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A step by step laboratory guide for end to side anastomosis: chicken wing model

Year 2021, Volume: 14 Issue: 2, 396 - 400, 01.04.2021
https://doi.org/10.31362/patd.844371

Abstract

Background: In vitro specimens are suitable models for the introduction of bypass surgery training of inexperienced neurosurgeons and residents. This paper aims to provide a guide for the applications of end to side anastomosis in the laboratory.

Materials and Methods: The chicken wings were purchased from a local supermarket and used to perform end to side anastomosis. The microscissors, knotting forceps and 10/0 sutures were used, and all stages of the procedure were performed under a desktop microscope.

Results: The experience required for bypass surgery, which is a skillful field in neurosurgery practice, can be obtained in the chicken wing model, which is a cheap and easily accessible method.

Conclusion: The chicken wing model is a practical and feasible method in training the end to side anastomosis in a microsurgery laboratory.

References

  • Reference 1. Yasargil MG, Yonekawa Y. Results of microsurgical extraintracranial arterial bypass in the treatment of cerebral ischemia. Neurosurgery 1977; 1:22–24. https://doi.org/10.1227/00006123-197707000-00005
  • Reference 2. Wessels L, Hecht N, Vajkoczy P. Bypass in neurosurgery-indications and techniques. Neurosurg Rev. 2019;42(2):389-393. https://doi.org/10.1007/s10143-018-0966-9
  • Reference 3. Hwang G, Oh CW, Park SQ, Sheen SH, Bang JS, Kang HS. Comparison of different microanastomosis training models: Model accuracy and practicality. J Korean Neurosurg Soc 2010;47:287-290. https://doi.org/10.3340/jkns.2010.47.4.287
  • Reference 4. Nam SM, Shin HS, Kim YB, Park ES, Choi CY. Microsurgical training with porcine thigh infusion model. J Reconstr Microsurg 2013;29(5):303-306. https://doi.org/10.1055/s-0033-1333623
  • Reference 5. Hino A. Training in microvascular surgery using a chicken wing artery. Neurosurgery 2003;52(6):1495-1497. https://doi.org/10.1227/01.neu.0000065174.83840.62
  • Reference 6. Abla AA, Uschold T, Preul MC, Zabramski JM. Comparative use of turkey and chicken wing brachial artery models for microvascular anastomosis training. J Neurosurg 2011 ;115(6):1231-1235. https://doi.org/10.3171/2011.7.JNS102013
  • Reference 7. Inoue T, Tsutsumi K, Adachi S, Tanaka S, Saito K, Kunii N. Effectiveness of suturing training with 10-0 nylon under fixed and maximum magnification (x 20) using desk type microscope. Surg Neurol 2006; 66:183-187. https://doi.org/10.1016/j.surneu.2005.11.064
  • Reference 8. Matsumura N, Hayashi N, Hamada H, Shibata T, Horie Y, Endo S. A newly designed training tool for microvascular anastomosis techniques: Microvascular Practice Card. Surg Neurol 2009; 71:616-620. https://doi.org/ 10.1016/j.surneu.2007.12.024
  • Reference 9. Mutoh T, Ishikawa T, Ono H, Yasui N. A new polyvinyl alcohol hydrogel vascular model (KEZLEX) for microvascular anastomosis training. Surg Neurol In. 2010;23;1:74. https://doi.org/10.4103/2152-7806.72626
  • Reference 10. Creighton FX, Feng AL, Goyal N, Emerick K, Deschler D. Chicken thigh microvascular training model improves resident surgical skills. Laryngoscope Investig Otolaryngol 2017;2(6):471-474. https://doi.org/10.1002/lio2.94
  • Reference 11. Schoeff S, Hernandez B, Robinson DJ, Jameson MJ, Shonka DC Jr. Microvascular anastomosis simulation using a chicken thigh model: Interval versus massed training. Laryngoscope 2017; 127(11):2490-2494. https://doi.org/10.1002/lary.26586
  • Reference 12. Higurashi M, Qian Y, Zecca M, Park YK, Umezu M, Morgan MK. Surgical training technology for cerebrovascular anastomosis. J Clin Neurosci 2014;21(4):554-558. https://doi.org/10.1016/j.jocn.2013.07.029
  • Reference 13. Couceiro J, Castro R, Tien H, Ozyurekoglu T. Step by step: microsurgical training method combining two nonliving animal models. J Vis Exp 2015;99:e52625. https://doi.org/10.3791/52625
  • Reference 14. Kim BJ, Kim ST, Jeong YG, Lee WH, Lee KS, Paeng SH. An efficient microvascular anastomosis training model based on chicken wings and simple instruments. J Cerebrovasc Endovasc Neurosurg 2013;15(1):20-25. https://doi.org/10.7461/jcen.2013.15.1.20
  • Reference 15. Vazkocy P, Horn P, Schmiedek P. Standard superficial temporal artery-middle cerebral artery bypass surgery in hemodynamic cerebral ischemia: Indication and technique. Operative Techniques in Neurosurgery 1999;2(3): 106-115. https://doi.org/10.1016/S1092-440X(99)80002-4
  • Reference 16. Tamrakar K. Learning Microvascular Anastomosis in Low Socioeconomic Vascular Models During Residency. Cureus 2017;9(4):e1199. https://doi.org/10.7759/cureus.1199

