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Mikroanastomoz eğitiminde basamaklı multimodal yaklaşım: Sentetik, biyolojik ve canlı modellerin katılımcı görüşlerine dayalı değerlendirilmesi

Yıl 2025, Cilt: 9 Sayı: 3, 465 - 471, 31.12.2025
https://doi.org/10.29058/mjwbs.1828399
https://izlik.org/JA66NP53LD

Öz

Amaç: Bu çalışma, ulusal bir nörovasküler sempozyumu sırasında uygulanan yapılandırılmış bir mikrocerrahi eğitim programında kullanılan dört mikroanastomoz eğitim modelinin (silikon tüp modeli, tavuk kanadı brakiyal arter modeli, UpSurgeOn Mycro simülatörü ve Wistar Albino sıçan modeli) algılanan eğitsel değerini değerlendirmektedir.
Gereç ve Yöntemler: On altı katılımcı, basamaklı bir eğitim dizisini takip eden iki günlük, on altı saatlik bir mikrocerrahi kursunu tamamladı. Her modalite için gerçekçilik, teknik zorluk, özgüven ve mikro-vasküler beceri gelişimine genel uygunluk gibi ölçütleri değerlendiren beşli Likert ölçekleri kullanılarak eğitim öncesi ve sonrası anketler uygulandı.
Bulgular: Tüm modaliteler eğitsel açıdan faydalı olarak algılandı ve mikroanastomoz becerilerinin farklı aşamalarında katkı sağladı. Silikon tüp modeli, erken aşama beceri kazanımı ve temel alet koordinasyonu geliştirilmesi için oldukça etkili olarak değerlendirildi. Tavuk kanadı brakiyal arter modeli, lojistik ve etik kısıtlamalardan kaçınırken temel biyolojik özellikleri yansıtması nedeniyle takdir edildi. Wistar Albino sıçan modeli, sürekli olarak eğitim programının en gerçekçi ve eğitsel açıdan en değerli bileşeni olarak değerlendirildi ve ameliyat koşullarına en yakın deneyimi sundu. UpSurgeOn Mycro simülatörü katılımcı beklentilerini karşılamasa da sentetik ve biyolojik modeller arasında yararlı bir köprü işlevi gördü.
Sonuç: Bu çok modelli basamaklı mikroanastomoz eğitim yaklaşımı, eğitsel açıdan değerli olarak algılanmış olup, her model beceri gelişiminin farklı aşamalarına katkıda bulunmuştur. Bu bulgular, yapılandırılmış simülasyon temelli mikroanastomoz eğitiminin ulusal nöroşirürji eğitim programlarına dâhil edilmesinin klinik pratiğe hazırlığı destekleyebileceğini göstermektedir.

Kaynakça

  • Wessels L, Hecht N, Vajkoczy P. Bypass in neurosurgery-indications and techniques. Neurosurg Rev. 2019;42(2):389-393. https://doi.org/10.1007/s10143-018-0966-9
  • Byvaltsev VA, Akshulakov SK, Polkin RA, Ochkal SV, Stepanov IA, Makhambetov YT, et al. Microvascular Anastomosis Training in Neurosurgery: A Review. Minim Invasive Surg. 2018;2018:6130286. https://doi.org/10.1155/2018/6130286
  • Prunières GJ, Taleb C, Hendriks S, Miyamoto H, Kuroshima N, Liverneaux PA, et al. Use of the Konnyaku Shirataki noodle as a low fidelity simulation training model for microvascular surgery in the operating theatre. Chir Main. 2014;33(2):106-111. https://doi.org/10.1016/j.main.2013.12.003
  • Atlan M, Lellouch AG, Legagneux J, Chaouat M, Masquelet AC, Letourneur D. A New Synthetic Model for Microvascular Anastomosis Training? A Randomized Comparative Study Between Silicone and Polyvinyl Alcohol Gelatin Tubes. J Surg Educ. 2018;75(1):182-187. https://doi.org/10.1016/j.jsurg.2017.06.008
  • Hino A. Training in microvascular surgery using a chicken wing artery. Neurosurgery. 2003;52(6):1495-1497; discussion 1497-1498. https://doi.org/10.1227/01.NEU.0000065174.83840.62
  • Egemen E, Yakar F. A step by step laboratory guide for end to side anastomosis: chicken wing model. Pam Med J. 2021;14(2):396-400. https://doi.org/10.31362/patd.844371
  • Hwang G, Oh CW, Park SQ, Sheen SH, Bang JS, Kang HS. Comparison of different microanastomosis training models: model accuracy and practicality. J Korean Neurosurg Soc. 2010;47(4):287-290. https://doi.org/10.3340/jkns.2010.47.4.287
  • Olabe J, Olabe J. Microsurgical training on an in vitro chicken wing infusion model. Surg Neurol. 2009;72(6):695-699. https://doi.org/10.1016/j.surneu.2008.12.008
  • Abla AA, Uschold T, Preul MC, Zabramski JM. Comparative use of turkey and chicken wing brachial artery models for microvascular anastomosis training. J Neurosurg. 2011;115(6):1231-1235. https://doi.org/10.3171/2011.7.JNS102013
  • Colpan ME, Slavin KV, Amin-Hanjani S, Calderon-Arnuphi M, Charbel FT. Microvascular anastomosis training model based on a Turkey neck with perfused arteries. Neurosurgery. 2008;62(5 Suppl 2):ONS407-10; discussion ONS410-1. https://doi.org/10.1227/01.neu.0000326026.01349.75
  • Guida L, Sebök M, Oliveira MM, van Niftrik CHB, Charbel FT, Cenzato M, et al. Neurosurgical Microvascular Anastomosis: Systematic Review of the Existing Simulators and Proposal of a New Training Classification System. Brain Sci. 2024;14(10):1031. https://doi.org/10.3390/brainsci14101031
  • Mattar TGDM, Santos GBD, Telles JPM, Rezende MR, Wei TH, Mattar Júnior R. Structured evaluation of a comprehensive microsurgical training program. Clinics (Sao Paulo). 2021;76:e3194. https://doi.org/10.6061/clinics/2021/e3194
  • Juratli MA, Becker F, Palmes D, Stöppeler S, Bahde R, Kebschull L, et al. Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital. BMC Med Educ. 2021;21(1):295. https://doi.org/10.1186/s12909-021-02737-1
  • Petrone S, Cofano F, Nicolosi F, Spena G, Moschino M, Di Perna G, et al. Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents. Front Surg. 2022;9:862948. https://doi.org/10.3389/fsurg.2022.862948
  • Ahmed R, Muirhead W, Williams SC, Bagchi B, Datta P, Gupta P, et al. A synthetic model simulator for intracranial aneurysm clipping: validation of the UpSurgeOn AneurysmBox. Front Surg. 2023;10:1185516. https://doi.org/10.3389/fsurg.2023.1185516

