Modelo integral de entrenamiento microquirúrgico y neuroendovascular con placenta humana

Abstract

Objective: Describe a training model in microsurgery and neuroendovascular surgery, using human placenta and low complexity resources.
Material and methods: 20 human placentas, instruments and sutures were used in microsurgery, Newton XX1 surgical microscope, material for endovascular procedures; radioscopy equipment (C-arch Phillips BV Pulsera), a bony skull and a Sugita head adapted for laboratory use. The exercises consisted of: 1. Dissection and exposure of the arterial and venous vessels of the chorion; 2. End-to-end, end-to-side, side-to-side anastomosis; 3. Generation of lateral, bifurcation or trifurcation aneurysms; 4. Creation of extra-intracranial bypass; 5. Clipping of aneurysms on the surface and inside the skull; 6. Pre and post clipping angiographic control. 7. Coil embolization of experimental aneurysms and placental vessels embolization with spongostan particles.
Results: Although the vessels have a different structure and consistency than usual for the neurosurgeon, the placenta offers a variability of sizes and formats to practice the different exercises.
Conclusion: Training in microsurgical and neurointerventionist techniques can be carried out in placental models, which allow progressive haptic development prior to performing an in vivo procedure.