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2018 ; 2018
(ä): 6130286
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Microvascular Anastomosis Training in Neurosurgery: A Review
#MMPMID29796313
Byvaltsev VA
; Akshulakov SK
; Polkin RA
; Ochkal SV
; Stepanov IA
; Makhambetov YT
; Kerimbayev TT
; Staren M
; Belykh E
; Preul MC
Minim Invasive Surg
2018[]; 2018
(ä): 6130286
PMID29796313
show ga
Cerebrovascular diseases are among the most widespread diseases in the world,
which largely determine the structure of morbidity and mortality rates.
Microvascular anastomosis techniques are important for revascularization
surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms
and even during resection of brain tumors that obstruct major cerebral arteries.
Training in microvascular surgery became even more difficult with less case
exposure and growth of the use of endovascular techniques. In this text we will
briefly discuss the history of microvascular surgery, review current literature
on simulation models with the emphasis on their merits and shortcomings, and
describe the views and opinions on the future of the microvascular training in
neurosurgery. In "dry" microsurgical training, various models created from
artificial materials that simulate biological tissues are used. The next stage in
training more experienced surgeons is to work with nonliving tissue models.
Microvascular training using live models is considered to be the most relevant
due to presence of the blood flow. Training on laboratory animals has high
indicators of face and constructive validity. One of the future directions in the
development of microsurgical techniques is the use of robotic systems. Robotic
systems may play a role in teaching future generations of microsurgeons. Modern
technologies allow access to highly accurate learning environments that are
extremely similar to real environment. Additionally, assessment of microsurgical
skills should become a fundamental part of the current evaluation of competence
within a microneurosurgical training program. Such an assessment tool could be
utilized to ensure a constant level of surgical competence within the
recertification process. It is important that this evaluation be based on
validated models.