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Minimally Invasive Surgery
Volume 2018, Article ID 6130286, 9 pages
https://doi.org/10.1155/2018/6130286
Review Article

Microvascular Anastomosis Training in Neurosurgery: A Review

1Irkutsk State Medical University, Krasnogo Vosstaniya St. 1, Irkutsk, Russia
2Irkutsk Scientific Center of Surgery and Traumatology, Bortsov Revolutsii St. 1, Irkutsk, Russia
3Railway Clinical Hospital, Irkutsk-Passazhirskiy of Russian Railways Ltd., Botkina St. 10, Irkutsk, Russia
4Irkutsk State Medical Academy of Postgraduate Education, Jubileiniyi 100, Irkutsk, Russia
5National Center of Neurosurgery, 34/1 Turan Av., Astana, Kazakhstan
6Department of Neurosurgery Research, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 West Thomas Road, Phoenix, AZ 85013, USA

Correspondence should be addressed to Vadim A. Byvaltsev; ur.xednay@midav57lavyb

Received 27 November 2017; Accepted 20 February 2018; Published 28 March 2018

Academic Editor: Peng Hui Wang

Copyright © 2018 Vadim A. Byvaltsev et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques. In this text we will briefly discuss the history of microvascular surgery, review current literature on simulation models with the emphasis on their merits and shortcomings, and describe the views and opinions on the future of the microvascular training in neurosurgery. In “dry” microsurgical training, various models created from artificial materials that simulate biological tissues are used. The next stage in training more experienced surgeons is to work with nonliving tissue models. Microvascular training using live models is considered to be the most relevant due to presence of the blood flow. Training on laboratory animals has high indicators of face and constructive validity. One of the future directions in the development of microsurgical techniques is the use of robotic systems. Robotic systems may play a role in teaching future generations of microsurgeons. Modern technologies allow access to highly accurate learning environments that are extremely similar to real environment. Additionally, assessment of microsurgical skills should become a fundamental part of the current evaluation of competence within a microneurosurgical training program. Such an assessment tool could be utilized to ensure a constant level of surgical competence within the recertification process. It is important that this evaluation be based on validated models.