The authors have no acknowledgements.

1. הכנה: <ol style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> להשיג מיקרוסקופ סטריאו שולחן, עם 3.5 x משתנה ל45x זום, 200 מ&quot;מ מרחק עבודה, מרחק בין אישונים משתנים מ&quot;מ 55 עד 75 ואביזר הובילו טבעת אור. כל מיקרוסקופ דומה הוא נאות, ניתן להגדיר על שולחן קטן זה ולא מאוד יקר. </li><li style=";text-align:right;direction:rtl"> לאסוף ולהכין סט של מכשירי מייקרו עם שני טנדרים מייקר, מספריים לנתח אחד, ומחט-נהג אחד; זה המינימום הנדרש, אותו יש לקחת בחשבון שמדובר במכשירים בפועל, ומכשירים באיכות גבוהה סוף אין צורך. </li><li style=";text-align:right;direction:rtl"> השתמש מיקרו-תפר 9/0 חוט חד לכל הנהלים. קנה זמין מסחרי ירכי עוף או כנפיים וצבען מזון בסופרמרקט המקומי. </li><li style=";text-align:right;direction:rtl"> Angio-קטטר 20 G משמש לבדיקות פתיחות בעורקי הירך העוף. לעורקי הזרוע נדרש קטטר G 27 דק. אלה ניתן לרכוש דרך האינטרנט בבית מרקחת מקומית אועם המכשירים להגדיר. קנה מזרק זמין מסחרי כדי להזריק את צבע מזון. </li></ol> 2. טכניקות לנתיחה מקרוסקופית: <ol style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> הגישה לכלי הירך היא פשוטה. לירכי עוף, לבצע טכניקה לנתיחה בוטה רק המדיאלי לפיר הירך, להפריד את שריר הירך מהעצם ולחשוף את העורק, וריד ועצב הירך. העצב יכול להיות גזור נוסף לשני fascicles הנפרד לסוגים שונים של שיטות לתיקון עצב. </li><li style=";text-align:right;direction:rtl"> כדי לגשת לעורק זרוע עוף בכנפי העוף, לחתוך את עור longitudinally עם מספריים, מהכתף עד קצה הכנף. שים לב לעורק פועל בין כופפי שרירי ויד אחוריים. </li></ol> 3. משטר אימונים מומלץ: <ol style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> מתאמן עם עורק הירך. הערה: הצעד הראשון במשטר האימונים הוא להתאמן עם עורק הירך העוף. </li></ol><ol style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> מניחים את החתיכה מתחת למיקרוסקופ ולהתחיל לנתיחה המייקר. לשחרר את עורק הירך מהרקמות הבסיסיות; ולחלק אותו בצורה אופקית. בצע adventicectomy. השתמש במייקרו-הטנדרים ומיקרו מספריים לקצץ כל adventicia שמעל לומן עורקים. יש לשטוף את לומן הפנימי במים ברז רגילים. רשום את זמן ההתחלה </li><li style=";text-align:right;direction:rtl"> לבצע מקצה לקצה השקה. <ol style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> התחל על הקיר האחורי של העורק בצד הנגדי