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

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.

Keywords

microsurgery training - nerve repair - nerve coaptation

Ethical Approval

Formal ethical approval was not required after seeking advice from our local ethics committee.

Publikationsverlauf

Artikel online veröffentlicht:
06. Juli 2022

• References

• 1 Lahiri A, Sebastin SJ, Yusoff SK, Sze Chong AK. Computer aided assessment in microsurgical training. J Hand Surg Asian Pac Vol 2016; 21 (02) 212-221
• 2 Javid P, Aydın A, Mohanna PN, Dasgupta P, Ahmed K. Current status of simulation and training models in microsurgery: a systematic review. Microsurgery 2019; 39 (07) 655-668
• 3 Harris ME, Tindall SC. Techniques of peripheral nerve repair. Neurosurg Clin N Am 1991; 2 (01) 93-104
• 4 Jeong HS, Moon MS, Kim HS, Lee HK, Yi SY. Microsurgical training with fresh chicken legs. Ann Plast Surg 2013; 70 (01) 57-61
• 5 Marsh DJ, Norton SE, Mok J, Patel HD, Chen HC. Microsurgical training: the chicken thigh model. Ann Plast Surg 2007; 59 (03) 355-356
• 6 Beris A, Gkiatas I, Gelalis I, Papadopoulos D, Kostas-Agnantis I. Current concepts in peripheral nerve surgery. Eur J Orthop Surg Traumatol 2019; 29 (02) 263-269
• 7 McInnes CW, Ha AY, Power HA, Tung TH, Moore AM. Femoral nerve decompression and sartorius-to-quadriceps nerve transfers for partial femoral nerve injury: a cadaveric study and early case series. J Neurosurg 2020; 1-8
• 8 Meek MF, Coert JH. Clinical use of nerve conduits in peripheral-nerve repair: review of the literature. J Reconstr Microsurg 2002; 18 (02) 97-109
• 9 Moore AM, Kasukurthi R, Magill CK, Farhadi HF, Borschel GH, Mackinnon SE. Limitations of conduits in peripheral nerve repairs. Hand (N Y) 2009; 4 (02) 180-186
• 10 Beris A, Kostas-Agnantis I, Gkiatas I, Gatsios D, Fotiadis D, Korompilias A. Microsurgery training: a combined educational program. Injury 2020; 51 (Suppl. 04) S131-S134
• 11 Lahiri A, Muttath SS, Yusoff SK, Chong AK. Maintaining effective microsurgery training with reduced utilisation of live rats. J Hand Surg Asian Pac Vol 2020; 25 (02) 206-213
• 12 Goubier J-N, Teboul F, Yeo S. Transfer of two motor branches of the anterior obturator nerve to the motor portion of the femoral nerve: an anatomical feasibility study. Microsurgery 2012; 32 (06) 463-465
• 13 Sucur D, Konstantinović P, Potparić Z. Fresh chicken leg: an experimental model for the microsurgical beginner. Br J Plast Surg 1981; 34 (04) 488-489