Name: step by step: microsurgical training method combining two nonliving animal models
Uploaded: 2015-05-09T14:00:00.000+00:00
Duration: 5 min 25 s
Description: Watch this Scientific Journal Video about Step By Step: Microsurgical training method combining two nonliving animal models at JoVE.com

The authors have no acknowledgements.

1. Preparazione: <ol><li> Ottenere un microscopio da tavolo stereo, con una variabile di 3,5 x di zoom 45x, 200 mm di distanza di lavoro, il 55 a 75 mm variabile distanza pupillare e un accessorio luce principale anello. Qualsiasi microscopio simile è adeguata, può essere impostato su un tavolino e non è estremamente costoso. </li><li> Raccogliere e preparare una serie di strumenti di microchirurgia con due pickup di microchirurgia, una forbice da dissezione, e un ago-guida; questo è il minimo richiesto, si deve tener conto del fatto che questi sono strumenti pratica, e strumenti di qualità elevata finali non sono necessari. </li><li> Utilizzare 9/0 monofilamento micro-sutura per tutte le pratiche. Comprare in commercio cosce di pollo o di ali e cibo colorante al supermercato locale. </li><li> A 20 G angio-catetere viene utilizzato per le prove di pervietà sul pollo arterie femorali. Per le arterie brachiale è necessario un più sottile 27 G catetere. Questi possono essere acquistati su internet in una farmacia locale ocon gli strumenti impostati. Comprare una siringa disponibile in commercio per iniettare il colorante alimentare. </li></ol> 2. macroscopiche tecniche di dissezione: <ol><li> L&#39;approccio ai vasi femorali è semplice. Per cosce di pollo, eseguire una tecnica di dissezione smussa appena mediale al diafisi femorale, separare il muscolo femorale dall&#39;osso ed esporre l&#39;arteria femorale, vena e nervi. Il nervo può essere ulteriormente sezionato in due fascicoli distinti per i diversi tipi di pratiche di riparazione dei nervi. </li><li> Per accedere brachiale pollo ali di pollo, incidere la pelle longitudinalmente con una forbice, dalla spalla fino alla punta dell&#39;ala. Osservare l&#39;arteria che corre tra la bicipiti e tricipiti brachiale. </li></ol> 3. regime di allenamento consigliato: <ol><li> Formazione con l&#39;arteria femorale. NOTA: Il primo passo per il regime di allenamento è quello di praticare con il pollo arteria femorale. </li></ol><ol><li> Posizionare il pezzo al microscopio e iniziare la dissezione microchirurgico. Liberare l&#39;arteria femorale dai tessuti sottostanti; e dividerlo orizzontalmente. Eseguire un adventicectomy. Utilizzare i micro-pickup e micro-forbici per tagliare qualsiasi adventicia sovrastante lume arterioso. Sciacquare il lume interno con acqua di rubinetto regolare. Annotare l&#39;ora di inizio </li><li> Eseguire un end to end anastomosi. <ol><li> Avviare sulla parete posteriore dell&#39;arteria sul lato opposto all&#39;operatore. Posizionare il primo punto; avviare sul lato sinistro se si lavora in orizzontale, sul lato inferiore se si lavora in verticale. Passare l&#39;ago dall&#39;esterno dell&#39;arteria verso il lume e quindi dal lume all&#39;esterno dell&#39;arteria. </li><li> Legare il punto, eseguire un doppio nodo, e poi due singoli tiri direzioni alternate. Completa l&#39;intera parete di fondo con la tecnica sopra descritta. </li><li> Iniziando dal lato destro se si lavora in senso orizzontale o il lato superiore, se siete working verticalmente, posizionare un singolo punto dall&#39;esterno verso il lume e quindi dal lume verso l&#39;esterno. Legare il nodo come descritto in precedenza. Completa la parete frontale ripetendo la procedura descritta in 3.1.2.2. </li><li> Annotare il tempo finale questo vi permetterà di tenere un registro di tempo, in modo da poter controllare la vostra progressione. NOTA: Gli autori preferiscono una tecnica a tratta fino; ma qualsiasi tipo di sutura microchirurgica può essere provato. E &#39;raccomandabile che il tirocinante compie circa 25 anastomosi microchirurgiche in questo modo, prima di poter provare altri scenari clinici. Questi includono innesto vena di lacune arteriose, capo all&#39;altro riparazioni nervose, e l&#39;uso di condotti vena per il trattamento delle lacune nervose. Una tecnica importante nella chirurgia microvascolare, che può essere appresa con questo metodo di allenamento è la sutura continua o in esecuzione, per eseguire questa tecnica i proventi tirocinante come 3.1.2.1 ma il stich non viene tagliato, continuerà a svolgere punti come in 3.1.2.1, senza taglio li uino a completare l&#39;intera sutura e legarlo al punto originale alla fine. </li></ol></li></ol><ol start="2"><li> Allenamento con l&#39;arteria brachiale <ol><li> Posizionare il pezzo al microscopio. Completare la procedura descritta sopra per l&#39;arteria femorale. NOTA: L&#39;unica differenza è la dimensione. L&#39;arteria brachiale è molto più piccola l&#39;arteria femorale e l&#39;anastomosi è considerevolmente più difficile. </li></ol></li><li> Test di pervietà <ol><li> Attraversare un 20 o 27 G angio-catetere liscio attraverso l&#39;anastomosi, per verificare la presenza di ostruzioni causate da punti di sutura entrambe le pareti dei vasi insieme. </li><li> Applicare una siringa con commerciale colorante alimentare al fine della angio-catetere, e profumato tingere nell&#39;arteria per verificare l&#39;assenza di perdite jet </li><li> Aprire l&#39;arteria longitudinalmente di visualizzare i punti, il loro parallelismo e la quantità di parete presa. </li></ol></li></ol>