למפעיל. מניחים את התפר הראשון; תתחיל בצד השמאל, אם עובד בצורה אופקית, בצד התחתון, אם עובד בצורה אנכית. להעביר את המחט מהצד החיצוני של העורק ללום ולאחר מכן מלומן לחלק החיצוני של העורק. </li><li style=";text-align:right;direction:rtl"> לקשור את התפר, לבצע קשר כפול ראשון, ולאחר מכן שני יחידים זורק כיוונים לסירוגין. השלם את הקיר האחורי כולו עם הטכניקה שתוארה לעיל. </li><li style=";text-align:right;direction:rtl"> החל מהיום בצד ימין אם אתה עובד בצורה אופקית או בצד העליון אם אתה ווrking אנכי, מקום תפר אחד ממחוץ ללום ולאחר מכן מלומן החוצה. לקשור את הקשר כפי שתואר לעיל. השלם את הקיר הקדמי חוזר ההליך מתואר ב3.1.2.2. </li><li style=";text-align:right;direction:rtl"> רשום את הפעם האחרונה זה יאפשר לך לשמור על זמן שיא, כך שאתה יכול לשלוט בהתקדמות שלך. הערה: המחברים מעדיפים טכניקת דרך אחת; אבל יכול להיות מתורגל בכל סוג של תפר מייקר. זה recommendable שהמתאמן משלים כ -25 anastomoses המייקר באופן זה לפני שהוא יכול לנסות תרחישים קליניים אחרים. אלה כוללים השתלת וריד לפערי עורקים, מקצה לקצה תיקוני עצב, ושימוש של צינורות וריד לטיפול בפערי עצב. טכניקה חשובה בניתוח כלי דם, שאפשר ללמוד עם שיטת אימון זו היא התפר המתמשך או ריצה, לבצע טכניקה זו תמורת החניך כ3.1.2.1 אבל סטיץ לא לחתוך, תמשיך לבצע תפרים כמו ב3.1.2.1 ללא חיתוכם until שתשלים את כל התפר ולקשור אותו לתפר המקורי בסוף. </li></ol></li></ol><ol start="2" style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> אימון עם עורק הזרוע <ol style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> מניחים את החתיכה מתחת למיקרוסקופ. להשלים את ההליך כפי שתואר לעיל לעורק הירך. הערה: ההבדל היחיד הוא הגודל. עורק הזרוע הוא קטן בהרבה מעורק הירך וההשקה היא הרבה יותר מאתגר. </li></ol></li><li style=";text-align:right;direction:rtl"> בדיקות patency <ol style=";text-align:right;direction:rtl"><li style=";text-align:right;direction:rtl"> לחצות angio-קטטר 27 או 20 G חלק באמצעות ההשקה, כדי לבדוק חסימות שנגרמו על ידי תפרים תפירת שני דפנות הכולים יחד. </li><li style=";text-align:right;direction:rtl"> החל מזרק עם צבען מזון מסחרי לסוף angio-קטטר, ותנקב לצבוע לתוך העורק לבדיקת דליפת סילון </li><li style=";text-align:right;direction:rtl"> פתח את העורק longitudinally לדמיין את התפרים, ההקבלה שלהם ואת כמות הקיר נלקחה. </li></ol></li></ol>

