Gustavo Perez-Abadia1,2, Lukas Pindur3,4, Johannes Frank5, Ingo Marzi5, Michael Sauerbier4, Sean M Carroll6, Luis Schnapp7,8, Manuel Mendez8, Sergio Sepulveda9, Paul Werker10, Xavier Libouton11, Oliver Barbier11, Jean-Paul Dehoux11, Marcelo E Maquieira12, Cuahutemoc Marques Espriella13, Irving Joshua14, Zachri N Ovadja3,15, Markus Spingler16, John H Barker3. 1. Department of Physiology, University of Louisville, Louisville, KY, USA. microsurgerycourse@gmail.com. 2. Department of Orthopedic Surgery, Director, Louisville MicroSurgery Teaching Course, University of Louisville, 511 S Floyd Street, 328F, MDR, Louisville, KY, 40292, USA. microsurgerycourse@gmail.com. 3. Frankfurt Initiative for Regenerative Medicine, JW Goethe-University, Frankfurt am Main, Germany. 4. Department of Plastic, Hand and Reconstructive Surgery, BG Trauma Center, Frankfurt am Main, Germany. 5. Department of Trauma, Hand and Reconstructive Surgery, JW Goethe-University, Frankfurt am Main, Germany. 6. Plastic Surgical Training to the Royal College of Surgeons in Ireland, Dublin, Ireland. 7. School of Medicine, University of Chile, Santiago, Chile. 8. Traumatologia and Orthopedica, Clinica Las Condes, Santiago, Chile. 9. Cirugia Plastica, Clinica Alemana, Santiago, Chile. 10. Department of Plastic and Reconstructive Surgery, University Medical Center Groningen, Groningen, The Netherlands. 11. Orthopedic and Traumatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium. 12. Traumatology and Hand Surgery, Buenos Aires, Argentina. 13. Department Plastic and Reconstructive PEMEX, Mexico City, Mexico. 14. Department of Physiology, University of Louisville, Louisville, KY, USA. 15. Department of Plastic, Reconstructive and Hand Surgery, AMC, Amsterdam, The Netherlands. 16. Microsurgical Instruments, S&T AG, Neuhausen am Rheinfall, Switzerland.
Abstract
PURPOSE: Microvascular surgery requires highly specialized and individualized training; most surgical residency training programs are not equipped with microsurgery teaching expertise and/or facilities. The aim of this manuscript was to describe the methodology and clinical effectiveness of an international microsurgery course, currently taught year-round in eight countries. METHODS: In the 5-day microsurgery course trainees perform arterial and venous end-to-end, end-to-side, one-way-up, and continuous suture anastomoses and vein graft techniques in live animals, supported by video demonstrations and hands-on guidance by a full-time instructor. To assess and monitor each trainee's progress, the course's effectiveness is evaluated using "in-course" evaluations, and participant satisfaction and clinical relevance are assessed using a "post-course" survey. RESULTS: Between 2007 and 2017, more than 600 trainees participated in the microsurgery course. "In-course" evaluations of patency rates revealed 80.3% (arterial) and 39% (venous) performed in end-to-end, 82.7% in end-to-side, 72.6% in continuous suture, and 89.5% (arterial) and 62.5% (venous) one-way-up anastomoses, and 58.1% in vein graft technique. "Post-course" survey results indicated that participants considered the most important components of the microcourse to be "practicing on live animals", followed by "the presence of a full-time instructor". In addition, almost all respondents indicated that they were more confident performing clinical microsurgery cases after completing the course. CONCLUSIONS: Microvascular surgery requires highly specialized and individualized training to achieve the competences required to perform and master the delicate fine motor skills necessary to successfully handle and anastomose very small and delicate microvascular structures. The ever-expanding clinical applications of microvascular procedures has led to an increased demand for training opportunities. By teaching time-tested basic motor skills that form the foundation of microsurgical technique this international microsurgery-teaching course is helping to meet this demand.
PURPOSE: Microvascular surgery requires highly specialized and individualized training; most surgical residency training programs are not equipped with microsurgery teaching expertise and/or facilities. The aim of this manuscript was to describe the methodology and clinical effectiveness of an international microsurgery course, currently taught year-round in eight countries. METHODS: In the 5-day microsurgery course trainees perform arterial and venous end-to-end, end-to-side, one-way-up, and continuous suture anastomoses and vein graft techniques in live animals, supported by video demonstrations and hands-on guidance by a full-time instructor. To assess and monitor each trainee's progress, the course's effectiveness is evaluated using "in-course" evaluations, and participant satisfaction and clinical relevance are assessed using a "post-course" survey. RESULTS: Between 2007 and 2017, more than 600 trainees participated in the microsurgery course. "In-course" evaluations of patency rates revealed 80.3% (arterial) and 39% (venous) performed in end-to-end, 82.7% in end-to-side, 72.6% in continuous suture, and 89.5% (arterial) and 62.5% (venous) one-way-up anastomoses, and 58.1% in vein graft technique. "Post-course" survey results indicated that participants considered the most important components of the microcourse to be "practicing on live animals", followed by "the presence of a full-time instructor". In addition, almost all respondents indicated that they were more confident performing clinical microsurgery cases after completing the course. CONCLUSIONS: Microvascular surgery requires highly specialized and individualized training to achieve the competences required to perform and master the delicate fine motor skills necessary to successfully handle and anastomose very small and delicate microvascular structures. The ever-expanding clinical applications of microvascular procedures has led to an increased demand for training opportunities. By teaching time-tested basic motor skills that form the foundation of microsurgical technique this international microsurgery-teaching course is helping to meet this demand.