<ol>
	<li>Lee, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Historical+events+on+development+of+experimental+microsurgical+organ+transplantation.">Historical events on development of experimental microsurgical organ transplantation.</a> Yonsei Med J. 45 (6), 1115-1120 (2004).</li><li>Shurey, S., Akelina, Y., Legagneux, J., Malzone, G., Jiga, L., Ghanem, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+rat+model+in+microsurgery+education:+classical+exercises+and+new+horizons.">The rat model in microsurgery education: classical exercises and new horizons.</a> Arch Plast Surg. 41 (3), 201-208 (2014).</li><li>Olabe, J., Olabe, J., Sancho, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+cadaveric+infusi&#243;n+model+for+neurosurgical+training.">Human cadaveric infusi&#243;n model for neurosurgical training.</a> Surg Neurol. 72, 700-702 (2009).</li><li>Peled, I. J., Kaplan, H. Y., Wexler, M. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microsilicone+anastomoses.">Microsilicone anastomoses.</a> Ann Plast Surg. 10 (4), 331-332 (1983).</li><li>Gluer, N. M., Rao, G. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Canniesburn+&#8220;ever-ready&#8221;+model+to+practise+microsurgery.">Canniesburn &#8220;ever-ready&#8221; model to practise microsurgery.</a> Br J Plast Surg. 43 (3), 381-382 (1990).</li><li>Hino, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Training+in+microvascular+surgery+using+a+Chicken+wing+artery.">Training in microvascular surgery using a Chicken wing artery.</a> Neurosurgery. 52 (6), 1495-1498 (2003).</li><li>Marsh, D. J., Norton, S. E., Mok, J., Patel, H. D., Chen, H. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microsurgical+training+the+Chicken+thigh+model.">Microsurgical training the Chicken thigh model.</a> Ann Plast Surg. 59 (3), 355-356 (2007).</li><li>Jeong, H. S., Moon, M. S., Kim, H. S., Lee, H. K., Yi, S. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microsurgical+training+with+fresh+chicken+legs+and+their+histological+characteristics.">Microsurgical training with fresh chicken legs and their histological characteristics.</a> Ann Plast Surg. 70 (1), 57-61 (2013).</li><li>Couceiro, J., Ozyurekoglu, T., Sanders, S., Tien, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microsurgical+training+regimen+with+nonliving+chicken+models.">Microsurgical training regimen with nonliving chicken models.</a> Microsurgery. 33 (3), 251-252 (2013).</li><li>Phoon, A. F., Gumley, G. J., Rtshiladze, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microsurgical+training+using+a+pulsatile+membrane+pump+and+chicken+thigh:+A+new,+realistic,+practical,+nonliving+educational+model.">Microsurgical training using a pulsatile membrane pump and chicken thigh: A new, realistic, practical, nonliving educational model.</a> Plast Reconstr Surg. 126 (5), 278e-279e (2010).</li><li>Zhou, Y., Gu, X., Xiang, J., Qian, S., Chen, Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparative+study+on+suture+versus+cuff+anastomosis+in+mouse+cervical+cardiac+transplant.">A comparative study on suture versus cuff anastomosis in mouse cervical cardiac transplant.</a> Exp Clin Transplant. 8 (3), 245-249 (2010).</li></ol>

The authors have nothing to disclose.