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The authors have nothing to disclose.

The clinical practice of microsurgery requires a continuous practice and a high level of expertise; it&#8217;s applications include free flaps, replantation and revascularization procedures, intracranial &#8211; extracranial anastomoses for neurosurgical procedures, peripheral nerve surgery and others. In spite of the wide variety of procedures that require microsurgical techniques, some of them are seldom performed in many centers. The surgeons therefore need sometimes to maintain their skill level rehearsing the surgeries on different practice models. 
The most widely spread training model is currently the rat 1,2; it is considered by many to be the &#8220;gold standard&#8221; in microsurgical instruction. Rats are indeed a very valuable tool in the teaching and learning of microsurgery. They provide a very similar environment to that of the clinical situation. This approach however exhibits some intrinsic limitations. The use of living animals presents an ethical dilemma; and is generally subjected to institutional review board approval. Furthermore they require anesthesia, and dedicated technicians and facilities. All These factors imply important economic costs; this restricts training on living animals to specific teaching units, experimental surgery departments and hospitals with similar resources. 
The use of nonliving animal models described in this protocol, has the advantage of not raising any ethical concerns; it does not require institutional review board approval. Economically it compares favorably to living animal training. The required equipment is limited and can be acquired over the internet for a reasonable price; the author&#8217;s tabletop stereomicroscope was bought for around 450 United States Dollars (USD) and the set of practice microsurgical instruments was purchased for around 150 USD. The author uses microsurgical sutures provided by his sponsoring institution; the price of sutures varies greatly and high quality sutures are not needed, a box of twelve sutures can be bought for around 70 USD on the internet. A microsurgical training station can be set up on a very limited area at home or at work; Jeong et al.8 Placed their microscope at the residents&#8217; office; whilst we9 used an available microscope close to the hand surgery fellows&#8217; quarters. 
The most critical point in the application of this protocol is the need for the trainee to be constant and to stay motivated with his training, it is therefore very important that he starts training with the bigger vessels first and then proceed to the smaller chicken wing vessels to avoid frustration. The limitations of training with nonliving models involve primarily the lack of bleeding and the inexistence of hemodynamic phenomena like vasospasm and clotting. The advantages and disadvantages of this type of training are summarized on Table 1. The three tests detailed in section three are aimed to help the trainee check the vessel&#8217;s patency in the absence of the earlier mentioned phenomena; they provide information on the quality of the trainee&#8217;s suture, leaking, suture misalignment, and lumen obstruction caused by stitches suturing the front and back wall together. 
The protocol can potentially be improved by the addition of a peristaltic pump10 to simulate vessel flow or by flooding the field with liquid to simulate superficial tension. It is the authors opinion that this would result in the production of an even more realistic training environment and this should be the direction of future research. 
Another possible field for development is the application of this training method to help the trainee learn more complex procedures, such as the cuff anastomosis technique11 before it&#8217;s actual application on animal research. The authors have however no experience with such techniques at present time. 
In conclusion the protocol described in the present manuscript allows a determined trainee to setup a small practice station and use it to learn, perfect and maintain microsurgical skills progressively and sustainably; without the need for special facilities and minimizing animal deaths.

An ample array of training models have been described for the learning and maintenance of both basic and advanced microsurgical skills. These include living animals1,2, human cadaveric specimens3, inert models4,5 and non-living animal models6-9.The Living animal models, specifically those using rats have been extensively used in the teaching of microsurgery 1,2; and they are considered the current gold standard of training. In spite of their remarkable instructive value, when an intensive or prolonged training is required; economical and ethical concerns can hinder their practical usage. 
Cadaveric models3 offer the opportunity to practice in an environment similar to that of the actual clinical situation; they are unfortunately restricted to anatomy labs and similar facilities, a microscope must be available at the lab as well; these models are therefore not widely available. Inert models such as rubber tubes, or gloves4,5 are cheap, and easily accessible, the required equipment for their application is minimal. The resemblance to a clinical situation is tenuous however; and their application is generally limited to the introductory stages of training, before the trainee starts practicing on rats. To the best of our knowledge Hino6 was the first to propose the use of non-living chicken for the development and maintenance of clinical microsurgical skills. His model is based on the extraction and subsequent usage of the chicken brachial artery from commercial chicken wings. This approach does not need institution review board approval, rodent anaesthesia, laboratory technicians or postoperative care. 
Following Hino&#180;s description of the chicken wing artery model numerous other nonliving animal models were published. The use of commercial chicken thighs was first suggested by Marsh et al.7 who reported the use of the femoral artery, vein and nerve for didactic purposes. This particular model expands the possibilities of training including structures different from the arteries; it permits the trainee to perform a variety of complex procedures such as vein grafts, nerve grafts or fascicular repairs. Jeong et al.8 Further studied Marsh&#8217; chicken thigh model and its applications to the teaching of resident doctors. The authors analysed chicken tissue samples histologically and found that it presented similarities to human tissues. The time to perform an anastomosis by the trainee was significantly reduced by practice in their study. They concluded that &#8220;the femoral neurovascular bundles of chicken are an appropriate and effective model for teaching and practicing microsurgery&#8221;. In 2013 my colleagues and I9 published a microsurgical training regimen that combined both the chicken thigh and the chicken wing models; this approach benefits from the versatility of the chicken thighs and from the limited size of the chicken wing artery which can represent more of a challenge than the femoral vessels for the more advanced trainees. 
On the current manuscript we describe step by step the process of setting up a microsurgical practice station; the materials required, how to dissect the neurovascular structures of each model and how to effectively apply the training regimen.

