Breast reconstruction Competency-based training Free flap surgery Head and neck reconstruction Microsurgery Structured training

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Main Results:

High flap survival rate (94.73%) in resident-performed surgeries, comparable to the institute's overall rate (95.53%).
No significant difference in outcomes between resident-performed and overall surgeries (p=0.812).
Residents performed 73-79 flap harvests and 18-22 microvascular anastomoses each.

Conclusions:

The structured training model effectively reduced the microsurgical learning curve.
Simulation-based practice and objective assessment maintain high patient care standards.
The program provides a replicable framework for accelerating microsurgical competency.