Abstract
Background Benchtop microsurgical training models that use digital tools (smartphones, tablets,
and virtual reality [VR]) for magnification are allowing trainees to practice without
operating microscopes. This systematic review identifies existing microscope-free
training models, compares models in their ability to enhance microsurgical skills,
and presents a step-by-step protocol for surgeons seeking to assemble their own microsurgery
training model.
Methods We queried PubMed, Embase, and Web of Science databases through November 2020 for
microsurgery training models and performed a systematic review following the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We collected
data including training model characteristics (cost, magnification, and components)
and outcomes (trainee satisfaction, image resolution, and faster suturing speed).
We also conducted a complimentary Google search to identify commercially available
microscope-free microsurgical training models or kits not reported in peer-reviewed
literature.
Results Literature search identified 1,805 publications; 24 of these met inclusion criteria.
Magnification tools most commonly included smartphones (n = 10), VR simulators (n = 4), and tablets (n = 3), with magnification ranging up to ×250 magnification on digital microscopy,
×50 on smartphones, and ×5 on tablets. Average cost of training models ranged from
$13 (magnification lens) to $15,000 (augmented reality model). Model were formally
assessed using workshops with trainees or attendings (n = 10), surveys to end-users (n = 5), and single-user training (n = 4); users-reported satisfaction with training models and demonstrated faster suturing
speed and increased suturing quality with model training. Five commercially available
microsurgery training models were identified through Google search.
Conclusion Benchtop microsurgery trainers using digital magnification successfully provide trainees
with increased ease of microsurgery training. Low-cost yet high magnification setups
using digital microscopes and smartphones are optimal for trainees to improve microsurgical
skills. Our assembly protocol, “1, 2, 3, Microsurgery,” provides instructions for
training model set up to fit the unique needs of any microsurgery trainee.
Keywords
microsurgery - digital - education - resident training - microscope