The clinical practice of microsurgery requires a continuous practice and a high level of expertise; it&#8217;s applications include free flaps, replantation and revascularization procedures, intracranial &#8211; extracranial anastomoses for neurosurgical procedures, peripheral nerve surgery and others. In spite of the wide variety of procedures that require microsurgical techniques, some of them are seldom performed in many centers. The surgeons therefore need sometimes to maintain their skill level rehearsing the surge...

An ample array of training models have been described for the learning and maintenance of both basic and advanced microsurgical skills. These include living animals1,2, human cadaveric specimens3, inert models4,5 and non-living animal models6-9.The Living animal models, specifically those using rats have been extensively used in the teaching of microsurgery 1,2; and they are considered the current gold standard of training. In spite of their remarkable instructive value, when an intensive or prolonged training is required; economical and ethical concerns can hinder their practical usage. 
Cadaveric models3 offer the opportunity to practice in an environment similar to that of the actual clinical situation; they are unfortunately restricted to anatomy labs and similar facilities, a microscope must be available at the lab as well; these models are therefore not widely available. Inert models such as rubber tubes, or gloves4,5 are cheap, and easily accessible, the required equipment for their application is minimal. The resemblance to a clinical situation is tenuous however; and their application is generally limited to the introductory stages of training, before the trainee starts practicing on rats. To the best of our knowledge Hino6 was the first to propose the use of non-living chicken for the development and maintenance of clinical microsurgical skills. His model is based on the extraction and subsequent usage of the chicken brachial artery from commercial chicken wings. This approach does not need institution review board approval, rodent anaesthesia, laboratory technicians or postoperative care. 
Following Hino&#180;s description of the chicken wing artery model numerous other nonliving animal models were published. The use of commercial chicken thighs was first suggested by Marsh et al.7 who reported the use of the femoral artery, vein and nerve for didactic purposes. This particular model expands the possibilities of training including structures different from the arteries; it permits the trainee to perform a variety of complex procedures such as vein grafts, nerve grafts or fascicular repairs. Jeong et al.8 Further studied Marsh&#8217; chicken thigh model and its applications to the teaching of resident doctors. The authors analysed chicken tissue samples histologically and found that it presented similarities to human tissues. The time to perform an anastomosis by the trainee was significantly reduced by practice in their study. They concluded that &#8220;the femoral neurovascular bundles of chicken are an appropriate and effective model for teaching and practicing microsurgery&#8221;. In 2013 my colleagues and I9 published a microsurgical training regimen that combined both the chicken thigh and the chicken wing models; this approach benefits from the versatility of the chicken thighs and from the limited size of the chicken wing artery which can represent more of a challenge than the femoral vessels for the more advanced trainees. 
On the current manuscript we describe step by step the process of setting up a microsurgical practice station; the materials required, how to dissect the neurovascular structures of each model and how to effectively apply the training regimen.

<table><tbody><tr><td>Stereomicroscope</td><td>Amscope</td><td>SM-1BX</td><td>Microscope</td></tr><tr><td>Led light</td><td>Amscope</td><td>LED-80S-YA</td><td>illumination system</td></tr><tr><td>Microsurgical instruments set</td><td>Chen hen microsurgical instruments</td><td>HC- X803-1</td><td>Microsurgical instruments</td></tr><tr><td>Microsurgical sutures</td><td>S/T microsurgical</td><td>9/0 Suture</td><td>Sutures</td></tr></tbody></table>

step by step: microsurgical training method combining two nonliving animal models

The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly laboratory rats. This method although extremely valuable can be economically demanding both for the surgeon and the sponsoring institution; it also requires special training facilities that may not always be available or accessible. Furthermore ethical concerns can limit the use of living animals for training purposes. Alternative training methods, such as inert tubes and gloves have not gained popularity among surgeons since they do not offer an experience similar to that of a clinical situation. Non-living animal models include the use of chicken thighs and wings; they offer a practice experience that resembles a clinical situation to a considerable extent. This type of training is relatively cheap and easily available. The microscope and instruments required can be acquired over the internet, and the chicken pieces can be bought at the local supermarket.
This approach allows a motivated trainee to rehearse different types of surgical techniques several times at a reasonable expense, helping to develop or maintain his surgical expertise if more complex facilities are not available. On the current manuscript we describe how to setup a small practice station, how to dissect the specimens, and how to practice both with the chicken thighs and with the chicken wings in a progressive fashion. This approach takes advantage on the versatility of the chicken thigh model and the small size of the chicken wing Brachial artery.

