Kraemer Bernhard, Hoffmann Juergen, Wallwiener Markus, Wallwiener Christian, Rajab Taufiek Konrad
University Hospital for Women, Tuebingen, Germany.
J Obstet Gynaecol Res. 2010 Oct;36(5):1075-9. doi: 10.1111/j.1447-0756.2010.01281.x. Epub 2010 Aug 17.
This study aims to introduce a training program for microvascular anastomosis that includes an in vivo model which is elegant and effective.
MATERIAL & METHODS: The infrarenal abdominal aorta or inferior vena cava of anesthetized live Sprague-Dawley rats were dissected, clamped and divided. Two trainees each created 12 microsurgical anastomoses in six animals. The training effect was measured by comparing the time taken to perform the initial anastomoses with the final attempts for each trainee. Afterwards, each anastomosis was probed to check whether the procedure was successful.
The training model was practical and easy to set up. The average diameter of the aorta measured 1.5 mm and the vein measured 2.1 mm, which reflects the situation in human gynecological reconstructive surgery. The achieved training effect over the course of the training was highly significant. Arterial anastomosis time improved by an average of 8.5 min (P < 0.01) and venous anastomosis time improved by an average of 13.2 min (P < 0.01). The success rate for arterial anastomoses was 67%. In contrast, venous anastomosis was a more difficult exercise, with a success rate of 36% (P < 0.05).
The study establishes a practicable in vivo model of microvascular anastomotic training for gynecologists.
本研究旨在引入一种微血管吻合训练方案，该方案包含一种优雅且有效的体内模型。
解剖、夹闭并切断麻醉状态下的Sprague-Dawley大鼠的肾下腹主动脉或下腔静脉。两名学员分别在六只动物身上进行12次显微外科吻合。通过比较每位学员进行初次吻合和最终尝试所花费的时间来衡量训练效果。之后，对每个吻合口进行探查，以检查手术是否成功。
该训练模型实用且易于搭建。所测主动脉平均直径为1.5毫米，静脉平均直径为2.1毫米，这反映了人类妇科重建手术的情况。在训练过程中所取得的训练效果非常显著。动脉吻合时间平均缩短了8.5分钟（P < 0.01），静脉吻合时间平均缩短了13.2分钟（P < 0.01）。动脉吻合成功率为67%。相比之下，静脉吻合难度更大，成功率为36%（P < 0.05）。
本研究为妇科医生建立了一种可行的微血管吻合训练体内模型。