End to side anastomoz için adım adım laboratuvar kılavuzu: tavuk kanadı modeli

Year 2021, Volume: 14 Issue: 2, 396 - 400, 01.04.2021
https://doi.org/10.31362/patd.844371

Abstract

Amaç: In vitro örnekler, deneyimsiz beyin cerrahları ve asistanların baypas cerrahisi eğitimine giriş için uygun modellerdir. Bu makale, laboratuvarda end to side anastomoz uygulamaları için bir rehber sağlamayı amaçlamaktadır.

Gereç ve yöntem: Tavuk kanatları yerel bir süpermarketten satın alındı ve ‘end to side’ anastomoz yapmak için kullanıldı. Mikroskaslar, düğümleme pensleri ve 10/0 sütürler kullanıldı ve prosedürün tüm aşamaları bir masaüstü mikroskobu ile gerçekleştirildi.

Bulgular: Nöroşirürji pratiğinde ustalık gerektiren bir alan olan baypas cerrahisi için gerekli deneyim, ucuz ve kolay ulaşılabilir bir yöntem olan tavuk kanadı modelinde elde edilebilir.

Sonuç: Tavuk kanadı modeli, bir mikrocerrahi laboratuvarında ‘end to side’ anastomoz eğitiminde pratik ve uygulanabilir bir yöntemdir.

