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The chicken wing training model in cerebrovascular microsurgery for the side-to-side bypass

  • Author Footnotes
    1 MPM and HAZ contributed equally to this paper.
    Matthew P. Mullarkey
    Footnotes
    1 MPM and HAZ contributed equally to this paper.
    Affiliations
    Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States
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  • Author Footnotes
    1 MPM and HAZ contributed equally to this paper.
    Hussein A. Zeineddine
    Footnotes
    1 MPM and HAZ contributed equally to this paper.
    Affiliations
    Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States
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  • Pedram Honarpishesh
    Affiliations
    Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States
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  • Matthew J. Kole
    Affiliations
    Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States
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  • Joseph Cochran
    Correspondence
    Corresponding author at: Department of Neurosurgery, The University of Texas Health Science Center at Houston, 7777 SW Freeway, Suite 840, Houston, TX 77074, United States.
    Affiliations
    Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States
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  • Author Footnotes
    1 MPM and HAZ contributed equally to this paper.

      Highlights

      • Describes a classic tool that allows neurosurgeons in training and junior attendings practice advanced microsurgical techniques and delves into strategy and anatomy of a side-to-side bypass.
      • The microsurgical anastomosis described here, in-situ side-to-side, mimics one of the most technical challenging bypasses performed in neurosurgery.
      • The model is easy to setup, efficient and cheap.

      Abstract

      In the expanding era of endovascular treatment and minimally invasive techniques, the neurosurgical trainees have a steady decrease in the exposure to microsurgical skills. However, there remain a need for neurosurgical trainees to be proficient at such skills, particularly for performing high-stakes interventions such as vascular bypasses. The scarcity of cerebrovascular bypasses coupled with the technical expertise it demands necessitates the presence of a training model for neurosurgical residents and fellows. Regarding the model utilizing the chicken wing for vascular anastomoses, the neurosurgical literature has described many models of bypasses involving the end-to-end and end-to-side anastomoses. The side-to-side anastomosis however is not clearly depicted in these papers. Here we focus on technique, chicken wing anatomy, and donor/recipient vessel diameters to provide a comprehensive guide for trainees. We describe a reproducible and reliable chicken wing model to perform an in-situ side-to-side bypass that incorporates integral elements of a successful bypass surgery.

      Keywords

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