J Reconstr Microsurg
DOI: 10.1055/s-0040-1714428
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Novel Porcine Kidney-Based Microsurgery Training Model for Developing Basic to Advanced Microsurgical Skills

Jose Maciel Caldas dos Reis
1  Department of Experimental Surgery, State University of Para Belem, Para, Brazil
,
Renan Kleber Costa Teixeira
1  Department of Experimental Surgery, State University of Para Belem, Para, Brazil
,
Deivid Ramos dos Santos
2  Department of Orthopedic Surgery, State University of Para Belem, Para, Brazil
,
Faustino Chaves Calvo
1  Department of Experimental Surgery, State University of Para Belem, Para, Brazil
,
Nayara Pontes de Araújo
1  Department of Experimental Surgery, State University of Para Belem, Para, Brazil
,
Wender Jesus Pena de Corrêa Junior
1  Department of Experimental Surgery, State University of Para Belem, Para, Brazil
,
Antonio Leonardo Jatahi Cavalcanti Pimentel
1  Department of Experimental Surgery, State University of Para Belem, Para, Brazil
,
Rui Sergio Monteiro de Barros
2  Department of Orthopedic Surgery, State University of Para Belem, Para, Brazil
› Author Affiliations
Further Information

Publication History

18 March 2020

16 June 2020

Publication Date:
22 July 2020 (online)

Abstract

Background Microsurgery training is critical to the practice of microvascular procedures in many surgical areas. However, even simple procedures require different levels of complex skills. Therefore, simulation-based surgical training, mainly in the area of vascular anastomosis, is of great importance. In this paper, we present a new microsurgery training model for the development of basic to advanced microsurgical skills.

Methods Porcine kidneys were purchased from a legal butchery slaughterhouse. First, kidneys were washed with water to remove blood and clots inside vessels. Then, dissection was performed throughout the vascular pedicle from the renal arteries to the segmentary branches. Finally, the longitudinal sectioning of the kidney parenchyma was performed to expose the vessels necessary for training. Sixty end-to-end anastomoses were performed. Specific instruments and materials were used to perform anastomoses and dissections with magnification by a video system. We evaluated the diameter of vessels, time to perform anastomosis, and patency of anastomosis.

Results There was no great anatomical variation among the porcine kidneys. The total length for dissection training was 25.80 ± 7.44 cm using the arterial and venous vessel. The average time to perform arterial anastomoses was 23.79 ± 4.55 minutes. For vessel diameters of ≤ 3, 4 to 6, and 7 to 10 mm, the average procedure times were 27.68 ± 3.39, 22.92 ± 4.12, and 20.77 ± 3.44 minutes, respectively. Regarding venous anastomosis, the average duration of the procedure was 26.17 ± 4.80 minutes, including durations of 31.61 ± 3.86, 25.66 ± 4.19, and 21.24 ± 3.79 minutes for vessel diameters of ≤ 7, 8 to 10, and >10 mm, respectively. Positive patency was achieved in all surgeries.

Conclusion The porcine kidney provides an inexpensive and convenient biological model for modeling microanastomosis with high fidelity to vascular structures.