{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:59:07Z","timestamp":1789844347924,"version":"4.0.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006447","name":"University of Zurich","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>We report on an intensive two-day training program on microanastomoses performed on perfused human placenta models. A specific scoring system was elaborated to evaluate the participants\u2019 microsurgical skills and report the participants\u2019 results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Trainees who attended the Zurich Microsurgery Courses in 2023 were included in the study. Before performing the microanastomoses, each participant received a visual didactic training. Training was made on perfused human placenta models. To perform the microvascular anastomoses, vessels of different diameters were chosen, and 9\u20130 and 10\u20130 microsutures were used. The course was structured in two days. On day one, participants practiced microvascular dissection, microsuturing and end-to-end anastomoses, while the second day was dedicated to end-to-side and to repeat the most useful microanastomosis depending on the specialty. A score system for the evaluation of a successful microanastomosis was developed and applied to assess the participants\u2019 anastomoses. User satisfaction was measured by means of a survey-based questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-two participants from different institutions, specializations and levels of experience were included. A significant improvement in the overall microsurgical skills of the included cohort was documented (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005). The initial average score per anastomosis of 3.56 points (SD 0.71) increased to an average of 3.8 points (SD 0.87) at the end of the course. The steepest learning curve was observed in the placement of knots (\u0394 0.48 points,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and microvascular dissection (\u0394 0.44 points,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Most participants rated the fidelity and importance of the placental microsuturing course as extremely high.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The two-day training program is efficient to teach microvascular dissection and microanastomosis techniques. A significant improvement of participants\u2019 microsurgical skills was reported. The human placenta model proved to be a high-fidelity simulator with great user satisfaction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-024-06286-6","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T09:59:55Z","timestamp":1731664795000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intensive 2-days training on perfused human placenta for microvascular anastomoses"],"prefix":"10.1007","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0424-1250","authenticated-orcid":false,"given":"Elisa","family":"Colombo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Helg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"H\u00f6bner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Seb\u00f6k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Haslinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"van Doormaal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Regli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"issue":"4","key":"6286_CR1","doi-asserted-by":"publisher","first-page":"915","DOI":"10.3171\/2015.8.JNS151346","volume":"125","author":"E Belykh","year":"2016","unstructured":"Belykh E, Lei T, Safavi-Abbasi S et al (2016) Low-flow and high-flow neurosurgical bypass and anastomosis training models using human and bovine placental vessels: a histological analysis and validation study. J Neurosurg 125(4):915\u2013928. https:\/\/doi.org\/10.3171\/2015.8.JNS151346","journal-title":"J Neurosurg"},{"key":"6286_CR2","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1016\/j.wneu.2017.06.045","volume":"105","author":"E Belykh","year":"2017","unstructured":"Belykh E, Miller EJ, Lei T et al (2017) Face, Content, and Construct Validity of an Aneurysm Clipping Model Using Human Placenta. World Neurosurg 105:952-960.e2. https:\/\/doi.org\/10.1016\/j.wneu.2017.06.045","journal-title":"World Neurosurg"},{"key":"6286_CR3","doi-asserted-by":"publisher","unstructured":"Ceccato GHW, Foltran RS, Franke K, et al. Two-Stage Pulsatile Human Placenta Model for Microvascular Anastomosis