• Manbachan Singh Bedi, Tanmay D Bhavthankar, Malleswara R Girijala, Jagadeesh K Babu, Vimala Ambati, Varun Jonalgadda, Elizabeth Ogando-Rivas, Kamesh Konchada, Chaitanya S Juluru, and Aravind Jvnk.
• Department of Neurosurgery, Mamata Medical College and Superspeciality Hospital, Khammam, Telangana, India. Electronic address: mbachan24@gmail.com.
• World Neurosurg. 2019 May 1; 125: 433-442.

BackgroundThe art of surgery is becoming increasingly complex and dependent on scopes, screens, and technology, inviting a complex learning curve and development of hand-eye coordination and dexterity among other skills. We introduce an affordable, do-it-yourself microsurgical simulator that can be set up using a smartphone and a pair of reflective prism glasses. The glasses employ periscopic prisms on either side that reflect light perpendicularly. When the visual input is combined with the magnification of a smartphone camera, a real-time microsurgical experience can be simulated.MethodsWe analyzed the performance of 2 trainee residents in performing their first 5 successful sutures with 5-0 polypropylene thread on the cut ends of a glove over the course of 3 months. The module was also assessed in a survey at an international conference of neurosurgeons.ResultsA significant improvement was observed in both residents at the end of each month versus baseline (P < 0.05). Of 27 survey participants, 3 (11%) reported access to a training laboratory in their institute. The module was rated 4/5 in terms of hand-eye coordination, 3.5/5 in management of microsurgical field, and 3.5/5 in depth perception.ConclusionsThe microsurgical simulation technique proved to be useful in performing complex microsurgical tasks. A significant improvement in microsurgical skills was observed among our trainees. The cost of building the module can be as low as U.S. $5. We endorse the use of this technique for resident training and skill development, especially in resource-challenged environments.Copyright © 2019 Elsevier Inc. All rights reserved.

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