Gli autori hanno chronometered loro tempi con il presente metodo di formazione e hanno visto ridurre sensibilmente i tempi per una anastomosi dell&#39;arteria femorale alla fine della terza settimana. Il tirocinante può controllare i miglioramenti sulla sua tecnica controllando i suoi tempi, le sue percentuali di pervietà e l&#39;allineamento dei suoi punti di sutura. Il sistema descritto in questo manoscritto è illustrato nella figura 1 comprende un microscopio da tavolo e una serie di strumenti di microchirurgia. L...

Watch this Scientific Journal Video about Step By Step: Microsurgical training method combining two nonliving animal models at JoVE.com

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

Passo dopo passo: metodo di allenamento Microsurgical combinare due modelli animali non viventi

Here we describe how to set up a small microsurgical practice station and a simple and inexpensive method for the training of microsurgery with non-living animal models.

The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly ...

step-step-microsurgical-training-method-combining-two-nonliving

Research

JoVE Journal

Medicine

15.2K Views.  POVISA Hospital. Here we describe how to set up a small microsurgical practice station and a simple and inexpensive method for the training of microsurgery with non-living animal models. 

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

Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique

Mouse models are of special interest in research since a wide variety of monoclonal antibodies and commercially defined inbred and knockout strains are available to perform mechanistic in vivo studies. While heart transplantation models using a suture technique were first successfully developed in rats, the translation into an equally widespread used murine equivalent was never achieved due the technical complexity of the microsurgical procedure. In contrast, non-suture cuff techniques, also developed initially in rats, were successfully adapted for use in mice1-3. This technique for revascularization involves two major steps I) everting the recipient vessel over a polyethylene cuff; II) pulling the donor vessel over the formerly everted recipient vessel and holding it in place with a circumferential tie. This ensures a continuity of the endothelial layer, short operating time and very high patency rates4.
Using this technique for vascular anastomosis we performed more than 1,000 cervical heart transplants with an overall success rate of 95%. For arterial inflow the common carotid artery and the proximal aortic arch were anastomosed resulting in a retrograde perfusion of the transplanted heart. For venous drainage the pulmonary artery of the graft was anastomosed with the external jugular vein of the recipient5.
Herein, we provide additional details of this technique to supplement the video.

The murine cervical heart transplantation model is well suited for immunological as well as ischemia reperfusion injury studies. We modified the procedure using a non-suture cuff technique and performed more than 1,000 successful transplants with this approach.
Herein, we provide additional details of this technique to supplement the video.

Murino cervicale Cuore trapianto Modello utilizzando una tecnica Cuff Modificato

Mouse models are of special interest in research since a wide variety of monoclonal antibodies and commercially defined inbred and knockout strains are ...

Ricerca

Medicina

Tracciamento in tempo reale di nanoparticelle nei tumori cerebrali utilizzando 2P-IVM nei topi

Two-Photon Intravital Microscopy of Glioblastoma in a Murine Model

The delivery of intravenously administered cancer therapeutics to brain tumors is limited by the blood-brain barrier. A method to directly image the accumulation and distribution of macromolecules in brain tumors in vivo would greatly enhance our ability to understand and optimize drug delivery in preclinical models. This protocol describes a method for real-time in vivo tracking of intravenously administered fluorescent-labeled nanoparticles with two-photon intravital microscopy (2P-IVM) in a mouse model of glioblastoma (GBM).
The protocol contains a multi-step description of the procedure, including anesthesia and analgesia of experimental animals, creating a cranial window, GBM cell implantation, placing a head bar, conducting 2P-IVM studies, and post-surgical care for long-term follow-up studies. We show representative 2P-IVM imaging sessions and image analysis, examine the advantages and disadvantages of this technology, and discuss potential applications.
This method can be easily modified and adapted for different research questions in the field of in vivo preclinical brain imaging.