<table><tbody><tr><td>Stereomicroscope</td><td>Amscope</td><td>SM-1BX</td><td>Microscope</td></tr><tr><td>Led light</td><td>Amscope</td><td>LED-80S-YA</td><td>illumination system</td></tr><tr><td>Microsurgical instruments set</td><td>Chen hen microsurgical instruments</td><td>HC- X803-1</td><td>Microsurgical instruments</td></tr><tr><td>Microsurgical sutures</td><td>S/T microsurgical</td><td>9/0 Suture</td><td>Sutures</td></tr></tbody></table>

step by step: microsurgical training method combining two nonliving animal models

The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly laboratory rats. This method although extremely valuable can be economically demanding both for the surgeon and the sponsoring institution; it also requires special training facilities that may not always be available or accessible. Furthermore ethical concerns can limit the use of living animals for training purposes. Alternative training methods, such as inert tubes and gloves have not gained popularity among surgeons since they do not offer an experience similar to that of a clinical situation. Non-living animal models include the use of chicken thighs and wings; they offer a practice experience that resembles a clinical situation to a considerable extent. This type of training is relatively cheap and easily available. The microscope and instruments required can be acquired over the internet, and the chicken pieces can be bought at the local supermarket.
This approach allows a motivated trainee to rehearse different types of surgical techniques several times at a reasonable expense, helping to develop or maintain his surgical expertise if more complex facilities are not available. On the current manuscript we describe how to setup a small practice station, how to dissect the specimens, and how to practice both with the chicken thighs and with the chicken wings in a progressive fashion. This approach takes advantage on the versatility of the chicken thigh model and the small size of the chicken wing Brachial artery.

המחברים chronometered פעמיהם עם שיטת האימון הנוכחית וראו את זה כדי להפחית באופן משמעותי את זמני השקה לעורק הירך בסוף השבוע השלישי. המתאמן יכול לשלוט על השיפורים בטכניקה שלו על ידי בדיקתו פעמים, אחוזי הפתיחות שלו והיישור של תפריו. המערכת המתוארת בכתב היד הזה מתואר באיור 1 כולל מיקרוסקופ שולחן וקבוצה של מכשירי מייקרו. הניתוחים מקרוסקופית מוצגים איורים 2 ו -3 דוגמא להשקת מייקר עורק הירך מוצג באיור 4. איור 5 מראה השקה מייקר עורק זרוע. איור 6 מציג תיקון עורק הירך עם שתל וריד. בדיקות patency מוצגות באיור 7. <img alt="איור 1" src="/files/ftp_upload/52625/52625fig1.jpg" /> איור 1: קורesponding תחנה בפועל מייקרו של המחבר עצמו. הוא כולל מיקרוסקופ שולחן וערכה של הכשרת מכשירי מייקרו. זה יכול להיות מוגדר על מרחב מוגבל מאוד במשרד או בבית. <img alt="איור 2" src="/files/ftp_upload/52625/52625fig2.jpg" /> איור 2: נתיחה מקרוסקופית של ירך עוף, יכולים להיחשף כלי הירך וגיד הנשה בקלות פועלים אצבע רק המדיאלי לפיר הירך. החץ האופקי מסמן את ראש עצם הירך. מטוס הנתיחה מסומן בחץ האנכי רק במקביל לפיר B הירך: עורק הירך (א) וריד (v) ועצב השת (n) מוצג כאן בפירוט. <img alt="איור 3" src="/files/ftp_upload/52625/52625fig3.jpg" /> איור 3 A ו- B: נתיחה מקרוסקופית של כנף עוף. הזרוע<html> rtery פועל בין שרירי הכופפים וTriceps. העורק מסומן בחץ בשני התמונות היא די שטחי והגישה היא פשוטה; זה יכול להיות מושגת במספריים בישול מסחריים. <img alt="איור 4" src="/files/ftp_upload/52625/52625fig4.jpg" /> איור 4: תמונה מיקרוסקופית של סוף עורק הירך לסיים תפר, טכניקה כאן דרך אחת עם תפרים בודדים בוצעה. כל סוג אחר של תפר יכול להיות מתורגל בשיקול דעתו של המתאמן. <img alt="איור 5" src="/files/ftp_upload/52625/52625fig5.jpg" /> איור 5: קצה לקצה תפר של עורק זרוע עוף. עורקים זה הם הרבה יותר קטנים מאשר הירך אלה וההליך הרבה יותר תובעני מבחינה טכנית. עומס / 52,625 / 52625fig6.jpg &quot;/&gt; איור 6: תיקון עורק הירך עם שתל וריד שנקטפו מוריד הירך. מודל ירך העוף הוא מאוד תכליתי המאפשר לסוגים שונים של תרגילים בפועל. <img alt="איור 7" src="/files/ftp_upload/52625/52625fig7.jpg" /> איור 7:. בדיקות patency: angio-צנתר בקוטר המתאים חצה את ההשקה כדי לבדוק חסימות שנגרמו על ידי stiches תפירת שני הקירות של כלי B:.. דאי הוא perfused דרך ההשקה לבדיקת דליפת C : ההשקה נפתחה longitudinally לדמיין יישור התפר.

