gms | German Medical Science

Objectives: Microsurgery is a complex manual skill, best taught through initial instruction on basic microsurgical techniques followed by years of practice in the operating room to master these skills. In 2008 the authors established a microsurgery teaching course in Germany. The purpose of this presentation is to describe our microsurgery course and provide numbers of trainees and procedures they have performed.

Method: Between 2008-2016, 178 trainees (123 males (69%), 55 females (31%)) from 30 countries participated in 37 weeks a separate five-day long courses, with a maximum of 5 participants in each week. The instructional lecture consisted of a theoretical part with 14-55 min of DVD lectures/day, combined with hands on practice. Starting on a rubber model then using the femoral arteries and veins of a living rat. A full time instructor was available any time, providing one-on-one instructions. The equipments used were clinical operation microscopes, with the best micro instruments and micro sutures available for clinical used.

Results: 95 trainees (53%) were from outside of Germany, and 83 trainees (47%) were from Germany. Four different groups of disciplines participated: Plastic Surgery (78 trainees), Trauma & Orthopedic Surgery (54 trainees), General Surgery (including Vascular/Neurosurgery, 37 trainees), and Research/Vet (9 trainees). Of the 178 total trainees 87 (49%) had no previous experience doing microsurgery and 24 had participated in a microsurgery course previously. During the courses 437 (average 2.5/student) arterial anastomoses were performed with a patency rate of 82%; 322 (average 1.8/student) venous anastomoses were performed, with a patency rate of 44% and 430 (average 2.4/student) challenging techniques (like vein grafts and end-to-side and continuous anastomosis) were performed, with a patency rate of 72%.

Conclusion: We have established a microsurgery course to teach basic microsurgical techniques and have trained participants from 4 different groups of specialties. We found that upon participating in the course, most of the participants, independent of their specialties, were able to perform anastomoses in rat femoral vessels. 152 (85%) of the participants were able to successfully perform more technically challenging techniques. Based on our experience and observations we believe that the method of instruction used in our course provides participants with the basic microsurgical skills necessary to perform microvascular anastomoses in a clinical setting.