Background Learning and straightening of surgical techniques requires continuous training that cannot overlook from lab activities. During microsurgery, specific bimanual abilities are necessary to perform perfect vessels dissection and anastomosis. In this scenario, the development of realistic training models is utmost important. Objective The aim of this research is to describe a detailed method of preparation of a dye-perfused human placenta training model and its application during microsurgical hands-on courses. An original description of training exercises has been reported. Moreover, a review of the literature on this topic has been performed. Methods Forty-five fresh human placentas were collected and prepared with a specific protocol. The model was used during four hands-on microsurgical training courses held in the Experimental Laboratory of Microsurgery “Botta 2” of the University of Pavia, Italy. The total number of participants was 40 divided into young specialists and residents of Neurosurgery, Otolaryngology and Maxillofacial surgeons. An on-line survey-based questionnaire, using the platform SurveyMonkey®, was administered to each participant to subjectively assess face and content validity of the proposed training model. Differences in categorical responses between groups were analyzed using chi-quadro (χ2) test for independence with STATA® 16 (StataCorp LLC) software. A comprehensive literature review of articles regarding the use of human placenta as a microsurgical training model was performed via multiple PubMed database searches. Results Forty-two of 45 placentas were considered appropriate for microsurgical model. In selected placentas, the arteries could be easily distinguished from the veins and all three vessels were cannulated and perfused with dyes. The model was used to perform vessels dissection and end-to-end, end-to-side and side-to-side anastomosis. Of the 40 course attendees, 33 completed the questionnaire, of which most indicated the placenta as a valuable, accurate, and reproducible model. No differences were observed among the groups. Conclusion The proposed model is an excellent tool for vascular microsurgical laboratory training. A standardized protocol makes its preparation easier and color perfusion enhances its reliability. The low-cost, accessibility, and the variety of size and number of placental vessels are the most important advantages of such polyhedral model, useful for several specialized surgical fields. Due to the possibility of choosing exercises with different degrees of difficulty, this model perfectly matches the philosophy of microsurgical practice. The application of rating scale that allow to verify the teaching efficacy of this training model represents the future step of this research.

Development of Dye-Perfused Human Placenta Model for Vascular Microsurgery Training: Preparation Protocol and Validation Testing in Hands-on Courses

DEL MAESTRO, MATTIA
2022-09-19

Abstract

Background Learning and straightening of surgical techniques requires continuous training that cannot overlook from lab activities. During microsurgery, specific bimanual abilities are necessary to perform perfect vessels dissection and anastomosis. In this scenario, the development of realistic training models is utmost important. Objective The aim of this research is to describe a detailed method of preparation of a dye-perfused human placenta training model and its application during microsurgical hands-on courses. An original description of training exercises has been reported. Moreover, a review of the literature on this topic has been performed. Methods Forty-five fresh human placentas were collected and prepared with a specific protocol. The model was used during four hands-on microsurgical training courses held in the Experimental Laboratory of Microsurgery “Botta 2” of the University of Pavia, Italy. The total number of participants was 40 divided into young specialists and residents of Neurosurgery, Otolaryngology and Maxillofacial surgeons. An on-line survey-based questionnaire, using the platform SurveyMonkey®, was administered to each participant to subjectively assess face and content validity of the proposed training model. Differences in categorical responses between groups were analyzed using chi-quadro (χ2) test for independence with STATA® 16 (StataCorp LLC) software. A comprehensive literature review of articles regarding the use of human placenta as a microsurgical training model was performed via multiple PubMed database searches. Results Forty-two of 45 placentas were considered appropriate for microsurgical model. In selected placentas, the arteries could be easily distinguished from the veins and all three vessels were cannulated and perfused with dyes. The model was used to perform vessels dissection and end-to-end, end-to-side and side-to-side anastomosis. Of the 40 course attendees, 33 completed the questionnaire, of which most indicated the placenta as a valuable, accurate, and reproducible model. No differences were observed among the groups. Conclusion The proposed model is an excellent tool for vascular microsurgical laboratory training. A standardized protocol makes its preparation easier and color perfusion enhances its reliability. The low-cost, accessibility, and the variety of size and number of placental vessels are the most important advantages of such polyhedral model, useful for several specialized surgical fields. Due to the possibility of choosing exercises with different degrees of difficulty, this model perfectly matches the philosophy of microsurgical practice. The application of rating scale that allow to verify the teaching efficacy of this training model represents the future step of this research.
19-set-2022
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Descrizione: Development of Dye-Perfused Human Placenta Model for Vascular Microsurgery Training: Preparation Protocol and Validation Testing in Hands-on Courses
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/1463186
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