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Step By Step: Microsurgical training method combining two nonliving animal models

צעד אחר צעד: שיטת אימון Microsurgical שילוב של שני מודלים של בעלי חיים דוממים

Here we describe how to set up a small microsurgical practice station and a simple and inexpensive method for the training of microsurgery with non-living animal models.

The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly ...

step-step-microsurgical-training-method-combining-two-nonliving

Universidad San Sebastian

Research

JoVE Journal

Medicine

15.2K Views.  POVISA Hospital. Here we describe how to set up a small microsurgical practice station and a simple and inexpensive method for the training of microsurgery with non-living animal models. 

Video: Step By Step: Microsurgical training method combining two nonliving animal models

A Novel Microsurgical Model for Heterotopic, En Bloc Chest Wall, Thymus, and Heart Transplantation in Mice

Exploration of novel strategies in organ transplantation to prolong allograft survival and minimizing the need for long-term maintenance immunosuppression must be pursued. Employing vascularized bone marrow transplantation and co-transplantation of the thymus have shown promise in this regard in various animal models.1-11 Vascularized bone marrow transplantation allows for the uninterrupted transfer of donor bone marrow cells within the preserved donor microenvironment, and the incorporation of thymus tissue with vascularized bone marrow transplantation has shown to increase T-cell chimerism ultimately playing a supportive role in the induction of immune regulation. The combination of solid organ and vascularized composite allotransplantation can uniquely combine these strategies in the form of a novel transplant model. Murine models serve as an excellent paradigm to explore the mechanisms of acute and chronic rejection, chimerism, and tolerance induction, thus providing the foundation to propagate superior allograft survival strategies for larger animal models and future clinical application. Herein, we developed a novel heterotopic en bloc chest wall, thymus, and heart transplant model in mice using a cervical non-suture cuff technique. The experience in syngeneic and allogeneic transplant settings is described for future broader immunological investigations via an instructional manuscript and video supplement.

To study combined solid organ and vascularized composite allotransplantation, we describe a novel heterotopic en bloc chest wall, thymus, and heart transplant model in mice using a cervical non-suture cuff technique.

Microsurgical דגם חדשני לHeterotopic, כמקשה אחת בחזה קיר, קורנית, ולב השתלה בעכברים

Exploration of novel strategies in organ transplantation to prolong allograft survival and minimizing the need for long-term maintenance immunosuppression ...

