microsurgery training-a home do-it-yourself model

LETTER TO THE EDITOR

MICROSURGERY 00:00–00 2014

MICROSURGERY TRAINING––A HOME DO-IT-YOURSELF MODEL

Dear Sir,

With the pressure of time, money, and competition

in today’s surgical training, having adequate practice to

better our skills is becoming an increasing struggle.1

Attending courses at most, provides a nonlasting famili-

arity of the various surgical techniques. Additionally,

with greater scrutiny of the ethical usage of live animals

in teaching microsurgery, simulated models have a role

to play in today’s microsurgical training.

A variety of live animal alternatives ranging from

synthetic materials to chicken leg or thigh have been

used.2,3 The main constraints to microsurgical excellence

are time at the microscope and access to the equipment.

Therefore, we have come up with a Do-It-Yourself

Model for Microsurgery Training at home that is cheap,

easily reproducible, and above all, realistic.

The equipment we used included: a table top micro-

scope with a X5–40 magnification (internal or external

lighting); a basic microsurgery kits which consists of nee-

dle holders, scalpels, scissors, and forceps. These can be

easily procured from Ebay medical training suppliers for

less than £200. For our purposes, we found a “Jeff and

Jenny” generic table top microscope made in China which

adequately served our purpose. This cost £149 from this

particular supplier.4 We would like to state that the suc-

cess of this table top microscope model is that it has an

adequate working distance and an option of internal/exter-

nal lighting to simulate intraoperative conditions. Our 10/0

microsurgical suture material can again be easily bought

from online stores based in China for practise.5 Many var-

ious sizes are available and come cheap and strong

enough for home use. The model we used for simulation

was chicken wings from Tesco’s value range which cost

under £5. The vessels and nerves on these chicken wings

range from 1 to 3 mm which are perfect for our purpose.

With the aforementioned equipment and specimen,

we were able to experiment with various microsurgery

scenarios. The key to microsurgery mastery is regular

practice, which this a Do-It-Yourself model permits in

the comfort of one’s home, which is significantly cheaper

than alternatives. The simplicity of approach and ease of

access of materials encourages one to train. We believe

that this method of training will not be a substitute for

formal microsurgical courses or technical tips from expe-

rienced instructors but instead provide a complementary

model for trainees who wish to hone or practise their

microsurgical skills learnt either on the job or from

courses. Without formal microsurgical training or teach-

ing, the learning curve with this Do-It-Yourself will be

much longer than a trainee who has had proper guidance.

We as trainees have undergone formal microsurgical

training but do feel that with this set up easily assembled

at home, our increase in technical ability has allowed us

to feel more comfortable working on microsurgical cases

in the clinical setting.

CHARLES YUEN YUNG LOH, M.B.B.S., M.Sc., M.R.C.S.

Plastic Surgery Department

Aberdeen Royal Infirmary

Aberdeen, UK

VINCENT TZE YANG TIONG, M.B.B.S.

Orthopaedic Surgery Department

Aberdeen Royal Infirmary

Aberdeen, UK

ALEX YUEN HUA LOH

University of Edinburgh, UK

THANASSI ATHANASSOPOULOS, M.B.B.S., D.M.,

F.R.C.S. (PLAST)

Plastic Surgery Department

Ninewells Hospital, Dundee, UKPublished online 00 Month 2014 in Wiley Online Library(wileyonlinelibrary.com). DOI: 10.1002/micr.22242

� 2014 Wiley Periodicals, Inc.

REFERENCES

1. Dean B, Pereira E. Surgeons and Training Time [Internet]. London:BMJ Careers; 2011. Oct 26, [cited 2013 Jun 18].

2. Ramachandran S, Chui CH-K, Tan B-K. The chicken aorta as asimulation-training model for microvascular surgery training. ArchPlast Surg 2013; 40:327–329.

3. Sch€offl H, Froschauer SM, Dunst KM, Hager D, Kwasny O, HuemerGM. Strategies for the reduction of live animal use in microsurgicaltraining and education. Altern Lab Anim 2008;36:153–160.

4. Available at: http://www.ebay.co.uk/usr/joy8899. Accessed on Febru-ary 14, 2014.

5. Available at: www.alibaba.com. Accessed on February 14, 2014.

2 Letter to the Editor

Microsurgery DOI 10.1002/micr