Arch Plast Surg.  2022 Jan;49(1):121-126. 10.5999/aps.2021.01340.

A comparison of using a smartphone versus a surgical microscope for microsurgical anastomosis in a non-living model

• Jianmongkol S
• Vinitpairot C
• Thitiworakarn N
• Wattanakamolchai S

• KMID: 2524927
• DOI: http://doi.org/10.5999/aps.2021.01340

Abstract

Background
Although they may not replace standard training methods that use surgical microscopes, smartphones equipped with high-resolution screens and high-definition cameras are an attractive alternative for practicing microsurgical skills. They are ubiquitous, simple to operate, and inexpensive. This study compared anastomoses of chicken femoral vessels using a smartphone camera versus a standard operative microscope.
Methods
Forty anastomoses of non-living chicken femoral vessels were divided into four groups. A resident and an experienced microsurgeon performed anastomoses of femoral chicken vessels with 8-0 and 10-0 sutures, using a smartphone camera and a surgical microscope. The time to complete the anastomosis and the number of anastomosis errors were compared using the Mann-Whitney U test.
Results
The time taken to perform an anastomosis by the experienced microsurgeon was significantly longer when using the smartphone (median: 32.5 minutes vs. 20 minutes, P<0.001). The resident completed the anastomoses with both types of equipment without a significant difference in the operative times. When using a smartphone, the operation times were not significantly different between the resident and the experienced microsurgeon (P=0.238). The resident showed non-significant differences in operation time and the number of errors when using a smartphone or an operative microscope (P=1.000 and P=0.065, respectively).
Conclusions
Microsurgical practice with non-living chicken femoral vessels can be performed with a smartphone, though it can take longer than with an operative microscope for experienced microsurgeons. The resident may also experience frustration and tend to make more anastomosis errors when using a smartphone versus an operative microscope.

Keyword

Smartphone / Microsurgery / Blood vessels / Anastomosis, surgical