A stepwise multimodal approach to microanastomosis training: Participant-reported evaluation of synthetic, biological, and living platforms

Yıl 2025, Cilt: 9 Sayı: 3, 465 - 471, 31.12.2025
https://doi.org/10.29058/mjwbs.1828399
https://izlik.org/JA66NP53LD

Öz

Aim: This study evaluates the perceived educational value of four microanastomosis training models: the silicone tube model, the chicken wing brachial artery model, the UpSurgeOn Mycro simulator, and the Wistar Albino rat model, used within a structured microsurgical training program delivered during a national neurovascular symposium.
Material and Methods: Sixteen participants completed a two-day, sixteen-hour microsurgical course that followed a stepwise training sequence. Pre-training and post-training surveys were administered for each modality using five-point Likert scales evaluating realism, technical difficulty, confidence, and overall suitability for microvascular skill development.
Results: All modalities were perceived as educationally beneficial and contributed to microanastomosis skill development at different stages. The silicone tube model was viewed as highly effective for early-stage skill acquisition and basic instrument coordination. The chicken wing brachial artery model was appreciated for reproducing key biological characteristics while avoiding the logistical and ethical constraints. The Wistar Albino rat model was consistently rated as the most realistic and educationally valuable component of the training program, providing the closest approximation to operative conditions. The UpSurgeOn Mycro simulator did not meet participants expectations but served as a useful bridge between synthetic and biologic models.
Conclusion: This multimodal stepwise approach to microanastomosis training was perceived as educationally valuable, with each model contributing at different stages of skill development. Based on these observations, incorporating structured simulation-based microanastomosis training into national neurosurgical education programs may help support preparedness for clinical practice.

