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"Pendahuluan. Sebelum berhadapan dengan pasien yang nyata, seorang ahli bedah plastik pemula berupaya meningkatkan ketrampilan dengan berlatih pada model. Penelitian ini mengimplementasikan metode pelatihan berbasis wet-lab menggunakan perfusi ke a.femoralis ayam untuk mengevaluasi peningkatan keterampilan mikro.Metode. Dua puluh satu residen bedah plastik (wanita n = 14 (66,7%) dan laki-laki n = 7 (33%)) tanpa pengalaman mikro sebelumnya direkrut dalam penelitian ini. Menjalani serangkaian pelatihan, yang terdiri dari satu sesi kognitif dan lima sesi berbasis keterampilan melakukan anastomosis término-terminal arteri femoralis ayam dengan diameter 2 mm. Pre dan post test dinilai menggunakan University of Western Ontario Microsurgical Assessment (UWOMSA). Sesi keterampilan yang direkam pada video, dan dinilai oleh konsultan mikro sebagai evaluator tunggal. Penelitian ini terbatas untuk arteri end-to-end anastomosis. Hasil. Dari total 42 video termasuk 21 modul simpul-mengikat dan 21 modul anastomosis. Median pre-test skor UWOMSA adalah 23 tapi tidak ada subjek yang berhasil mencapai skor maksimal 30. Skor median post-test adalah 27,5 (hampir 5 poin perbaikan, P = 0,0) dan 2 subyek mencapai skor 30. Nilai rata-rata waktu yang dihabiskan untuk menyelesaikan prosedur anastomosis juga lebih cepat dari 41,86 menjadi 34,14 menit (P = 0,01).Kesimpulan. Menerapkan pelatihan yang diusulkan akan meningkatkan keterampilan pemasangan anastomosis.

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Background. Before entering real clinical setting, a novice plastic surgeon will benefit from repetitive training on non-living models. This study implements the bench-top training method using perfused chicken thigh model to evaluate improvement in microsurgical skills.

Methods. Twenty-one plastic surgery residents (women n=14 (66.7%) and men n=7 (33%)) with no prior microsurgical experience were recruited in this study. They underwent a set of training, consisting of one cognitive session and five skill-based sessions performing the end-to-end anastomosis using chicken femoral artery with a diameter of 2 mm. They were assessed using the University of Western Ontario Microsurgical Skills Assessment (UWOMSA) scoring system at the first skill session and re-evaluated at the fifth skill session. The skill sessions are recorded on video, blinded, and assessed by a consultant microsurgery as a single evaluator. The study was limited to arterial end-to-end anastomosis.

Results. Forty-two videos were reviewed, including 21 knot-tying sessions and 21 anastomoses. The median pre-test UWOMSA score was 23 but none of the subjects managed to reach the maximal score of 30. The median post-test results were 27.5 (almost 5 points improvement, P=0.0) and 2 subjects achieved a score of 30. The average time spent to accomplish the full anastomosis procedure was also reduced from 41.86 to 34.14 minutes (P=0.01).

Conclusion. Using the proposed training skill-based session will improve the subject’s microvascular anastomosis skill."

"after the world witnessed groundbreaking early advances in assisted reproduction that utilized conventional in vitro fertilization in the human, more complex invasive techniques of oocyte and embryo manipulation were introduced to treat human subfertility. amongst these were numrous micromanipulation techniques such as partial zona dissection (PZD; 1988), subzonal insemination (SUZI, 1988) and subsequently ICSI, which became the most powelful tool of assisted fertilization (1992). ICSI requires micromanipulation of both the male and the female gamete. another importand approach is laser-assisted opening of the zona pellucida at different stages of preimplantation development either; to assist hatching (1990) or to remove cells for preimplantation genetic diagnosis (1989), or fragments to restore the integrity of an embryo (1999). sometimes even blastocysts considered for vitrification need further manipulation in order to artificially shrink the blastocoel which facilitates survival of expanded blastocyst (2002). other methods for reproductive purposes, however, failed to gain acceptance in population, such as cytoplasm transfer (1997), nuchler transfer (1998) and cloning (1996), to name but a few"

""Written by a pioneering leader in the development of vitreoretinal surgical techniques and instruments, Vitreous Microsurgery is a comprehensive how-to guide to all vitreoretinal procedures. This thoroughly updated Fifth Edition describes many new techniques and refinements of established procedures and includes new chapters and new illustrations. More than 170 three-dimensional full-color illustrations--many by the Charles Retina Institute's resident medical artist, Byron Wood--enable surgeons to clearly visualize the techniques. The focus of the text is on the decision making process a surgeon goes through in evaluating the best course of treatment for his/​her patient undergoing vitreous surgery. The book describes in detail clinically proven methods of managing the anterior and posterior segment vitreous surgery patient in a systematic manner. The text is organized in a building block approach with general methodology preceding its application to specific disease states. The book stresses algorithms for intra-operative decision making, relying on knowledge of physical principles and performed in the order of ascending risk. A companion website included with purchase offers the fully searchable text and an online image bank"--Provided by publisher."