Journals / Batı Karadeniz Tıp Dergisi / 2025 / Cilt: 9 Sayı: 3

A stepwise multimodal approach to microanastomosis training: Participant-reported evaluation of synthetic, biological, and living platforms

Mikroanastomoz eğitiminde basamaklı multimodal yaklaşım: Sentetik, biyolojik ve canlı modellerin katılımcı görüşlerine dayalı değerlendirilmesi

Serkan Civlan(Department of Neurosurgery, Pamukkale University, School of Medicine, Denizli, Türkiye)0000-0001-8915-8186
Mehmet Sabri Gürbüz(Department of Neurosurgery, Istanbul Medeniyet University, İstanbul, Türkiye)0000-0002-3764-389X
Nevzat Doğukan Erbek(Department of Neurosurgery, Pamukkale University, School of Medicine, Denizli, Türkiye)0009-0001-1995-5611
Burak Karaaslan(Department of Neurosurgery, Gazi University, Faculty of Medicine, Ankara, Türkiye)0000-0003-1015-396X
Batuhan Bakırarar(Department of Biostatistics, Ankara University, Faculty of Medicine, Ankara, Türkiye)0000-0002-5662-8193
Çağrı Elbir(Department of Neurosurgery, Ankara Etlik City Hospital, Ankara, Türkiye)0000-0002-8747-2187
Göktuğ Ülkü(Department of Neurosurgery, Ankara Etlik City Hospital, Ankara, Türkiye)0000-0003-1430-2977
Mustafa Arıcı(Department of Neurosurgery, Van Training and Research Hospital, Van, Türkiye)0000-0003-2947-2880
Erhan Türkoğlu(Department of Neurosurgery, Hacettepe University, School of Medicine, Ankara, Türkiye)0000-0001-7044-617X
Mehmet Erdal Coşkun(Department of Neurosurgery, Pamukkale University, School of Medicine, Denizli, Türkiye)0000-0002-2816-0722
Fatih Yakar(Department of Neurosurgery, Pamukkale University, School of Medicine, Denizli, Türkiye)0000-0001-7414-3766
Pages
465–471
Publication Date
2025-12-31
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Pre-training and post-training surveys were administered for each modality using five-point Likert scales evaluating realism, technical difficulty, confidence, and overall suitability for microvascular skill development.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: This study evaluates the perceived educational value of four microanastomosis training models: the silicone tube model, the chicken wing brachial artery model, the UpSurgeOn Mycro simulator, and the Wistar Albino rat model, used within a structured microsurgical training program delivered during a national neurovascular symposium.
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Key Findings & Data:The Wistar Albino rat model was consistently rated as the most realistic and educationally valuable component of the training program, providing the closest approximation to operative conditions.
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Conclusion & Impact:Pre-training and post-training surveys were administered for each modality using five-point Likert scales evaluating realism, technical difficulty, confidence, and overall suitability for microvascular skill development.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Mikrocerrahi · cerrahi anostomoz · vasküler cerrahi girişimler

Abstract

Aim: This study evaluates the perceived educational value of four microanastomosis training models: the silicone tube model, the chicken wing brachial artery model, the UpSurgeOn Mycro simulator, and the Wistar Albino rat model, used within a structured microsurgical training program delivered during a national neurovascular symposium. Material and Methods: Sixteen participants completed a two-day, sixteen-hour microsurgical course that followed a stepwise training sequence. Pre-training and post-training surveys were administered for each modality using five-point Likert scales evaluating realism, technical difficulty, confidence, and overall suitability for microvascular skill development. Results: All modalities were perceived as educationally beneficial and contributed to microanastomosis skill development at different stages. The silicone tube model was viewed as highly effective for early-stage skill acquisition and basic instrument coordination. The chicken wing brachial artery model was appreciated for reproducing key biological characteristics while avoiding the logistical and ethical constraints. The Wistar Albino rat model was consistently rated as the most realistic and educationally valuable component of the training program, providing the closest approximation to operative conditions. The UpSurgeOn Mycro simulator did not meet participants expectations but served as a useful bridge between synthetic and biologic models. Conclusion: This multimodal stepwise approach to microanastomosis training was perceived as educationally valuable, with each model contributing at different stages of skill development. Based on these observations, incorporating structured simulation-based microanastomosis training into national neurosurgical education programs may help support preparedness for clinical practice.

