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J Reconstr Microsurg 2022; 38(02): 106-114
DOI: 10.1055/s-0041-1731761
Original Article

No Microscope? No Problem: A Systematic Review of Microscope-Free Microsurgery Training Models

Jonlin Chen 
1   Department of Plastic and Reconstructive Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
,
Helen Xun
1   Department of Plastic and Reconstructive Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
,
Mya Abousy
1   Department of Plastic and Reconstructive Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
,
Chao Long
1   Department of Plastic and Reconstructive Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
,
Justin M. Sacks
2   Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, St. Louis, Missouri
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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

Supplementary Material



Publication History

Received: 25 January 2021

Accepted: 12 May 2021

Article published online:
23 August 2021

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