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Mastering Lymphaticovenular Anastomosis Through Human Cadaver Simulation: A Comprehensive Training Model
Yazan Mahafza, MD,
Sonia Kukreja-Pandey, MD¹,
Elizabeth A. Bailey, MD²,
Melis Salman, MD¹,
Wei F. Chen, MD, FACS¹
¹Cleveland Clinic, Cleveland, OH, USA
²University of Pittsburgh, Pittsburgh, PA, USA
The Hashemite University
2025-01-09
Presenter: Yazan Mahafza
Affidavit:
The work represents the resident's original research, conducted under appropriate supervision. The resident has made contributions to the conceptualization, design, data analysis, and interpretation of the project. I approve the submission of this abstract.
Director Name: Wei F. Chen, MD, FACS
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: General Reconstruction
Abstract:
Purpose:
The success of the super microsurgical lymphaticovenular anastomosis (LVA) procedure heavily relies on the technical skill of the surgeon which can be attained through simulation. Existing training models do not address critical procedural steps like lymphatic vessel identification and selecting appropriate anastomotic configurations. This article provides an evaluation of the human cadaver as a simulation model for LVA.
Methods:
Three supermicrosurgeons simulated LVA on unembalmed human cadavers during a 6-month period. A dye was injected intradermally in the wrist/foot and sequential incisions were made in the volar forearm/ dorsal leg exploring for lymphatics and veins, performing LVA whenever feasible. The supermicrosurgeons noted their operative findings after each session and responded to a questionnaire for the model evaluation at the end of the 6-month period.
Results:
Twenty limbs (10 upper, 10 lower) in 11 cadavers were utilized during 6 months. Proximal flow of the injected dye was observed in 5 of the 20 limbs. A total of 42 incisions were made, 44 lymphatic channels were identified and a total of 31 LVAs were completed. All three supermicrosurgeons reported a realistic operating room experience and found the fidelity of human cadaver simulation superior to their previously used models.
Conclusion:
LVA simulation in a human cadaver is feasible. This model provides high-fidelity advanced training in LVA allowing practice of all key operative steps.
