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Intensive hands-on microsurgery course provides a solid foundation for performing clinical microvascular surgery

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Microvascular surgery requires highly specialized and individualized training; most surgical residency training programs are not equipped with microsurgery teaching expertise and/or facilities. The aim of this manuscript was to describe the methodology and clinical effectiveness of an international microsurgery course, currently taught year-round in eight countries.

Methods

In the 5-day microsurgery course trainees perform arterial and venous end-to-end, end-to-side, one-way-up, and continuous suture anastomoses and vein graft techniques in live animals, supported by video demonstrations and hands-on guidance by a full-time instructor. To assess and monitor each trainee’s progress, the course’s effectiveness is evaluated using “in-course” evaluations, and participant satisfaction and clinical relevance are assessed using a “post-course” survey.

Results

Between 2007 and 2017, more than 600 trainees participated in the microsurgery course. “In-course” evaluations of patency rates revealed 80.3% (arterial) and 39% (venous) performed in end-to-end, 82.7% in end-to-side, 72.6% in continuous suture, and 89.5% (arterial) and 62.5% (venous) one-way-up anastomoses, and 58.1% in vein graft technique. “Post-course” survey results indicated that participants considered the most important components of the microcourse to be “practicing on live animals”, followed by “the presence of a full-time instructor”. In addition, almost all respondents indicated that they were more confident performing clinical microsurgery cases after completing the course.

Conclusions

Microvascular surgery requires highly specialized and individualized training to achieve the competences required to perform and master the delicate fine motor skills necessary to successfully handle and anastomose very small and delicate microvascular structures. The ever-expanding clinical applications of microvascular procedures has led to an increased demand for training opportunities. By teaching time-tested basic motor skills that form the foundation of microsurgical technique this international microsurgery-teaching course is helping to meet this demand.

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Acknowledgements

The authors would like to thank the following individuals for their generous support at the respective institutions, where the International Microsurgery Course is taught: Drs. Alf Theisen and Christa Tandi, at J.W. Goethe University in Frankfurt am Main, Germany. Mr. Wolfgang Krieger, Area Sales Manager, Carl Zeiss Meditec mbH, Oberkochen, Germany. Gang Chen, Senior Research Fellow and MRTF Manager, Dept. Physiology and Neurodegeneration, Royal College of Surgeons (RCSI) and Roisin Scally, RCSI Surgical Affairs, Dublin, Ireland. Flip A. Klatter, Head University Medical Center Groningen (UMCG) Research and Development Facility and Director, Central Animal Facility (CDP) and Annemieke Smit, Microsurgery coordinator, CDP, UMCG, Groningen, The Netherlands. Vera Van Aalst, Staff Member of Depart. Plastic and Reconstructive Surgery, University Medical Center Groningen (UMCG), Groningen, The Netherlands.

Funding

The work described herein was supported in part by the Friedrichsheim Foundation (Stiftung Friedrichsheim) located in Frankfurt, Germany.

