Ex Vivo Rabbit: A Novel High-Fidelity Training Model for Microsurgical and Supermicrosurgical Training.

Autores de IIS La Fe

• Concepcion Lorca Garcia

  Autor

• Ivan Heredia Alcalde

  Autor

• Pedro Alvedro Ruiz

  Autor

• Maria Garcia Garcia

  Autor

• Alberto Ruíz Cases

  Autor

• María Dolores Pérez Del Caz

  Autor

Grupos

• Dermatología y Regeneración Tisular

Abstract

The development of appropriate microsurgical and supermicrosurgical skills is essential for reconstructive surgeons. Training courses frequently employ in vivo models, which have various drawbacks: Limited availability, high cost, and/or ethical conflicts. To overcome these limitations, we looked for an inert model that was analogous to the gold standard in vivo, surpassing the classic ex vivo models at the same time.We studied the ex vivo rabbit as an animal training model by means of 10 specimen dissections, microscopically analyzing the mean caliber and length of its main vascular pedicles and comparing them to those of the most common flaps and recipient vessels employed in reconstructive surgery. We designed a routine with increasingly difficult exercises, which we propose as a training plan.The rabbit's main vascular pedicles have a mean caliber of 0.4 mm (internal mammary), 0.8 mm (iliolumbar), 0.9 mm (brachial), 1.2 mm (femoral), 1.5 mm (renal), 1.9 mm (common carotid), and 2.8 mm (aorta). They allow for a progressive increase in the level of complexity, as well as the practice of a wide variety of techniques (end-to-end anastomosis between vessels of different sizes, end-to-side anastomosis, neurorrhaphies, nerve transfers, ortho- and heterotopic replants, and free flaps).The ex vivo rabbit serves as a valid alternative to other recognized high-fidelity microsurgical models, overcoming the limitations of in vivo-it is easily accessible, inexpensive, and inert-as well as ex vivo-it offers a wide range of calibers and the possibility of practicing advanced techniques-models which have been used in the past.

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Keywords

• Anastomosis, Surgical; Animals; Microsurgery; Models, Animal; Plastic Surgery Procedures; Rabbits; Recipient Vessels; Surgical Flaps; adult; article; controlled study; end to end anastomosis; end to side anastomosis; ex vivo study; exercise; female; femur; free tissue graft; human; human tissue; Leporidae; male; microsurgery; nerve transplantation; nonhuman; reconstructive surgery; therapy; training; vascular pedicle; anastomosis; animal; animal model; education; Leporidae; plastic surgery; recipient vessel; surgical flaps; vascularization