Hino Akihiko
Department of Neurosurgery, Saiseikai Shigaken Hospital, Ohashi 2-4-1, Ritto, Shiga 520-30, Japan.
Neurosurgery. 2003 Jun;52(6):1495-7; discussion 1497-8. doi: 10.1227/01.neu.0000065174.83840.62.
Microarterial anastomosis is now seldom performed for treatment of atherosclerotic occlusive cerebrovascular disease. However, a small but significant number of procedures still require this technique. When a surgeon's clinical experience is limited, regular practice is required to maintain and improve surgical skills. The present training system involves passage from suturing of synthetic materials (such as Silastic tubes) to practice with experimental living animals or cadavers. However, these methods are neither convenient nor practical for daily exercises and rehearsals. I present a unique training exercise for microarterial anastomosis, using a chicken wing artery.
A brachial artery can be extracted from a chicken wing. The artery is 5 to 6 cm long and measures approximately 1 mm in diameter. The artery can be used to practice end-to-end, end-to-side, or side-to-side anastomosis under the microscope.
Several advantages are noted: the materials are cheap, convenient to manage, and easy to obtain, and neither specific facilities to maintain living animals nor anesthesia is needed. Moreover, the diameter and structure of the material are identical to those of human cortical vessels, making the rehearsal quite similar to the actual surgical experience.
This exercise is useful not only for young surgeons who wish to learn microsurgical techniques but also for more experienced surgeons who need to maintain or improve their skills.
目前,微动脉吻合术在治疗动脉粥样硬化性闭塞性脑血管疾病中很少使用。然而,仍有少量但数量可观的手术需要这项技术。当外科医生的临床经验有限时,需要定期练习以保持和提高手术技能。目前的训练系统包括从缝合合成材料(如硅橡胶管)过渡到用实验活体动物或尸体进行练习。然而,这些方法对于日常练习和演练既不方便也不实用。我介绍一种使用鸡翅动脉进行微动脉吻合术的独特训练方法。
可以从鸡翅中取出肱动脉。该动脉长5至6厘米,直径约1毫米。该动脉可用于在显微镜下进行端端、端侧或侧侧吻合术练习。
该方法具有几个优点:材料便宜、易于管理且容易获得,既不需要饲养活体动物的特殊设施,也不需要麻醉。此外,材料的直径和结构与人类皮质血管相同,使得演练与实际手术体验非常相似。
这项练习不仅对希望学习显微外科技术的年轻外科医生有用,而且对需要保持或提高技能的经验更丰富的外科医生也有用。