Bedi Manbachan Singh, Bhavthankar Tanmay D, Girijala Malleswara R, Babu Jagadeesh K, Ambati Vimala, Jonalgadda Varun, Ogando-Rivas Elizabeth, Konchada Kamesh, Juluru Chaitanya S, Jvnk Aravind
Department of Neurosurgery, Mamata Medical College and Superspeciality Hospital, Khammam, Telangana, India.
Department of Neurosurgery, Mamata Medical College and Superspeciality Hospital, Khammam, Telangana, India.
World Neurosurg. 2019 May;125:433-442. doi: 10.1016/j.wneu.2019.01.141. Epub 2019 Feb 2.
The art of surgery is becoming increasingly complex and dependent on scopes, screens, and technology, inviting a complex learning curve and development of hand-eye coordination and dexterity among other skills. We introduce an affordable, do-it-yourself microsurgical simulator that can be set up using a smartphone and a pair of reflective prism glasses. The glasses employ periscopic prisms on either side that reflect light perpendicularly. When the visual input is combined with the magnification of a smartphone camera, a real-time microsurgical experience can be simulated.
We analyzed the performance of 2 trainee residents in performing their first 5 successful sutures with 5-0 polypropylene thread on the cut ends of a glove over the course of 3 months. The module was also assessed in a survey at an international conference of neurosurgeons.
A significant improvement was observed in both residents at the end of each month versus baseline (P < 0.05). Of 27 survey participants, 3 (11%) reported access to a training laboratory in their institute. The module was rated 4/5 in terms of hand-eye coordination, 3.5/5 in management of microsurgical field, and 3.5/5 in depth perception.
The microsurgical simulation technique proved to be useful in performing complex microsurgical tasks. A significant improvement in microsurgical skills was observed among our trainees. The cost of building the module can be as low as U.S. $5. We endorse the use of this technique for resident training and skill development, especially in resource-challenged environments.
外科手术技术日益复杂，依赖于各种内镜、屏幕和技术，这带来了复杂的学习曲线，并需要培养手眼协调能力和灵活性等技能。我们推出了一种价格实惠的自制显微手术模拟器，它可以通过一部智能手机和一副反射棱镜眼镜搭建而成。这种眼镜两侧使用潜望镜棱镜，可垂直反射光线。当视觉输入与智能手机摄像头的放大功能相结合时，就能模拟实时显微手术体验。
我们分析了2名住院医师培训学员在3个月内使用5-0聚丙烯线在手套切口端成功完成前5次缝合的表现。该模块还在一次国际神经外科医生会议的调查中进行了评估。
与基线相比，两名住院医师在每个月末均有显著进步（P < 0.05）。在27名参与调查者中，3人（11%）报告其所在机构设有培训实验室。该模块在手眼协调方面的评分是4/5，在显微手术视野管理方面是3.5/5，在深度感知方面是3.5/5。
显微手术模拟技术在执行复杂显微手术任务中被证明是有用的。我们的学员在显微手术技能方面有显著提高。搭建该模块的成本可低至5美元。我们支持将这项技术用于住院医师培训和技能发展，尤其是在资源匮乏的环境中。
