Lahiri Amitabha, Muttath Sandeep Sebastin, Yusoff Siti Khadijah, Chong Alphonsus Ks
Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.
J Hand Surg Asian Pac Vol. 2020 Jun;25(2):206-213. doi: 10.1142/S2424835520500241.
Microvascular surgery is now an integral part of many surgical disciplines, and the success of these procedures relies on the technical skills of the surgeon. Although numerous training models and simulations have been developed, the living rat model is favoured for its high fidelity to clinical microsurgery. However, there are serious ethical concerns over the use of live models for training. The aim of this study was to demonstrate if effective skill acquisition was possible with a reduction in the number of live rats. Two course structures were designed, that were implemented. Total training hours remained the same in both the courses, but the number of rats used was reduced from conventional five rats per participant to four in group A and to three in group B while increasing the training time spent on synthetic and ex-vivo models. We assessed the effectiveness of the courses by comparing the patency rates, the time taken per anastomosis and efficiency of the utilisation rate of rats. There were 30 participants in Group A and 28 participants in group B. We observed that group B was able to perform anastomosis in a significantly shorter time and with patency rates similar to group A in spite of a lesser number of rats used in the training. we were able to conclusively demonstrate that it was possible to reduce live rat usage in microsurgical training without compromising on the quality of training.
微血管手术如今是许多外科领域不可或缺的一部分，这些手术的成功依赖于外科医生的技术技能。尽管已经开发出众多培训模型和模拟方法，但活体大鼠模型因其对临床显微手术的高度逼真度而受到青睐。然而，使用活体模型进行培训存在严重的伦理问题。本研究的目的是证明减少活体大鼠数量的情况下是否有可能实现有效的技能习得。设计并实施了两种课程结构。两门课程的总培训时长保持不变，但每组使用的大鼠数量从常规的每位参与者5只减少到A组的4只和B组的3只，同时增加了在合成模型和离体模型上花费的培训时间。我们通过比较通畅率、每次吻合所需时间以及大鼠利用率来评估课程的有效性。A组有30名参与者，B组有28名参与者。我们观察到，尽管B组在培训中使用的大鼠数量较少，但能够在显著更短的时间内完成吻合，且通畅率与A组相似。我们能够确凿地证明，在不影响培训质量的情况下，减少显微手术培训中活体大鼠的使用是可行的。
