Alphonsus Chong's Personal Wiki

Background: The 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.

Methods: We 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.

Results: A 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.

Conclusions: The 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.

Keywords: Dexterity; Hand-eye coordination; Lazy glasses; Learning curve in microsurgery; Microsurgery simulator; Microsurgery skill training; Operating microscope.

• very small number - n = 2
• not real microsurgery - 5-0
• ? magnification?
• no transfer of skills examined – either microscope use or microsurgical skill
• not so good for depth perception or management of microsurgical field

• microscopes

Bedi, M. S., Bhavthankar, T. D., Girijala, M. R., Babu, J. K., Ambati, V., Jonalgadda, V., Ogando-Rivas, E., Konchada, K., Juluru, C. S., & Jvnk, A. (2019). Lazy Glass Microsurgical Trainer: A Frugal Solution for Microsurgical Training. World Neurosurgery, 125, 433–442. https://doi.org/10.1016/j.wneu.2019.01.141