Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital

Abstract

Background: Microsurgical techniques are an important part of clinical and experimental research. Here we present our step-by-step microsurgery training course developed at the Münster University Hospital. The goal of this course was to create a short, modular curriculum with clearly described and easy to follow working steps in accordance with the Guidelines for Training in Surgical Research in Animals by the Academy of Surgical Research.

Methods: Over the course of 10 years, we conducted an annual 2.5 day (20 h) microsurgical training course with a total of 120 participants.

Results: Prior to the course, 90% of the participants reported to have never performed a microanastomosis before. During the 10 years a total of 84.2% of the participants performed microanastomoses without assistance, 15% required assistance and only 0.8% failed.

Conclusions: Our step-by-step microsurgery training course gives a brief overview of the didactic basics and the organization of a microsurgical training course and could serve as a guide for teaching microsurgical skills. During the 2.5-day curriculum, it was possible to teach, and for participants to subsequently perform a microsurgical anastomosis. The independent reproducibility of the learned material after the course is not yet known, therefore further investigations are necessary. With this step-by-step curriculum, we were able to conduct a successful training program, shown by the fact that each participant is able to perform microvascular anastomoses on a reproducible basis.

Keywords: Anastomosis; Curricular training; Microsurgery; Microsurgical training; Training; Vascular anastomosis.

Fig. 1

Workplace. Each participant works with a binocular microscope. Each microscope has an extra eyepiece

Fig. 2

Instrument set. Straight and curved micro-forceps, straight and curved micro-scissors, micro needle holder, 2 x Biemer vessel clips

Fig. 3

Practical exercises are divided into 10 Steps. A good simulation is characterized by a high degree of authenticity, low cost and a good supply

Fig. 4

The “Dummy”. The dummy represents the perfect low fidelity simulation for microanastomosis. First, a roller is covered with latex (a, b), then a “[·]” is cut out (c). A tube is sewn, using single-stitch technique (d, e). This tube is cut and then sewn together, using running suture (f-i)

Fig. 5

Self-assessment of participants regarding independent performance of 10 learning steps before and after the curriculum. All steps were outlined before evaluation; the participants were then interviewed the first time. At the end of the course a second self-assessment was obtained. The median is shown on the five-step-scale (“not theoretical knowledge” to “self-contained performance without help”). The red curve represents the assessment before the course. The black dashed curve is the self- assessment after the course