Preparation of Murine Submandibular Salivary Gland for Upright Intravital Microscopy

The submandibular salivary gland (SMG) is one of the three major salivary glands, and is of interest for many different fields of biological research, including cell biology, oncology, dentistry, and immunology. The SMG is an exocrine gland comprised of secretory epithelial cells, myofibroblasts, endothelial cells, nerves, and extracellular matrix. Dynamic cellular processes in the rat and mouse SMG have previously been imaged, mostly using inverted multi-photon microscope systems. Here, we describe a straightforward protocol for the surgical preparation and stabilization of the murine SMG in anesthetized mice for in vivo imaging with upright multi-photon microscope systems. We present representative intravital image sets of endogenous and adoptively transferred fluorescent cells, including the labeling of blood vessels or salivary ducts and second harmonic generation to visualize fibrillar collagen. In sum, our protocol allows for surgical preparation of mouse salivary glands in upright microscopy systems, which are commonly used for intravital imaging in the field of immunology.

We describe a protocol to surgically expose and stabilize the murine submandibular salivary gland for intravital imaging using upright intravital microscopy. This protocol is easily adaptable to other exocrine glands of the head and neck region of mice and other small rodents.

הכנה של בלוטת הרוק Submandibular מאתר מיקרוסקופ Intravital זקופה

The submandibular salivary gland (SMG) is one of the three major salivary glands, and is of interest for many different fields of biological research, ...

Immunology and Infection

Surgical Training for the Implantation of Neocortical Microelectrode Arrays Using a Formaldehyde-fixed Human Cadaver Model

This protocol describes a procedure to assist surgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain. Recent technological progress has enabled the fabrication of microelectrode arrays that allow recording the activity of multiple individual neurons in the neocortex of the human brain. These arrays have the potential to bring unique insight onto the neuronal correlates of cerebral function in health and disease. Furthermore, the identification and decoding of volitional neuronal activity opens the possibility to establish brain-computer interfaces, and thus might help restore lost neurological functions. The implantation of neocortical microelectrode arrays is an invasive procedure requiring a supra-centimetric craniotomy and the exposure of the cortical surface; thus, the procedure must be performed by an adequately trained neurosurgeon. In order to provide an opportunity for surgical training, we designed a procedure based on a human cadaver model. The use of a formaldehyde-fixed human cadaver bypasses the practical, ethical and financial difficulties of surgical practice on animals (especially non-human primates) while preserving the macroscopic structure of the head, skull, meninges and cerebral surface and allowing realistic, operating room-like positioning and instrumentation. Furthermore, the use of a human cadaver is closer to clinical daily practice than any non-human model. The major drawbacks of the cadaveric simulation are the absence of cerebral pulsation and of blood and cerebrospinal fluid circulation. We suggest that a formaldehyde-fixed human cadaver model is an adequate, practical and cost-effective approach to ensure proper surgical training before implanting microelectrode arrays in the living human neocortex.

We designed a procedure in which a formaldehyde-fixed human cadaver is used to assist neurosurgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain.

אימוני ניתוח ההשתלה של מערכים Neocortical Microelectrode באמצעות מודל של פורמלדהיד-קבוע גווייה אנושי

This protocol describes a procedure to assist surgeons in training for the implantation of microelectrode arrays into the neocortex of the human brain. ...

Porcine As a Training Module for Head and Neck Microvascular Reconstruction

Live models that resemble surgical conditions of humans are needed for training free-flap harvesting and anastomosis. Animal models for training purposes have been available for years in many surgical fields. We used the female (because they are easy to handle for the procedure) Yorkshire pigs for the head and neck reconstruction by harvesting the deep inferior epigastric artery perforator or the superior epigastric artery perforator flap. The anastomosis site (neck skin defect or tracheal wall defect) was prepared via the dissection of the common carotid artery and the internal jugular vein, in which 3.5&#215; loupe magnification was used for anastomosis as we use on human cases in real life. This procedure demonstrates a new training method using a reliable learning model and provides a detailed anatomy in a live scenario. We focused on the ischemia time, harvesting, vessel anastomosis, and designing the flap to fit the defect site. This model improves tissue handling and with the use of proper instruments can be repeated many times so that the surgeon is fully confident before starting the surgery on humans.

Here we present a protocol for the use of the pig superior epigastric artery perforator flap as a learning module for head and neck microvascular reconstruction.

