Abstract

Introduction: Rat hind limb transplantation is a complex animal model of vascularized composite allotransplantation (VCA). A basic microsurgical training is required prior to the implementation of this model. Aim: To propose a training program for the acquisition of basic skills to perform a microsurgical VCA model. Animals and Methods: The training program was conducted in two stages. First, at the dry lab, basic suturing skills with 9-0 to 11-0 nylon sutures were practiced, reproduced from surgical videos performed by experts. In a second stage, at the wet lab using 13 Lewis rats, 6 hind limb microsurgical dissections were performed and the important steps for transplantation were identified: 10 end to end femoral artery anastomoses with 10-0 nylon interrupted suture; 10 end to end femoral vein anastomoses with 10-0 nylon suture; 3 femoral vein interposition in the femoral artery; 6 end to end sciatic nerve neurorrhaphy; 4 femur osteosynthesis with 21g needle and wire cerclage. Anastomotic patency rate and anastomotic surgical time were recorded. Results: Arterial and venous patency rate was 100 and 90% respectively. Surgical time decreased from 49 to 24 minutes on arterial anastomoses and from 55 to 25 minutes on venous anastomoses after completion of the training program. When a vein interposition was performed, an immediate patency rate of 100% was obtained. Conclusion: A successful staged training model of basic microsurgical skills was performed, in order to perform a VCA model.