Kaynakça

  • Wessels L, Hecht N, Vajkoczy P. Bypass in neurosurgery-indications and techniques. Neurosurg Rev. 2019;42(2):389-393. https://doi.org/10.1007/s10143-018-0966-9
  • Byvaltsev VA, Akshulakov SK, Polkin RA, Ochkal SV, Stepanov IA, Makhambetov YT, et al. Microvascular Anastomosis Training in Neurosurgery: A Review. Minim Invasive Surg. 2018;2018:6130286. https://doi.org/10.1155/2018/6130286
  • Prunières GJ, Taleb C, Hendriks S, Miyamoto H, Kuroshima N, Liverneaux PA, et al. Use of the Konnyaku Shirataki noodle as a low fidelity simulation training model for microvascular surgery in the operating theatre. Chir Main. 2014;33(2):106-111. https://doi.org/10.1016/j.main.2013.12.003
  • Atlan M, Lellouch AG, Legagneux J, Chaouat M, Masquelet AC, Letourneur D. A New Synthetic Model for Microvascular Anastomosis Training? A Randomized Comparative Study Between Silicone and Polyvinyl Alcohol Gelatin Tubes. J Surg Educ. 2018;75(1):182-187. https://doi.org/10.1016/j.jsurg.2017.06.008
  • Hino A. Training in microvascular surgery using a chicken wing artery. Neurosurgery. 2003;52(6):1495-1497; discussion 1497-1498. https://doi.org/10.1227/01.NEU.0000065174.83840.62
  • Egemen E, Yakar F. A step by step laboratory guide for end to side anastomosis: chicken wing model. Pam Med J. 2021;14(2):396-400. https://doi.org/10.31362/patd.844371
  • Hwang G, Oh CW, Park SQ, Sheen SH, Bang JS, Kang HS. Comparison of different microanastomosis training models: model accuracy and practicality. J Korean Neurosurg Soc. 2010;47(4):287-290. https://doi.org/10.3340/jkns.2010.47.4.287
  • Olabe J, Olabe J. Microsurgical training on an in vitro chicken wing infusion model. Surg Neurol. 2009;72(6):695-699. https://doi.org/10.1016/j.surneu.2008.12.008
  • Abla AA, Uschold T, Preul MC, Zabramski JM. Comparative use of turkey and chicken wing brachial artery models for microvascular anastomosis training. J Neurosurg. 2011;115(6):1231-1235. https://doi.org/10.3171/2011.7.JNS102013
  • Colpan ME, Slavin KV, Amin-Hanjani S, Calderon-Arnuphi M, Charbel FT. Microvascular anastomosis training model based on a Turkey neck with perfused arteries. Neurosurgery. 2008;62(5 Suppl 2):ONS407-10; discussion ONS410-1. https://doi.org/10.1227/01.neu.0000326026.01349.75
  • Guida L, Sebök M, Oliveira MM, van Niftrik CHB, Charbel FT, Cenzato M, et al. Neurosurgical Microvascular Anastomosis: Systematic Review of the Existing Simulators and Proposal of a New Training Classification System. Brain Sci. 2024;14(10):1031. https://doi.org/10.3390/brainsci14101031
  • Mattar TGDM, Santos GBD, Telles JPM, Rezende MR, Wei TH, Mattar Júnior R. Structured evaluation of a comprehensive microsurgical training program. Clinics (Sao Paulo). 2021;76:e3194. https://doi.org/10.6061/clinics/2021/e3194
  • Juratli MA, Becker F, Palmes D, Stöppeler S, Bahde R, Kebschull L, et al. Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital. BMC Med Educ. 2021;21(1):295. https://doi.org/10.1186/s12909-021-02737-1
  • Petrone S, Cofano F, Nicolosi F, Spena G, Moschino M, Di Perna G, et al. Virtual-Augmented Reality and Life-Like Neurosurgical Simulator for Training: First Evaluation of a Hands-On Experience for Residents. Front Surg. 2022;9:862948. https://doi.org/10.3389/fsurg.2022.862948
  • Ahmed R, Muirhead W, Williams SC, Bagchi B, Datta P, Gupta P, et al. A synthetic model simulator for intracranial aneurysm clipping: validation of the UpSurgeOn AneurysmBox. Front Surg. 2023;10:1185516. https://doi.org/10.3389/fsurg.2023.1185516
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Beyin ve Sinir Cerrahisi (Nöroşirurji)
Bölüm Araştırma Makalesi
Yazarlar

Serkan Civlan 0000-0001-8915-8186

Mehmet Sabri Gürbüz 0000-0002-3764-389X

Nevzat Doğukan Erbek 0009-0001-1995-5611

Burak Karaaslan 0000-0003-1015-396X

Batuhan Bakırarar 0000-0002-5662-8193

Çağrı Elbir 0000-0002-8747-2187

Göktuğ Ülkü 0000-0003-1430-2977

Mustafa Arıcı 0000-0003-2947-2880

Erhan Türkoğlu 0000-0001-7044-617X

Mehmet Erdal Coşkun 0000-0002-2816-0722

Fatih Yakar 0000-0001-7414-3766

Gönderilme Tarihi 22 Kasım 2025
Kabul Tarihi 20 Aralık 2025
Yayımlanma Tarihi 31 Aralık 2025
DOI https://doi.org/10.29058/mjwbs.1828399
IZ https://izlik.org/JA66NP53LD
Yayımlandığı Sayı Yıl 2025 Cilt: 9 Sayı: 3

Kaynak Göster

Vancouver 1.Serkan Civlan, Mehmet Sabri Gürbüz, Nevzat Doğukan Erbek, Burak Karaaslan, Batuhan Bakırarar, Çağrı Elbir, Göktuğ Ülkü, Mustafa Arıcı, Erhan Türkoğlu, Mehmet Erdal Coşkun, Fatih Yakar. A stepwise multimodal approach to microanastomosis training: Participant-reported evaluation of synthetic, biological, and living platforms. Med J West Black Sea. 01 Aralık 2025;9(3):465-71. doi:10.29058/mjwbs.1828399

Batı Karadeniz Tıp Dergisi, Zonguldak Bülent Ecevit Üniversitesi tarafından yayımlanan, uluslararası, hakemli ve açık erişimli bir dergidir. İlk sayısı 2017 yılında yayımlanan dergi, yılda üç kez (Nisan, Ağustos ve Aralık aylarında) yayımlanmakta olup Türkçe ve İngilizce makalelere yer verir.