Özet

Amaç: Bu çalışma, ulusal bir nörovasküler sempozyumu sırasında uygulanan yapılandırılmış bir mikrocerrahi eğitim programında kullanılan dört mikroanastomoz eğitim modelinin (silikon tüp modeli, tavuk kanadı brakiyal arter modeli, UpSurgeOn Mycro simülatörü ve Wistar Albino sıçan modeli) algılanan eğitsel değerini değerlendirmektedir. Gereç ve Yöntemler: On altı katılımcı, basamaklı bir eğitim dizisini takip eden iki günlük, on altı saatlik bir mikrocerrahi kursunu tamamladı. Her modalite için gerçekçilik, teknik zorluk, özgüven ve mikro-vasküler beceri gelişimine genel uygunluk gibi ölçütleri değerlendiren beşli Likert ölçekleri kullanılarak eğitim öncesi ve sonrası anketler uygulandı. Bulgular: Tüm modaliteler eğitsel açıdan faydalı olarak algılandı ve mikroanastomoz becerilerinin farklı aşamalarında katkı sağladı. Silikon tüp modeli, erken aşama beceri kazanımı ve temel alet koordinasyonu geliştirilmesi için oldukça etkili olarak değerlendirildi. Tavuk kanadı brakiyal arter modeli, lojistik ve etik kısıtlamalardan kaçınırken temel biyolojik özellikleri yansıtması nedeniyle takdir edildi. Wistar Albino sıçan modeli, sürekli olarak eğitim programının en gerçekçi ve eğitsel açıdan en değerli bileşeni olarak değerlendirildi ve ameliyat koşullarına en yakın deneyimi sundu. UpSurgeOn Mycro simülatörü katılımcı beklentilerini karşılamasa da sentetik ve biyolojik modeller arasında yararlı bir köprü işlevi gördü. Sonuç: Bu çok modelli basamaklı mikroanastomoz eğitim yaklaşımı, eğitsel açıdan değerli olarak algılanmış olup, her model beceri gelişiminin farklı aşamalarına katkıda bulunmuştur. Bu bulgular, yapılandırılmış simülasyon temelli mikroanastomoz eğitiminin ulusal nöroşirürji eğitim programlarına dâhil edilmesinin klinik pratiğe hazırlığı destekleyebileceğini göstermektedir.

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Cite This Article

Civlan, S., Gürbüz, M. S., Erbek, N. D., Karaaslan, B., Bakırarar, B., Elbir, Ç., Ülkü, G., Arıcı, M., Türkoğlu, E., Coşkun, M. E., Yakar, F. (2025). A stepwise multimodal approach to microanastomosis training: Participant-reported evaluation of synthetic, biological, and living platforms. Batı Karadeniz Tıp Dergisi, Cilt: 9 Sayı: 3, 465–471. https://doi.org/10.29058/mjwbs.1828399

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References (15)

  1. 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
  2. Byvaltsev VA, Akshulakov SK, Polkin RA, Ochkal SV, Stepanov IA, Makhambetov YT, et al. Microvascular Anastomosis Training in Neurosurgery: A Review. Minim Invasive Surg. 2018;2018:6130286. https://doi.org/10.1155/2018/6130286
  3. Prunières GJ, Taleb C, Hendriks S, Miyamoto H, Kuroshima N, Liverneaux PA, et al. Use of the Konnyaku Shirataki noodle as a low fidelity simulation training model for microvascular surgery in the operating theatre. Chir Main. 2014;33(2):106-111. https://doi.org/10.1016/j.main.2013.12.003
  4. Atlan M, Lellouch AG, Legagneux J, Chaouat M, Masquelet AC, Letourneur D. A New Synthetic Model for Microvascular Anastomosis Training? A Randomized Comparative Study Between Silicone and Polyvinyl Alcohol Gelatin Tubes. J Surg Educ. 2018;75(1):182-187. https://doi.org/10.1016/j.jsurg.2017.06.008
  5. Hino A. Training in microvascular surgery using a chicken wing artery. Neurosurgery. 2003;52(6):1495-1497; discussion 1497-1498. https://doi.org/10.1227/01.NEU.0000065174.83840.62
  6. Egemen E, Yakar F. A step by step laboratory guide for end to side anastomosis: chicken wing model. Pam Med J. 2021;14(2):396-400. https://doi.org/10.31362/patd.844371
  7. 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(4):287-290. https://doi.org/10.3340/jkns.2010.47.4.287
  8. Olabe J, Olabe J. Microsurgical training on an in vitro chicken wing infusion model. Surg Neurol. 2009;72(6):695-699. https://doi.org/10.1016/j.surneu.2008.12.008
  9. 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
  10. Colpan ME, Slavin KV, Amin-Hanjani S, Calderon-Arnuphi M, Charbel FT. Microvascular anastomosis training model based on a Turkey neck with perfused arteries. Neurosurgery. 2008;62(5 Suppl 2):ONS407-10; discussion ONS410-1. https://doi.org/10.1227/01.neu.0000326026.01349.75
  11. Guida L, Sebök M, Oliveira MM, van Niftrik CHB, Charbel FT, Cenzato M, et al. Neurosurgical Microvascular Anastomosis: Systematic Review of the Existing Simulators and Proposal of a New Training Classification System. Brain Sci. 2024;14(10):1031. https://doi.org/10.3390/brainsci14101031
  12. Mattar TGDM, Santos GBD, Telles JPM, Rezende MR, Wei TH, Mattar Júnior R. Structured evaluation of a comprehensive microsurgical training program. Clinics (Sao Paulo). 2021;76:e3194. https://doi.org/10.6061/clinics/2021/e3194
  13. Juratli MA, Becker F, Palmes D, Stöppeler S, Bahde R, Kebschull L, et al. Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital. BMC Med Educ. 2021;21(1):295. https://doi.org/10.1186/s12909-021-02737-1
  14. Petrone S, Cofano F, Nicolosi F, Spena G, Moschino M, Di Perna G, et al. Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents. Front Surg. 2022;9:862948. https://doi.org/10.3389/fsurg.2022.862948
  15. Ahmed R, Muirhead W, Williams SC, Bagchi B, Datta P, Gupta P, et al. A synthetic model simulator for intracranial aneurysm clipping: validation of the UpSurgeOn AneurysmBox. Front Surg. 2023;10:1185516. https://doi.org/10.3389/fsurg.2023.1185516