• Federico Carlos Gallardo, Jorge Luis Bustamante, Clara Martin, Cristian Marcelo Orellana, Mauricio Rojas Caviglia, Guillermo Garcia Oriola, Agustin Ignacio Diaz, Pablo Augusto Rubino, and Vicent Quilis Quesada.
• Departament of Neurosurgery, Hospital de Alta Complejidad El Cruce, Buenos Aires, Argentina. Electronic address: federicogallardo89@gmail.com.
• World Neurosurg. 2020 Nov 1; 143: 11-16.

BackgroundSimulation allows surgical trainees to acquire surgical skills in a safe environment. With the aim of reducing the use of animal experimentation, different alternative nonliving models have been pursued. However, one of the main disadvantages of these nonliving models has been the absence of arterial flow, pulsation, and the ability to integrate both during a procedure on a blood vessel. In the present report, we have introduced a microvascular surgery simulation training model that uses a fiscally responsible and replicable pulsatile flow system.MethodsWe connected 30 human placentas to a pulsatile flow system and used them to simulate aneurysm clipping and vascular anastomosis.ResultsThe presence of the pulsatile flow system allowed for the simulation of a hydrodynamic mechanism similar to that found in real life. In the aneurysm simulation, the arterial flow could be evaluated before and after clipping the aneurysm using a Doppler ultrasound system. When practicing anastomosis, the use of the pulsatile flow system allowed us to assess the vascular flow through the anastomosis, with verification using the Doppler ultrasound system. Leaks were manifested as "blood" pulsatile ejections and were more frequent at the beginning of the surgical practice, showing a learning curve.ConclusionsWe have provided a step-by-step guide for the assembly of a replicable and inexpensive pulsatile flow system and its use in placentas for the simulation of, and training in, performing different types of anastomoses and intracranial aneurysms surgery.Copyright © 2020 Elsevier Inc. All rights reserved.

6 keywords...

hide…