Autore in primo piano: Strategie di imaging multimodale per ottimizzare la somministrazione di farmaci e la diagnosi precoce nel trattamento del glioblastoma

We present a novel approach for two-photon microscopy of the tumor delivery of fluorescent-labeled iron oxide nanoparticles to glioblastoma in a mouse model.

Microscopia intravitale a due fotoni del glioblastoma in un modello murino

The delivery of intravenously administered cancer therapeutics to brain tumors is limited by the blood-brain barrier. A method to directly image the ...

Ricerca sul cancro

<meta charset="utf8"></head><body>Riparazione comune dell'arteria carotide dopo l'iniezione in un modello murino

Facilitating Repeat Intracarotid Injections in Mouse Models by a Novel Injection Site Repair Technique

Given recent advances in the delivery of novel antitumor therapeutics using endovascular selective intraarterial delivery methods in neuro-oncology, there is an urgent need to develop methods for intracarotid injections in mouse models, including methods to repair the carotid artery in mice after injection to allow for subsequent injections. We developed a method of intracarotid injection in a mouse model to deliver therapeutics into the internal carotid artery (ICA) with two alternative procedures. 
During injection, the needle is inserted into the common carotid artery (CCA) after tying a suture around the external carotid artery (ECA) and injected therapeutics are delivered into the ICA. Following injection, the common carotid artery (CCA) can be ligated, which limits the number of intracarotid injections to one. The alternative procedure described in this article includes a modification where intracarotid artery injection is followed by injection site repair of the CCA, which restores blood flow within the CCA and avoids the complication of cerebral ischemia seen in some mouse models. 
We also compared the delivery of bone marrow-derived human mesenchymal stem cells (BM-hMSCs) to intracranial tumors when delivered through intracarotid injection with and without injection site repair following the injection. Delivery of BM-hMSCs does not differ significantly between the methods. Our results demonstrate that injection site repair of the CCA allows for repeat injections through the same artery and does not impair the delivery and distribution of injected material, thus providing a model with greater flexibility that more closely emulates intracarotid injection in humans.

<meta charset="utf8"></head><body>Autore in primo piano: Avanzamento del trattamento del glioblastoma attraverso strategie di somministrazione intraarteriosa per virus oncolitici e microRNA

Repair of the intracarotid artery in a mouse model after injection returns blood flow to the artery without negatively impacting the distribution of the injected material. Injection site repair facilitates subsequent injections through the same artery and prevents cerebral ischemia in mouse strains that lack a complete Circle of Willis.

Facilitare la ripetizione delle iniezioni intracarotidei in modelli murini mediante una nuova tecnica di riparazione del sito di iniezione

Given recent advances in the delivery of novel antitumor therapeutics using endovascular selective intraarterial delivery methods in neuro-oncology, there ...

A Novel Microsurgical Model for Heterotopic, En Bloc Chest Wall, Thymus, and Heart Transplantation in Mice

Exploration of novel strategies in organ transplantation to prolong allograft survival and minimizing the need for long-term maintenance immunosuppression must be pursued. Employing vascularized bone marrow transplantation and co-transplantation of the thymus have shown promise in this regard in various animal models.1-11 Vascularized bone marrow transplantation allows for the uninterrupted transfer of donor bone marrow cells within the preserved donor microenvironment, and the incorporation of thymus tissue with vascularized bone marrow transplantation has shown to increase T-cell chimerism ultimately playing a supportive role in the induction of immune regulation. The combination of solid organ and vascularized composite allotransplantation can uniquely combine these strategies in the form of a novel transplant model. Murine models serve as an excellent paradigm to explore the mechanisms of acute and chronic rejection, chimerism, and tolerance induction, thus providing the foundation to propagate superior allograft survival strategies for larger animal models and future clinical application. Herein, we developed a novel heterotopic en bloc chest wall, thymus, and heart transplant model in mice using a cervical non-suture cuff technique. The experience in syngeneic and allogeneic transplant settings is described for future broader immunological investigations via an instructional manuscript and video supplement.

To study combined solid organ and vascularized composite allotransplantation, we describe a novel heterotopic en bloc chest wall, thymus, and heart transplant model in mice using a cervical non-suture cuff technique.

A Novel microchirurgica modello per eterotopica, in blocco parete toracica, Timo, e trapianto cardiaco nei topi

Exploration of novel strategies in organ transplantation to prolong allograft survival and minimizing the need for long-term maintenance immunosuppression ...

