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J Reconstr Microsurg 2022; 38(04): 313-320
DOI: 10.1055/s-0041-1735291
Original Article

A Comparison of the Use of Two-Dimensional and Three-Dimensional Visualization Systems by Novice and Experienced Microsurgeons in Microsurgical Vessel Anastomosis: An Analysis Using the Chicken Model

Wen-Chien Wang
1   Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan
,
Hsiang-Wei Hu
2   Department of Medical Education, National Cheng Kung University Hospital, Tainan, Taiwan
,
Pedro Ciudad
3   Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
4   School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
5   Department of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital, Lima, Peru
,
Bor-Shyh Lin
6   Institute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan, Taiwan
,
Hung-Chi Chen
3   Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
4   School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
,
Chang-Cheng Chang
3   Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan
4   School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
6   Institute of Imaging and Biomedical Photonics, National Yang Ming Chiao Tung University, Tainan, Taiwan
7   Institute of Cosmeceutics, China Medical University, Taichung, Taiwan
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Abstract

Background Various studies have discussed the benefits of applying three-dimensional (3D) techniques, specifically its advantages with respect to ergonomics, feasibility, and the rate of learning achievable in microsurgery training. However, no study has been conducted that compares the operator experience of using two-dimensional (2D) and 3D systems in microsurgical training. The aim of this study is to compare 2D- and 3D-assisted microsurgical training in novices based on anastomosis of chicken femoral arteries.

Methods The participants were grouped by previous microsurgical experience. Group A includes novice participants. Group B includes 2D-experienced participants. Group C includes both participants in groups A and B. A questionnaire composed of 10 parameters in the field of image quality, dexterity, ergonomic, and feasibility will be filled out after each participant finished their anastomoses by the 2D and 3D systems.

Results The results demonstrated 3D system was scored better on “field of view” (p = 0.004), “less tremor” (p = 0.005), “neck/upper back comfort” (p = 0.043), “lower back comfort” (p = 0.015), “technical feasibility” (p = 0.020), and “educational feasibility” (p = 0.004) in group A (N = 12). In group B (N = 9), 3D system was scored better on “field of view” (p = 0.041) but worse on “image resolution” (p = 0.031).

Conclusion With the 3D visualization system for microsurgical anastomosis of chicken femoral model, there are significant improvements in the field of view, stability, ergonomics, and educational value compared with 2D system among all participants. Accordingly, 3D-assisted microsurgery training can be a novel and potential popular training method.

Keywords

microsurgical training - three-dimensional (3D) visualization system - chicken femoral artery - medical - microsurgery

Note

We have presented a subset of our findings at 6th World Congress of World Association of Plastic Surgeons of Chinese Descend in Taipei in 2018, annual meeting of Taiwan Society for Reconstructive Microsurgery in Taipei in 2019, and 10th Congress of World Society for Reconstructive Microsurgery in 2019.


Ethical Approval

This research project was approved by the Research Ethics Committee (REC) of China Medical University Hospital (REC No.: CMUH107-REC1-146).




Publication History

Received: 14 February 2021

Accepted: 31 May 2021

Article published online:
28 August 2021

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  • References

  • 1 Chan WY, Matteucci P, Southern SJ. Validation of microsurgical models in microsurgery training and competence: a review. Microsurgery 2007; 27 (05) 494-499
    CrossrefPubMedGoogle Scholar
  • 2 Leal Ghezzi T, Campos Corleta O. 30 Years of robotic surgery. World J Surg 2016; 40 (10) 2550-2557
    CrossrefPubMedGoogle Scholar
  • 3 Becker H, Melzer A, Schurr MO, Buess G. 3-D video techniques in endoscopic surgery. Endosc Surg Allied Technol 1993; 1 (01) 40-46
    PubMedGoogle Scholar
  • 4 Mendez BM, Chiodo MV, Vandevender D, Patel PA. Heads-up 3D microscopy: an ergonomic and educational approach to microsurgery. Plast Reconstr Surg Glob Open 2016; 4 (05) e717
    CrossrefPubMedGoogle Scholar
  • 5 Kotsougiani D, Hundepool CA, Bulstra LF, Shin DM, Shin AY, Bishop AT. The learning rate in three dimensional high definition video assisted microvascular anastomosis in a rat model. J Plast Reconstr Aesthet Surg 2016; 69 (11) 1528-1536
    CrossrefPubMedGoogle Scholar
  • 6 Wong AK, Davis GB, Nguyen TJ. et al. Assessment of three-dimensional high-definition visualization technology to perform microvascular anastomosis. J Plast Reconstr Aesthet Surg 2014; 67 (07) 967-972
    CrossrefPubMedGoogle Scholar
  • 7 Lakhiani C, Fisher SM, Janhofer DE, Song DH. Ergonomics in microsurgery. J Surg Oncol 2018; 118 (05) 840-844
    CrossrefPubMedGoogle Scholar
  • 8 Howarth AL, Hallbeck S, Mahabir RC, Lemaine V, Evans GRD, Noland SS. Work-related musculoskeletal discomfort and injury in microsurgeons. J Reconstr Microsurg 2019; 35 (05) 322-328
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Jeong HS, Moon MS, Kim HS, Lee HK, Yi SY. Microsurgical training with fresh chicken legs. Ann Plast Surg 2013; 70 (01) 57-61
    CrossrefPubMedGoogle Scholar
  • 10 Blidisel A, Jiga L, Nistor A, Dornean V, Hoinoiu B, Ionac M. Video-assisted versus conventional microsurgical training: a comparative study in the rat model. Microsurgery 2007; 27 (05) 446-450
    CrossrefPubMedGoogle Scholar
  • 11 Pafitanis G, Serrar Y, Raveendran M, Ghanem A, Myers S. The chicken thigh adductor profundus free muscle flap: a novel validated non-living microsurgery simulation training model. Arch Plast Surg 2017; 44 (04) 293-300
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Gunasagaran J, Rasid RJ, Mappiare S, Devarajooh C, Ahmad TS. Microgrids: a model for basic microsurgery skills training. Malays Orthop J 2018; 12 (02) 37-41
    CrossrefPubMedGoogle Scholar
  • 13 Godwin Y, Macdonald CR, Kaur S, Zhelin L, Baber C. The impact of cervical musculoskeletal disorders on UK consultant plastic surgeons: can we reduce morbidity with applied ergonomics?. Ann Plast Surg 2017; 78 (06) 602-610
    CrossrefPubMedGoogle Scholar
  • 14 Franken RJ, Gupta SC, Banis Jr JC. et al. Microsurgery without a microscope: laboratory evaluation of a three-dimensional on-screen microsurgery system. Microsurgery 1995; 16 (11) 746-751
    CrossrefPubMedGoogle Scholar