Abstract
BACKGROUND: Structured laboratory-based microsurgical training is considered beneficial for junior residents before they begin to work in a neurosurgical operating room. The optimal duration of such training remains unclear. We studied the effect of a 40-h microsurgical laboratory course on the development of basic microsurgical skills among novices. METHODS: A total of 27 medical students participated in the study. Seven students (5 men, 2 women) underwent a structured microsurgical laboratory training program over four weeks. 20 students (10 women, 10 men) served as an untrained control group. None of the students had prior experience in microsuturing or working under magnification. The intervention group practiced for two hours per day, five days per week, over a four-week period. Skill development was assessed at baseline, after two weeks, and after four weeks of training with a microsuturing test task, and was monitored continuously throughout the training period with a microscraping test task. Microsurgical performance was compared between the intervention and the control groups using a test task performed under a surgical exoscope after two weeks of training. This task assessed complex depth perception and hand-eye coordination through the precise placement of a microneedle into small, concealed targets. RESULTS: For the microsuturing task the median time improved throughout the training (baseline: 44 min (interquartile range IQR = 22), 20 h training: 21 min (IQR = 6), 40 h training: 14 min (IQR = 4)). Similarly, the duration of the scraping task improved (baseline: 40 min (IQR 2), 20 h training: 15 min (IQR = 7), 40 h training: 13 min (IQR = 7)). The quality of work, including scraping accuracy, suture tightness and spacing, remained consistent in both tasks. In the exoscope task, the intervention group outperformed the control group (median task duration 6 min 54 s, IQR = 3 min vs 9 min 24 s, IQR = 6 min; p = 0.04). CONCLUSIONS: Novices demonstrated rapid improvement during a 40-h microsurgical laboratory training course. Even less than 40 h of structured practice might be enough for surgical novices, such as neurosurgery residents, to learn the most basic microsurgical skills prior to assisting in the operating room.