• Antti Huotarinen, Mika Niemelä, and Behnam Rezai Jahromi.
• Department of Neurosurgery, Helsinki University Hospital, Clinical Neurosciences, Neurosurgery, University of Helsinki, Helsinki, Finland. Electronic address: antti.huotarinen@hus.fi.
• World Neurosurg. 2017 Nov 1; 107: 358-361.

BackgroundResidents' lives are hectic-it is hard to find a place and time for training basic and advanced microsurgical skills. Surgical instruments and sutures can be purchased (or loaned from another department), but the most expensive and space-occupying device is the microscope. In developing countries, microscopes are used where they are needed most, in operating rooms. Furthermore, a conventional microscope is not portable. For all of these reasons, the availability of microscopes for training microsurgery is limited.MethodWe used a coffee cup and smartphone (CCS) as a training device instead of a microscope. The coffee cup was the base, and the smartphone functioned to magnify, illuminate, and visualize objects. We measured 2 residents' performance on end-to-end artificial bypass before and after 5 days of CCS-based training.ResultsWe were able to quickly set up the environment for practicing microsurgical skills in any surrounding. After 5 days of training with CCS we could see significant development of microsurgical performance with a conventional microscope as well. The learning curve was dependent on baseline performance.ConclusionCCS is efficient, mobile, and easy to set up. Even though our smartphone-based training was in 2 dimensions, we could improve our microsurgical performance with conventional microscopes, which have 3-dimensional capability. CCS also provides an easy method to record one's microsurgical training. CCS improved both of the subjects' microsurgical performance, making it a good alternative for a traditional microscope.Copyright © 2017 Elsevier Inc. All rights reserved.

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