title: The realization of preferable operative working space through the microsurgical training with rats-the importance of the process.
abstract: BACKGROUND
  Adequate experience is necessary for microneurosurgery; however, the development of less invasive therapies may contribute to a reduction in the clinical case volume of beginning neurosurgeons. Microsurgical training with rats, which enables operators to experience the dissecting process, has an advantage compared with the training reported previously. We demonstrate our microsurgical training method for anastomoses in rats with emphasis on dissecting technique.
  
  
  METHODS
  Retired Wistar rats were used. The NIH guidelines for the care and use of laboratory animals were followed. The training was performed in cervical and femoral region. The anastomosis between the artery and the vein is used in the current study.
  
  
  RESULTS
  The most important point of this training is the process. Making a sufficient working space for bypass surgery is more important than making an anastomosis itself. For these purposes, "looking carefully" and "treating only the bleeding point" are indispensable. "Stripping" the surrounding connective tissues to expose the vessels is also useful. In anastomoses, first stitch must always be initiated with the presumption that the suture will be difficult to stitch. Otherwise, the operator may be forced to abandon the procedure at the end. Another important point is the need for equality between anastomotic planes of the donor and recipient.
  
  
  CONCLUSIONS
  For favorable working space, every tissue and structure to be dissected must be unfolded. Without proper retraction, a favorable operative space will never be visualized. The continuation of practice in these steps will dramatically improve the operative view through the microscope.
authors.affiliation: Department of Neurosurgery, Nippon Medical School, Tokyo 113-8603, Japan. ryu@nms.ac.jp
authors.forename: Ryuzaburo
authors.initials: R
authors.lastname: Kanazawa
authors.forename: Akira
authors.initials: A
authors.lastname: Teramoto
mesh_terms: D000714:Anastomosis, Surgical / Q000193:education*; D000818:Animals; D004210:Dissection / Q000193:education; D008866:Microsurgery / Q000193:education*; D023421:Models, Animal; D019635:Neurosurgical Procedures / Q000193:education*; D051381:Rats; D017208:Rats, Wistar