חזירי כמו מודול אימון עבור שחזור Microvascular הראש והצוואר

Live models that resemble surgical conditions of humans are needed for training free-flap harvesting and anastomosis. Animal models for training purposes ...

Learning Modern Laryngeal Surgery in a Dissection Laboratory

Surgery for laryngeal malignancies requires millimetric accuracy from the different endoscopic and open techniques available. Practice of this surgery is almost completely reserved to a few referral centers that deal with a large proportion of this pathology. Practice on human specimens is not always possible for ethical, economic, or availability reasons. The aim of this study is to provide a reproducible method for the organization of a laryngeal laboratory on ex vivo animal models where it is possible to approach, learn, and refine laryngeal techniques. Porcine and ovine larynges are ideal, affordable, models to simulate laryngeal surgery given their similarity to the human larynx in their anatomical layout and tissue composition. Herein, the surgical steps of transoral laser surgery, open partial horizontal laryngectomy, and total laryngectomy are reported. The merging of endoscopic and exoscopic views guarantees an inside-out perspective, which is vital for the comprehension of the complex laryngeal anatomy. The method was successfully adopted during three sessions of a dissection course &#34;Lary-Gym&#34;. Further perspectives on robotic surgical training are described.

The purpose of this paper is to illustrate how to organize a reproducible laboratory for laryngeal surgery on affordable and closely similar animal laryngeal models in order to improve anatomical and surgical knowledge and skills.

למידה ניתוח מודרני הגרון במעבדה לחיתוך

Surgery for laryngeal malignancies requires millimetric accuracy from the different endoscopic and open techniques available. Practice of this surgery is ...

A Revised Method for Inducing Secondary Lymphedema in the Hindlimb of Mice

Animal models are of paramount importance in the research of lymphedema in order to understand the pathophysiology of the disease but also to explore potential treatment options. This mouse model allows researchers to induce significant lymphedema lasting at least 8 weeks. Lymphedema is induced using a combination of fractioned radiotherapy and surgical ablation of lymphatics. This model requires that the mice get a dose of 10 Gray (Gy) radiation before and after surgery. The surgical part of the model involves ligation of three lymph vessels and extraction of two lymph nodes from the mouse hindlimb. Having access to microsurgical tools and a microscope is essential, due to the small anatomical structures of mice. The advantage of this model is that it results in statistically significant lymphedema, which provides a good basis for evaluating different treatment options. It is also a great and easily available option for microsurgical training. The limitation of this model is that the procedure can be time consuming, especially if not practiced in advance. The model results in objectively quantifiable lymphedema in mice, without causing severe morbidity and has been tested in three separate projects.

This animal model enables researchers to induce statistically significant secondary lymphedema in the hindlimb of mice, lasting at least 8 weeks. The model can be used to study the pathophysiology of lymphedema and to investigate novel treatment options.

שיטה מתוקנת לגרימת ימפתית משנית בתוך הגפיים של עכברים

Animal models are of paramount importance in the research of lymphedema in order to understand the pathophysiology of the disease but also to explore ...

Modeling Stroke in Mice: Focal Cortical Lesions by Photothrombosis

Stroke is a leading cause of death and acquired adult disability in developed countries. Despite extensive investigation for novel therapeutic strategies, there remain limited therapeutic options for stroke patients. Therefore, more research is needed for pathophysiological pathways such as post-stroke inflammation, angiogenesis, neuronal plasticity, and regeneration. Given the inability of in vitro models to reproduce the complexity of the brain, experimental stroke models are essential for the analysis and subsequent evaluation of novel drug targets for these mechanisms. In addition, detailed standardized models for all procedures are urgently needed to overcome the so-called replication crisis. As an effort within the ImmunoStroke research consortium, a standardized photothrombotic mouse model using an intraperitoneal injection of Rose Bengal and the illumination of the intact skull with a 561 nm laser is described. This model allows the performance of stroke in mice with allocation to any cortical region of the brain without invasive surgery; thus, enabling the study of stroke in various areas of the brain. In this video, the surgical methods of stroke induction in the photothrombotic model along with&#160;histological analysis are demonstrated.