Training in Neurosurgery. World Neurosurg. Published online September 9, 2023:S1878\u20138750(23)01229\u20139. https:\/\/doi.org\/10.1016\/j.wneu.2023.08.118","DOI":"10.1016\/j.wneu.2023.08.118"},{"issue":"3","key":"6286_CR4","doi-asserted-by":"publisher","first-page":"846","DOI":"10.3171\/2016.10.JNS162083","volume":"128","author":"MMR de Oliveira","year":"2018","unstructured":"de Oliveira MMR, Ferrarez CE, Ramos TM et al (2018) Learning brain aneurysm microsurgical skills in a human placenta model: predictive validity. J Neurosurg 128(3):846\u2013852. https:\/\/doi.org\/10.3171\/2016.10.JNS162083","journal-title":"J Neurosurg"},{"key":"6286_CR5","doi-asserted-by":"publisher","first-page":"e854","DOI":"10.1016\/j.wneu.2020.11.034","volume":"146","author":"M Del Maestro","year":"2021","unstructured":"Del Maestro M, Rampini AD, Mauramati S et al (2021) Dye-Perfused Human Placenta for Vascular Microneurosurgery Training: Preparation Protocol and Validation Testing. World Neurosurg 146:e854\u2013e864. https:\/\/doi.org\/10.1016\/j.wneu.2020.11.034","journal-title":"World Neurosurg"},{"key":"6286_CR6","doi-asserted-by":"publisher","first-page":"e378","DOI":"10.1016\/j.wneu.2020.07.027","volume":"142","author":"CE Ferrarez","year":"2020","unstructured":"Ferrarez CE, Bertani R, Leite Batista DM et al (2020) Superficial Temporal Artery-Middle Cerebral Artery Bypass Ex Vivo Hybrid Simulator: Face, Content, Construct, and Concurrent Validity. World Neurosurg 142:e378\u2013e384. https:\/\/doi.org\/10.1016\/j.wneu.2020.07.027","journal-title":"World Neurosurg"},{"key":"6286_CR7","doi-asserted-by":"publisher","unstructured":"Fritz, T., Simon, R., Krieglsstein, C. et al (1999) The human placenta: an ideal practice model for microvascular anastomosis. Der Chirurg 70:96\u201399. https:\/\/doi.org\/10.1007\/s001040050615","DOI":"10.1007\/s001040050615"},{"issue":"1","key":"6286_CR8","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1002\/micr.1920010110","volume":"1","author":"M Goldstein","year":"1979","unstructured":"Goldstein M (1979) Use of fresh human placenta for microsurgical training. J Microsurg 1(1):70\u201371. https:\/\/doi.org\/10.1002\/micr.1920010110","journal-title":"J Microsurg"},{"issue":"9","key":"6286_CR9","doi-asserted-by":"publisher","first-page":"2525","DOI":"10.1007\/s00701-021-04905-0","volume":"163","author":"M Gomar-Alba","year":"2021","unstructured":"Gomar-Alba M, Parr\u00f3n-Carre\u00f1o T, Narro-Donate JM et al (2021) Microsurgical training: vascular control and intraoperative vessel rupture in the human placenta infusion model. Acta Neurochir (Wien) 163(9):2525\u20132532. https:\/\/doi.org\/10.1007\/s00701-021-04905-0","journal-title":"Acta Neurochir (Wien)"},{"issue":"4","key":"6286_CR10","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1016\/j.jocn.2013.07.029","volume":"21","author":"M Higurashi","year":"2014","unstructured":"Higurashi M, Qian Y, Zecca M, Park YK, Umezu M, Morgan MK (2014) Surgical training technology for cerebrovascular anastomosis. J Clin Neurosci Off J Neurosurg Soc Australas 21(4):554\u2013558. https:\/\/doi.org\/10.1016\/j.jocn.2013.07.029","journal-title":"J Clin Neurosci Off J Neurosurg Soc Australas"},{"issue":"7","key":"6286_CR11","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1002\/micr.20541","volume":"28","author":"VG Ilie","year":"2008","unstructured":"Ilie VG, Ilie VI, Dobreanu C, Ghetu N, Luchian S, Pieptu D (2008) Training of microsurgical skills on nonliving models. Microsurgery 28(7):571\u2013577. https:\/\/doi.org\/10.1002\/micr.20541","journal-title":"Microsurgery"},{"key":"6286_CR12","doi-asserted-by":"publisher","unstructured":"H\u00f6bner LM, Staartjes VE, Colombo E, Seb\u00f6k M, Regli L, Esposito G (2023) How we do it: the Zurich Microsurgery Lab technique for placenta preparation. Acta Neurochir (Wien). https:\/\/doi.org\/10.1007\/s00701-023-05847-5","DOI":"10.1007\/s00701-023-05847-5"},{"key":"6286_CR13","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.wneu.2017.08.132","volume":"108","author":"P Mokhtari","year":"2017","unstructured":"Mokhtari P, Tayebi Meybodi A, Lawton MT, Payman A, Benet A (2017) Transfer of Learning from Practicing Microvascular Anastomosis on Silastic Tubes to Rat Abdominal Aorta. World Neurosurg 108:230\u2013235. https:\/\/doi.org\/10.1016\/j.wneu.2017.08.132","journal-title":"World Neurosurg"},{"key":"6286_CR14","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.jocn.2021.06.001","volume":"90","author":"P