Training of deep microsurgical skill: Establishment of a high-volume intracranial carotid bypass model.
OBJECTIVE
To establish a model for a high-volume intracranial carotid bypass operation.


METHODS
High-volume internal carotid-middle cerebral artery bypass was performed on 9 cadaver heads with arteries of porcine forearms as grafts by 6 residents with no previous experience in vascular anastomosis on cadavers. The intima was dissected immediately after the anastomoses were completed to observe the patency of anastomosis.


RESULTS
After different duration periods of training using this model, 36 vascular anastomoses on 18 sides were successfully performed by the 6 residents with a self-made difficulty regulation device. As the difficulty level increased, the time needed for anastomosis lengthened and patency rate showed a decreasing trend. As the amount of training increased, the residents were able to decrease the amount of time to complete the operation with increasing patency rates.


CONCLUSIONS
The model of high-volume internal carotid-middle cerebral artery bypass with arteries of porcine forearms has the advantages of material similarity, easy access of grafts, better simulation of intraoperative conditions, and adjustable difficulties. Our results suggest that this new procedure has a better simulation-training platform which is closer to the real surgical procedure for surgeons willing to master the technique of a high-volume bypass operation.
Department of neurosurgery, Tianjin Medical University General Hospital, 300052 Tianjin, China; Department of neurosurgery, Tianjin Huanhu Hospital, 300060 Tianjin, China.
L
L
Ma
Department of neurosurgery, Tianjin Huanhu Hospital, 300060 Tianjin, China.
J
J
Li
Department of neurosurgery, Central Hospital of ZiBo, ZiBo, 255036 Shandong Province, China.
X
X
Zhang
Department of neurosurgery, Tianjin Huanhu Hospital, 300060 Tianjin, China.
H
H
Ren
Department of neurosurgery, Tianjin Huanhu Hospital, 300060 Tianjin, China.
Z
Z
Xu
Department of neurosurgery, Tianjin Huanhu Hospital, 300060 Tianjin, China. Electronic address: 946676456@qq.com.
Y
Y
Huang
Department of neurosurgery, Tianjin Medical University General Hospital, 300052 Tianjin, China. Electronic address: 445297731@qq.com.
R
R
Jiang
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002102:Cadaver; D002548:Cerebral Revascularization / Q000379:methods; D001026:Coronary Artery Bypass / Q000193:education* / Q000379:methods; D006801:Humans; D008866:Microsurgery / Q000193:education* / Q000379:methods; D020768:Middle Cerebral Artery / Q000601:surgery*; D013552:Swine
Anastomose vasculaire; Bypass; Carotid; Carotide; Haut débit; High-volume; Pontage; Vascular anastomosis