Described here is the photothrombotic stroke model, where a stroke is produced through the intact skull by inducing permanent microvascular occlusion using laser illumination after administration of a photosensitive dye.

שבץ דוגמנות בעכברים: נגעים קליפת המוח מוקד על ידי פוטוטרומבוזיס

Stroke is a leading cause of death and acquired adult disability in developed countries. Despite extensive investigation for novel therapeutic strategies, ...

Neuroscience

Generating Murine Model of Myocardial Infarction: A Surgical Procedure for Permanent Ligation of Left Anterior Descending Coronary Artery in Mouse Model

Source: Lugrin, J. et al. <a href="https://www-jove-com.bdigitaluss.remotexs.co/video/59591" target="_blank">Murine Myocardial Infarction Model using Permanent Ligation of Left Anterior Descending Coronary Artery</a>. J. Vis. Exp. (2019)
In this video, we describe a surgical procedure to generate a mouse model of myocardial infarction by permanently ligating the left anterior descending coronary artery.

יצירת מודל מורין של אוטם שריר הלב: הליך כירורגי לקשירה קבועה של עורק כלילי יורד קדמי שמאלי במודל עכבר

Source: Lugrin, J. et al. Murine Myocardial Infarction Model using Permanent Ligation of Left Anterior Descending Coronary Artery. J. Vis. Exp. (2019)
In ...

JoVE Encyclopedia of Experiments

Biology

Rodent Models

Adult

Fluorescence-guided Tumor Resection and MSC-seeded Scaffold Implantation in Murine Model: A Surgical Procedure to Deliver Therapeutic Mesenchymal Stem Cells into Brain Tumor Resection Cavity in Mouse Model

Source: Sheets, K. T. et al. <a href="https://www-jove-com.bdigitaluss.remotexs.co/video/57452" target="_blank">Image-Guided Resection of Glioblastoma and Intracranial Implantation of Therapeutic Stem Cell-seeded Scaffolds.</a>&#160;J. Vis. Exp.&#160;(2018)
This video presents the surgical procedure for image-guided tumor resection and implantation of a bio-scaffold seeded with genetically engineered mesenchymal stem cells or MSCs expressing tumor necrosis factor-related apoptosis-inducing ligand or TRAIL. These therapeutic MSCs have the potential in treatment of brain tumors.

כריתת גידול מונחה פלואורסצנטיות והשתלת פיגום זרעי MSC במודל מורין: הליך כירורגי להעברת תאי גזע מזנכימליים טיפוליים לחלל כריתת גידול במוח במודל עכבר

Source: Sheets, K. T. et al. Image-Guided Resection of Glioblastoma and Intracranial Implantation of Therapeutic Stem Cell-seeded Scaffolds.&#160;J. Vis. ...

Cancer Research

Cancers of the Nervous System

In vivo studies

Filament Insertion-based Transient Stroke Model: A Surgical Procedure to Perform Middle Cerebral Artery Occlusion in Murine Brain

Source: Llovera, G., et al. <a href="https://www-jove-com.bdigitaluss.remotexs.co/v/62573">Modeling Stroke in Mice: Transient Middle Cerebral Artery Occlusion via the External Carotid Artery.</a> J. Vis. Exp (2021).
This video describes the procedure to develop transient stroke in a murine model using silicon-coated filament-based occlusion of the middle cerebral artery.&#160;The developed model mimics human stroke, thus helping to investigate novel therapeutic strategies for treating stroke.

מודל שבץ חולף מבוסס החדרת נימה: הליך כירורגי לביצוע חסימת עורק מוחי אמצעי במוח מורין

Source: Llovera, G., et al. Modeling Stroke in Mice: Transient Middle Cerebral Artery Occlusion via the External Carotid Artery. J. Vis. Exp (2021).
This ...