References

  • Reference 1. Yasargil MG, Yonekawa Y. Results of microsurgical extraintracranial arterial bypass in the treatment of cerebral ischemia. Neurosurgery 1977; 1:22–24. https://doi.org/10.1227/00006123-197707000-00005
  • Reference 2. Wessels L, Hecht N, Vajkoczy P. Bypass in neurosurgery-indications and techniques. Neurosurg Rev. 2019;42(2):389-393. https://doi.org/10.1007/s10143-018-0966-9
  • Reference 3. Hwang G, Oh CW, Park SQ, Sheen SH, Bang JS, Kang HS. Comparison of different microanastomosis training models: Model accuracy and practicality. J Korean Neurosurg Soc 2010;47:287-290. https://doi.org/10.3340/jkns.2010.47.4.287
  • Reference 4. Nam SM, Shin HS, Kim YB, Park ES, Choi CY. Microsurgical training with porcine thigh infusion model. J Reconstr Microsurg 2013;29(5):303-306. https://doi.org/10.1055/s-0033-1333623
  • Reference 5. Hino A. Training in microvascular surgery using a chicken wing artery. Neurosurgery 2003;52(6):1495-1497. https://doi.org/10.1227/01.neu.0000065174.83840.62
  • Reference 6. Abla AA, Uschold T, Preul MC, Zabramski JM. Comparative use of turkey and chicken wing brachial artery models for microvascular anastomosis training. J Neurosurg 2011 ;115(6):1231-1235. https://doi.org/10.3171/2011.7.JNS102013
  • Reference 7. Inoue T, Tsutsumi K, Adachi S, Tanaka S, Saito K, Kunii N. Effectiveness of suturing training with 10-0 nylon under fixed and maximum magnification (x 20) using desk type microscope. Surg Neurol 2006; 66:183-187. https://doi.org/10.1016/j.surneu.2005.11.064
  • Reference 8. Matsumura N, Hayashi N, Hamada H, Shibata T, Horie Y, Endo S. A newly designed training tool for microvascular anastomosis techniques: Microvascular Practice Card. Surg Neurol 2009; 71:616-620. https://doi.org/ 10.1016/j.surneu.2007.12.024
  • Reference 9. Mutoh T, Ishikawa T, Ono H, Yasui N. A new polyvinyl alcohol hydrogel vascular model (KEZLEX) for microvascular anastomosis training. Surg Neurol In. 2010;23;1:74. https://doi.org/10.4103/2152-7806.72626
  • Reference 10. Creighton FX, Feng AL, Goyal N, Emerick K, Deschler D. Chicken thigh microvascular training model improves resident surgical skills. Laryngoscope Investig Otolaryngol 2017;2(6):471-474. https://doi.org/10.1002/lio2.94
  • Reference 11. Schoeff S, Hernandez B, Robinson DJ, Jameson MJ, Shonka DC Jr. Microvascular anastomosis simulation using a chicken thigh model: Interval versus massed training. Laryngoscope 2017; 127(11):2490-2494. https://doi.org/10.1002/lary.26586
  • Reference 12. Higurashi M, Qian Y, Zecca M, Park YK, Umezu M, Morgan MK. Surgical training technology for cerebrovascular anastomosis. J Clin Neurosci 2014;21(4):554-558. https://doi.org/10.1016/j.jocn.2013.07.029
  • Reference 13. Couceiro J, Castro R, Tien H, Ozyurekoglu T. Step by step: microsurgical training method combining two nonliving animal models. J Vis Exp 2015;99:e52625. https://doi.org/10.3791/52625
  • Reference 14. Kim BJ, Kim ST, Jeong YG, Lee WH, Lee KS, Paeng SH. An efficient microvascular anastomosis training model based on chicken wings and simple instruments. J Cerebrovasc Endovasc Neurosurg 2013;15(1):20-25. https://doi.org/10.7461/jcen.2013.15.1.20
  • Reference 15. Vazkocy P, Horn P, Schmiedek P. Standard superficial temporal artery-middle cerebral artery bypass surgery in hemodynamic cerebral ischemia: Indication and technique. Operative Techniques in Neurosurgery 1999;2(3): 106-115. https://doi.org/10.1016/S1092-440X(99)80002-4
  • Reference 16. Tamrakar K. Learning Microvascular Anastomosis in Low Socioeconomic Vascular Models During Residency. Cureus 2017;9(4):e1199. https://doi.org/10.7759/cureus.1199
There are 16 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research Article
Authors

Emrah Egemen 0000-0003-4930-4577

Fatih Yakar 0000-0001-7414-3766

Publication Date April 1, 2021
Submission Date December 21, 2020
Acceptance Date January 18, 2021
Published in Issue Year 2021 Volume: 14 Issue: 2

Cite

AMA Egemen E, Yakar F. A step by step laboratory guide for end to side anastomosis: chicken wing model. Pam Med J. April 2021;14(2):396-400. doi:10.31362/patd.844371

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