Mokhtari","year":"2021","unstructured":"Mokhtari P, Tayebi Meybodi A, Lawton MT (2021) Learning microvascular anastomosis: Analysis of practice patterns. J Clin Neurosci 90:212\u2013216. https:\/\/doi.org\/10.1016\/j.jocn.2021.06.001","journal-title":"J Clin Neurosci"},{"key":"6286_CR15","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.jocn.2021.06.001","volume":"90","author":"P Mokhtari","year":"2021","unstructured":"Mokhtari P, Tayebi Meybodi A, Lawton MT (2021) Learning microvascular anastomosis: Analysis of practice patterns. J Clin Neurosci Off J Neurosurg Soc Australas 90:212\u2013216. https:\/\/doi.org\/10.1016\/j.jocn.2021.06.001","journal-title":"J Clin Neurosci Off J Neurosurg Soc Australas"},{"issue":"3","key":"6286_CR16","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1097\/01.sla.0000234808.85789.6a","volume":"244","author":"CAE Moulton","year":"2006","unstructured":"Moulton CAE, Dubrowski A, Macrae H, Graham B, Grober E, Reznick R (2006) Teaching surgical skills: what kind of practice makes perfect?: a randomized, controlled trial. Ann Surg 244(3):400\u2013409. https:\/\/doi.org\/10.1097\/01.sla.0000234808.85789.6a","journal-title":"Ann Surg"},{"key":"6286_CR17","doi-asserted-by":"publisher","unstructured":"Oliveira Magaldi M, Nicolato A, Godinho JV, et al (2014) Human placenta aneurysm model for training neurosurgeons in vascular microsurgery. Neurosurgery 10 Suppl 4:592\u2013600; discussion 600\u2013601. https:\/\/doi.org\/10.1227\/NEU.0000000000000553","DOI":"10.1227\/NEU.0000000000000553"},{"key":"6286_CR18","doi-asserted-by":"publisher","first-page":"e694","DOI":"10.1016\/j.wneu.2018.07.246","volume":"119","author":"MM Oliveira","year":"2018","unstructured":"Oliveira MM, Wendling L, Malheiros JA et al (2018) Human Placenta Simulator for Intracranial-Intracranial Bypass: Vascular Anatomy and 5 Bypass Techniques. World Neurosurg 119:e694\u2013e702. https:\/\/doi.org\/10.1016\/j.wneu.2018.07.246","journal-title":"World Neurosurg"},{"issue":"4","key":"6286_CR19","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1590\/s0004-282x2008000600019","volume":"66","author":"FR Romero","year":"2008","unstructured":"Romero FR, Fernandes ST, Chaddad-Neto F, Ramos JG, de Campos JM, de Oliveira E (2008) Microsurgical techniques using human placenta. Arq Neuropsiquiatr 66(4):876\u2013878. https:\/\/doi.org\/10.1590\/s0004-282x2008000600019","journal-title":"Arq Neuropsiquiatr"},{"issue":"3","key":"6286_CR20","doi-asserted-by":"publisher","first-page":"201","DOI":"10.5999\/aps.2014.41.3.201","volume":"41","author":"S Shurey","year":"2014","unstructured":"Shurey S, Akelina Y, Legagneux J, Malzone G, Jiga L, Ghanem AM (2014) The rat model in microsurgery education: classical exercises and new horizons. Arch Plast Surg 41(3):201\u2013208. https:\/\/doi.org\/10.5999\/aps.2014.41.3.201","journal-title":"Arch Plast Surg"},{"issue":"3","key":"6286_CR21","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1002\/micr.20473","volume":"28","author":"M Takeuchi","year":"2008","unstructured":"Takeuchi M, Hayashi N, Hamada H, Matsumura N, Nishijo H, Endo S (2008) A new training method to improve deep microsurgical skills using a mannequin head. Microsurgery 28(3):168\u2013170. https:\/\/doi.org\/10.1002\/micr.20473","journal-title":"Microsurgery"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-024-06286-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-024-06286-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-024-06286-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T15:57:16Z","timestamp":1740153436000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-024-06286-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,15]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["6286"],"URL":"https:\/\/doi.org\/10.1007\/s00701-024-06286-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4692723\/v1","asserted-by":"object"}]},"ISSN":["0942-0940"],"issn-type":[{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,15]]},"assertion":[{"value":"5 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 November 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The use of each placenta at the Zurich Microsurgery Course required presence of a written consent for imaging and biologic data use signed by the mother. The trainees at the Zurich Microsurgery Courses participated voluntarily to the study and no consent was signed.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"459"}}