Author information

Author notes

  1. Gustavo Perez-Abadia and Lukas Pindur contributed equally to this work.

Authors and Affiliations

  1. Department of Physiology, University of Louisville, Louisville, KY, USA

    Gustavo Perez-Abadia & Irving Joshua

  2. Frankfurt Initiative for Regenerative Medicine, JW Goethe-University, Frankfurt am Main, Germany

    Lukas Pindur, Zachri N. Ovadja & John H. Barker

  3. Department of Trauma, Hand and Reconstructive Surgery, JW Goethe-University, Frankfurt am Main, Germany

    Johannes Frank & Ingo Marzi

  4. Department of Plastic, Hand and Reconstructive Surgery, BG Trauma Center, Frankfurt am Main, Germany

    Lukas Pindur & Michael Sauerbier

  5. Plastic Surgical Training to the Royal College of Surgeons in Ireland, Dublin, Ireland

    Sean M. Carroll

  6. School of Medicine, University of Chile, Santiago, Chile

    Luis Schnapp

  7. Traumatologia and Orthopedica, Clinica Las Condes, Santiago, Chile

    Luis Schnapp & Manuel Mendez

  8. Cirugia Plastica, Clinica Alemana, Santiago, Chile

    Sergio Sepulveda

  9. Department of Plastic and Reconstructive Surgery, University Medical Center Groningen, Groningen, The Netherlands

    Paul Werker

  10. Orthopedic and Traumatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium

    Xavier Libouton, Oliver Barbier & Jean-Paul Dehoux

  11. Traumatology and Hand Surgery, Buenos Aires, Argentina

    Marcelo E. Maquieira

  12. Department Plastic and Reconstructive PEMEX, Mexico City, Mexico

    Cuahutemoc Marques Espriella

  13. Department of Plastic, Reconstructive and Hand Surgery, AMC, Amsterdam, The Netherlands

    Zachri N. Ovadja

  14. Microsurgical Instruments, S&T AG, Neuhausen am Rheinfall, Switzerland

    Markus Spingler

  15. Department of Orthopedic Surgery, Director, Louisville MicroSurgery Teaching Course, University of Louisville, 511 S Floyd Street, 328F, MDR, Louisville, KY, 40292, USA

    Gustavo Perez-Abadia

Authors
  1. Gustavo Perez-Abadia
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  2. Lukas Pindur
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  3. Johannes Frank
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  4. Ingo Marzi
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  5. Michael Sauerbier
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  6. Sean M. Carroll
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  7. Luis Schnapp
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  8. Manuel Mendez
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  9. Sergio Sepulveda
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  10. Paul Werker
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  11. Xavier Libouton
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  12. Oliver Barbier
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  13. Jean-Paul Dehoux
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  14. Marcelo E. Maquieira
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  15. Cuahutemoc Marques Espriella
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  16. Irving Joshua
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  17. Zachri N. Ovadja
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  18. Markus Spingler
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  19. John H. Barker
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Contributions

GPA: instructor of the course, contributed to conceptualizing the study, collecting data and reviewing the manuscript, LP and JHB: conceptualized the study, collected, organized, analyzed, and interpreted data, and wrote, revised and reviewed the manuscript; ZNO: collected data and reviewed the manuscript, MSP: provided background information and reviewed the manuscript, and JF, IM, MSA, SMC, LS, MM, SS, PW, XL, OB, JPD, MEM, CME and IJ: reviewed the manuscript. All authors had full access to all data contained in the article, reviewed the paper prior to submission and take responsibility for its integrity and accuracy.

Corresponding author

Correspondence to Gustavo Perez-Abadia.

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Conflict of interest

Markus Spingler is the President and CEO in the company S&T AG—Microsurgical Instruments. Gustavo Perez-Abadia is the President of Maximum, LLC and the Director and Instructor of the International microcourse described in this paper and charges a fee for attending the course. Lukas Pindur has no commercial associations or financial interests to declare. Johannes Frank has no commercial associations or financial interests to declare. Ingo Marzi has no commercial associations or financial interests to declare. Michael Sauerbier has no commercial associations or financial interests to declare. Sean M. Carroll has no commercial associations or financial interests to declare. Luis Schnapp has no commercial associations or financial interests to declare. Manuel Mendez has no commercial associations or financial interests to declare. Sergio Sepulveda has no commercial associations or financial interests to declare. Paul Werker has no commercial associations or financial interests to declare. Xavier Libouton has no commercial associations or financial interests to declare. Oliver Barbier has no commercial associations or financial interests to declare. Jean-Paul Dehoux has no commercial associations or financial interests to declare. Marcelo E. Maquieira has no commercial associations or financial interests to declare. Cuahutemoc Marques E. has no commercial associations or financial interests to declare. Irving Joshua has no commercial associations or financial interests to declare. Zachri N. Ovadja has no commercial associations or financial interests to declare. John H. Barker has no commercial associations or financial interests to declare.

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Perez-Abadia, G., Pindur, L., Frank, J. et al. Intensive hands-on microsurgery course provides a solid foundation for performing clinical microvascular surgery. Eur J Trauma Emerg Surg 49, 115–123 (2023). https://doi.org/10.1007/s00068-022-02040-8

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  • DOI: https://doi.org/10.1007/s00068-022-02040-8

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