Surgical Training for the Implantation of Neocortical Microelectrode Arrays Using a Formaldehyde-fixed Human Cadaver Model

This protocol describes a procedure to assist surgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain. Recent technological progress has enabled the fabrication of microelectrode arrays that allow recording the activity of multiple individual neurons in the neocortex of the human brain. These arrays have the potential to bring unique insight onto the neuronal correlates of cerebral function in health and disease. Furthermore, the identification and decoding of volitional neuronal activity opens the possibility to establish brain-computer interfaces, and thus might help restore lost neurological functions. The implantation of neocortical microelectrode arrays is an invasive procedure requiring a supra-centimetric craniotomy and the exposure of the cortical surface; thus, the procedure must be performed by an adequately trained neurosurgeon. In order to provide an opportunity for surgical training, we designed a procedure based on a human cadaver model. The use of a formaldehyde-fixed human cadaver bypasses the practical, ethical and financial difficulties of surgical practice on animals (especially non-human primates) while preserving the macroscopic structure of the head, skull, meninges and cerebral surface and allowing realistic, operating room-like positioning and instrumentation. Furthermore, the use of a human cadaver is closer to clinical daily practice than any non-human model. The major drawbacks of the cadaveric simulation are the absence of cerebral pulsation and of blood and cerebrospinal fluid circulation. We suggest that a formaldehyde-fixed human cadaver model is an adequate, practical and cost-effective approach to ensure proper surgical training before implanting microelectrode arrays in the living human neocortex.

We designed a procedure in which a formaldehyde-fixed human cadaver is used to assist neurosurgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain.

Training chirurgico per l'impianto di microelettrodi Neocortical utilizzando un modello di cadavere umano formaldeide-fisso

This protocol describes a procedure to assist surgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain. ...

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators

Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome (TTTS), but is technically challenging and can lead to significant complications. Acquiring and maintaining the necessary surgical skills require consistent practice, a critical caseload, and time. Training on realistic surgical simulators can potentially shorten this steep learning curve and enables several proceduralists to acquire procedure-specific skills simultaneously. Here we describe realistic simulators designed to allow the user familiarity with the equipment and specific steps required in the surgical treatment of TTTS, including fetoscopic handling, approaches to anterior and posterior placenta, recognition of anastomoses, and efficient coagulation of vessels. We describe the skills that are especially important in conducting placental laser coagulation that the surgeon can practice on the model and apply in a clinical case. These models can be adapted easily depending on the availability of materials and require standard fetoscopy equipment. Such training systems are complementary to traditional surgical apprenticeships and can be useful aids for fetal medicine units that provide this clinical service.

Practicing the specific skills required for fetoscopic laser coagulation of monochorionic placental anastomoses on realistic models can aid less experienced surgeons in overcoming the steep learning curve associated with this procedure that is now regarded as the standard of care for twin-twin transfusion syndrome.

Modello di Training chirurgico: Acquisizione di competenze in photocoagulation del Laser Fetoscopic di Monochorionic Diamniotic Twin Placenta utilizzando simulatori realistici

Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome ...

Passo dopo passo: metodo di allenamento Microsurgical combinare due modelli animali non viventi

Riepilogo

Esplora Altri Video

Capitoli in questo video

Murino cervicale Cuore trapianto Modello utilizzando una tecnica Cuff Modificato

Microscopia intravitale a due fotoni del glioblastoma in un modello murino

Microscopia intravitale a due fotoni del glioblastoma in un modello murino

Microscopia intravitale a due fotoni del glioblastoma in un modello murino

Facilitare la ripetizione delle iniezioni intracarotidei in modelli murini mediante una nuova tecnica di riparazione del sito di iniezione

Facilitare la ripetizione delle iniezioni intracarotidei in modelli murini mediante una nuova tecnica di riparazione del sito di iniezione

Facilitare la ripetizione delle iniezioni intracarotidei in modelli murini mediante una nuova tecnica di riparazione del sito di iniezione

A Novel microchirurgica modello per eterotopica, in blocco parete toracica, Timo, e trapianto cardiaco nei topi

Training chirurgico per l'impianto di microelettrodi Neocortical utilizzando un modello di cadavere umano formaldeide-fisso

Modello di Training chirurgico: Acquisizione di competenze in photocoagulation del Laser Fetoscopic di Monochorionic Diamniotic Twin Placenta utilizzando simulatori realistici