Putting the heart into microvascular training: The Micropump, a practical “heart-like” device to enhance vascular anastomosis non-living simulation

Publication date: Available online 16 August 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Georgios Pafitanis, Lilli Cooper, Roshan Vijayan, Ali Ghanem, Simon Myers
IntroductionNon-living simulation models are effective training platforms in learning to achieve a structurally patent microvascular anastomosis. However, a gap still exists between non-living and living models in providing physiological feedback. We have an ethical obligation to optimise non-living resources, to minimise the use of living animals in microsurgical training.Materials and MethodsA Micropump apparatus was developed with cheap tube plastic tubes, cannulas and a fish tank pump, to enable a closed circuit pulsatile variable flow through target non-biological and biological vessels.ResultsThe Micropump was tested for vessel pulsatility, flow measurements, branches ligation, anastomosis leakage and end-to-end anastomosis end-product assessment. It demonstrated realistic pulsatile flow from 0-29ml/min using artificial blood and leakage from a non-ligated arterial branch. It was also used to assess an end-to-end chicken arterial anastomosis (1.7 millimeters) in a closed heart-like circulation, demonstrating physiological patency, positive Acland test and setting threshold of trans-anastomotic leakage above 15ml/min. (Video 1)ConclusionThe variable pulsatile Micropump is a cheap, effective and realistic "heart-like" device enhancing constructive feedback during vessel branches ligation, preparation, anastomosis end-product assessment testing in non-living vascular model training.



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