利用体视显微镜和简单仪器进行显微外科训练的机会

K. Babichev, A. Stanishevskiy, R. S. Martynov, D. V. Svistov
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引用次数: 0

摘要

背景。现代神经外科要求外科医生熟练掌握显微外科技术,以保证手术的效率和安全性。保持和发展这些技能是神经外科的主要目标之一。显微外科技术简单模型的最佳使用。为此,我们使用立体显微镜和简单的显微仪器,使训练不受主要活动或在家的干扰。介绍一种基于体视显微镜和可用于日常训练的简单显微仪器的显微神经外科训练。材料和方法。采用简易显微器械和体视显微镜进行吻合和缝合训练。所有设备和工具均在全球速卖通网上交易平台购买。我们用9/0-12/0尼龙在固定和最高倍率下缝合纱布的相邻纤维。以鸡血管为材料进行吻合训练。采用臂动脉近端至桡动脉远端一长段血管进行吻合。先进行端侧吻合,再进行相应节段端端吻合。此外,我们还使用自制的乐高盒子,在有限的深场地中训练灵活性和机动性。通过缝合和吻合器的时间和质量来评价显微外科技术的进步。这些模型使用的仪器价格合理,简单易用。最简单但同时有效的训练方法,就是缝合纱布的相邻纤维。每天的训练使我们提高了吻合技术,将吻合端侧的时间从40分钟减少到22分40秒。我们注意到,使用纱布的相邻纤维缝合,减少了15分钟的练习时间。与模拟真实临床环境相比,这种训练系统有一定的缺点。然而,由于极其容易获取和使用,体视显微镜和简单的仪器使我们能够使用它们进行日常训练。这导致了该技术的陡峭学习曲线。本研究提出了一种利用立体显微镜和简单的显微仪器进行显微神经外科训练的有效可行的方法。通过不断的训练,我们的手工技能得到了提高,这证明了无论是在神经外科医生的培训中,还是在未来,显微外科训练都是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Opportunities of microsurgical training using a stereomicroscope and simple instruments
Background. Modern neurosurgery requires the surgeon to be skilled in microsurgical techniques to be able to operate efficiency and safety. Maintaining and developing these skills is one of main goal for neurosurgery. Optimal use of simple models for microsurgical techniques. For this purpose, we use an stereomicroscope and simple microinstruments to enable training without interruption from the main activity or at home.Aim. To introduce a microneurosurgery training based on use of stereomicroscope and simple microinstruments that can be used for daily training.Materials and methods. Simple microinstruments and stereomicroscope were used for anastomosis and suturing training. All equipment and tools were purchased on the AliExpress online trading platform. We suture neighboring fibers of the gauze with 9/0-12/0 nylon under fixed and highest magnification. Chicken blood vessels were used as a material for anastomosis training. A long segment of blood vessel from the proximal brachial artery to the distal radial artery was used for anastomosis. End-to-side anastomosis was practiced first, and the training continued with end-to-end anastomosis of the appropriate segments. Also, we used homemade box made of LEGO for training dexterity and maneuverability in the limited and deep field. Progress in changing microsurgical skills was assessed by the duration and quality of suturing and anastomoses.Results. The instruments used for these models were affordable, simple and easy to use. The simple, but the same time effective training, is the suture neighboring fibers of the gauze. Daily training allowed us improve the skills of anastomosis reducing time for anastomosis end-to-side from 40 min to 22 min 40 sec. The same results we noticed using suture neighboring fibers of the gauze, reducing time of exercises by 15 min. This training system is somewhat of a drawback compared to the simulation of a real clinical setting. However, due to the extremely easy accessibility and accessibility, the stereomicroscope and simple instrument allow us to use them for daily training. This resulted in a steep learning curve of the technique.Conclusion. This study suggests an effective and feasible method for microneurosurgical training using stereomicroscope and simple microinstruments. The improvement of our manual skills, marked by constant training, testifies about the necessity of microsurgical training both in the training of neurosurgeons and in the future.
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