Surgical Anatomy and Exercises Using the Chicken Thigh Sciatic Nerve for Microsurgery Training.

IF 0.3 Q4 SURGERY Journal of Hand and Microsurgery Pub Date : 2022-07-06 eCollection Date: 2023-12-01 DOI:10.1055/s-0042-1749444
Alphonsus K S Chong, Lan Anh T Le, Amitabha Lahiri, Khadijah Yusoff, George W Yip, Feng Pan, Wendy Teo, Janice C Y Liao, Jin Xi Lim
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Abstract

Introduction  Vessel repair in a chicken thigh is commonly used in microsurgery training model. The sciatic nerve is closely associated with the vessels and has been used for training nerve coaptation, which has different technical considerations from vessel anastomosis. We describe in detail the relevant surgical anatomy and training exercises that can be used with this model. Methods  With 32 fresh store-bought chicken thighs, 16 were used to analyze the gross and histological features of the sciatic nerve, and 16 were intended to create and perform training models. Results  The average visible length of the nerve in the thigh was 51 mm (standard deviation [SD] 2.57 mm). The average diameter of the nerve was 2 mm (SD 0.33 mm) and was largest at its proximal end (3.21 mm, SD 0.27 mm). The nerve consistently branched into two along the chicken thigh, with more branching subsequently. This simulation model is appropriate not only for the classical end-to-end epineural suture, but also for advanced exercises, in terms of longitudinal fasciculus dissection, mismatched size nerve transfer, injured nerve preparation, and vein conduit technique. Dyeing of nerve fascicles enhanced the visibility of nerve surface quality. Conclusion  The sciatic nerve in the chicken thigh is a suitable and accessible model for microsurgery training. The branching and fascicular patterns of the nerve lends itself well to both novice training and advanced simulation. We have incorporated this model into our training curricula.

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使用鸡大腿坐骨神经进行显微外科培训的外科解剖和练习。
导言 在鸡大腿上进行血管修复是显微外科训练模型的常用方法。坐骨神经与血管密切相关,因此被用于训练神经吻合,这与血管吻合有不同的技术考虑。我们将详细介绍与该模型相关的手术解剖和训练方法。方法 使用 32 只新鲜的商店购买的鸡腿,其中 16 只用于分析坐骨神经的大体和组织学特征,16 只用于创建和执行训练模型。结果 大腿神经的平均可见长度为 51 毫米(标准差 [SD] 2.57 毫米)。神经的平均直径为 2 毫米(标准差为 0.33 毫米),近端最大(3.21 毫米,标准差为 0.27 毫米)。神经在鸡大腿处一直一分为二,随后分支更多。该模拟模型不仅适用于经典的端对端会厌神经缝合,也适用于纵向神经束解剖、大小不匹配的神经转移、损伤神经准备和静脉导管技术等高级练习。对神经束染色可提高神经表面质量的可见度。结论 鸡大腿坐骨神经是显微外科培训的一个合适且容易获得的模型。神经的分支和筋膜模式非常适合新手培训和高级模拟。我们已将该模型纳入培训课程。
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CiteScore
1.00
自引率
25.00%
发文量
39
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