Introduction: Microsurgery is a general term for surgery requiring an operating microscope, small specialized microsurgical instruments, and microsurgical sutures, permitting very delicate operations, as the "reconnection" of severed blood vessels and nerves The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerve coaptation (typically less than 3 mm in diameter) which have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Microsurgical techniques are utilized by several specialties today, such as: general surgery, ophthalmology, orthopedic surgery, gynecological surgery, otolaryngology, neurosurgery, oral and maxillofacial surgery, plastic surgery, and pediatric surgery.

Objectives of the lesson: The students are introduced by a specialized instructor to the basic techniques of microsurgery, such as how to use the microinstruments and handle microsutures, under the microscope. Furthermore, literature was handed out to the students to provide theoretical information on basic techniques. Furthermore, students do practice suturing and knots on different planes using latex rubber glove practice card, and silastic lumen. From our experience with the course, we can state that the students were really impressed by the simple models and had a lot of fun with the practical exercises.

Lesson contents: Objective of Microsurgery. History of Microsurgery. Experimental Surgery. Microscope, Microsurgical instruments and Microsutures. How can be Microsurgeon. Replantations after fingers and hand amputations. Indications and Contraindications. Decision for replantation. Overview of technique of replantation. Microvascular grafts. Microsurgery for Brachial Plexus and peripheral nerve injuries. Nerve repair with nerve grafts. Application of Microsurgery in Orthopaedic trauma and Reconstruction. Free and pedicled flaps. Free flap transfer for extensive tissue defects of the limbs, extensive bone defects, complex trauma injuries, oncological resections, and congenital abnormalities. Research and Future of Microsurgery.

Learning outcomes: The course besides the theoretical introduction is combined with practical training with the use of the operating microscope, micro instruments, fine suture 8-0, 9-0 by practicing suturing on different planes using latex rubber glove practice card. At the end of the program the basic techniques can be learned by students and most of them are able to apply sutures and tying the knots under the microscope on nonvital models . Each student encouraged to submit a "small thesis" on different microsurgical fields, for the final examination test of the program.

Hours of training per student: 26

From the 8th Semester

ECTS: 2