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Moist-condition Training for Cerebrovascular Anastomosis: A Practical Step after
Mastering Basic Manipulations
#MMPMID26226981
Shimizu S
; Sekiguchi T
; Mochizuki T
; Sato K
; Koizumi H
; Nakayama K
; Yamamoto I
; Kumabe T
Neurol Med Chir (Tokyo)
2015[]; 55
(8
): 689-92
PMID26226981
show ga
As cerebrovascular anastomosis is performed in moist conditions that may impede
precise manipulations, surgeons must undergo extensive preoperative training. We
developed a simple moist-condition training method. It involves placing a
free-floating inner platform hosting an artery from a chicken wing in an outer
container filled with tap water to just below the specimen. Trainees performed
anastomosis under magnification. Training sessions mimicked difficulties
encountered during operations such as poor visibility of the lumen and problems
handling the sutures. A retrospective comparison of 100 wet- and 100
dry-condition training sessions for end-to-side anastomoses with 8 stitches
showed that under moist condition the time required for the entire procedure was
significantly longer (17.8 ± 2.1 vs. 15.3 ± 2.1 min, p < 0.01) and the incidence
of wrong stitching was greater (0.38 vs. 0%, p = 0.04). In 8 cases after
introducing moist-condition training, the time required in superficial temporal
artery to middle cerebral artery bypass surgery was significantly shorter than 8
cases before introducing the training (32.3 ± 5.6 min vs. 48.3 ± 15.9 min, p =
0.01). Incidence of wrong stitches was less in cases after introducing
moist-condition training (2.7 vs. 7.4%, p = 0.10). Those indicate that
moist-condition training is a useful and practical step and a bridge between
training for basic manipulations under dry conditions and actual surgery.
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