Abstract
Background Supermicrosurgery is a technique used for dissection and anastomosis of submillimeter
diameter vessels. This technique requires precise hand movements and superb eye–hand
coordination, making continuous training necessary. Biological in vivo and ex vivo
models have been described for this purpose, the latter being more accessible and
cost-effective. The aim of this study is to present a new ex vivo training model using
a chicken leg.
Methods In 28 chicken legs, an anatomical study was performed. An intramuscular perforator
vessel was identified and dissected. Arterial diameters of 0.7, 0.5, and 0.3 mm were
identified and consistency of the perforator was assessed. In additional 10 chicken
legs, 25 submillimeter arteries were anastomosed using this perforator vessel. Five
arteries of 0.3 and 10 of 0.5 mm were anastomosed with nylon 11–0 and 12–0 sutures.
Intravascular stent (IVaS) technique and open guide (OG) technique were used in 0.5-mm
arteries. A total of 10 arteries of 0.7 mm were anastomosed using 10–0 sutures in
a conventional fashion. Dissection and anastomosis time were recorded and patency
was tested.
Results We were able to identify 0.7 to 0.3 mm diameter arteries in all the specimens and
confirm the consistency of the perforator. The median time for dissection was 13.4
minutes. The median time for anastomosis was 32.3 minutes for 0.3-mm arteries, 24.3
minutes for 0.5-mm arteries using IVaS, 29.5 minutes for the OG technique, and 20.9
minutes for the 0.7 mm diameter arteries. All the anastomoses were permeable.
Conclusion Due to its consistent and adequate diameter vessels, this model is adequate for training
supermicrosurgical skills.
Keywords
supermicrosurgery - supermicrosurgery simulation - supermicrosurgery training
