Education of microsurgical technique for young surgeons by International Society for Experimental Microsurgery West Japan and future prospects

The need for microscopic vascular anastomosis has increased in the field of gastrointestinal surgery. Herein we report the activities for microsurgical training by ISEM West Japan.Since 2015, we have held the Hands-on seminar twice a year using artificial blood vessel. The participants sutured it with 9-0 polypropylene suture under bench microscopes. Competitions for microsurgical arterial anastomosis were held in the seminar, in which we evaluated the anastomosis regarding the leakage and patency.Totally 208 participants attended the hands-on seminar. No relation was seen between the years of surgical experience and the score. However, there was a relation between the number of participation and the score.Through our hands-on seminar, young surgeon could improve technique and motivation for the microsurgery.

THE MOST REALISTIC SURGICAL SIMULATION MODEL TO GAIN SKILLS IN LAPAROSCOPIC SURGERY IS THE CADAVERIC MODEL THIEL, ACCORDING TO OPINIONS OF DIFFERENT SPECIALIST SURGEONS

INTRODUCTION Laparoscopic procedures are still a challenge for the surgeon residents and young surgeon physicians. Different learning systems have been used without achieving a realism faithful to the lived in the operation room. All existing surgical simulation systems should be compared, with the aim of identifying the most realistic of them, for improving the surgical learning. MATERIAL AND METHODS An 18-item survey was sent to different specialized surgeons (general surgeons, gynecologists and urologists) who participated in international postgraduate laparoscopic surgery courses on cadavers embalmed by Thiel method. Participants were asked to the differences and improving skills in each surgical procedure, about the different surgical simulation models that the participants had already used. Surgeons were asked if they would recommend doing it during residency to improve their confidence in the operating room. RESULTS Attendees (n = 104) had a response rate of 92% (96 replies). The 91.8% surgeons recognized that Thiel model was more realistic than others simulation methods. The 97.9 % of respondents believed that had improved their surgical skills. Globally, 96.9% (93) of the participants surveyed recommended the conducting of these courses with Thiel cadavers to different colleagues of other specialties as a reliable simulation measure during the residency period. CONCLUSIONS Participants in the laparoscopic surgery course on the cadaver Thiel recognized that this is more realistic surgical simulation model than conventional models, one of the best ways to gain confidence and improve laparoscopic skills in operation room for inexperienced surgeons.

Orthotopic liver transplantation of pigs using porto/caval-jugular shunt for research work or off-site training of young surgeon

Although the training of liver transplant procedure is highly important to young transplant surgeons, it is too hard to secure the learning opportunity, especially in the countries like Japan whose organ transplants from deceased-donors are relatively rare. In such a situation, the surgical training in large animals such as pigs seems to be helpful in improving their skills. Consequently, under the assist by the Ministry of Education, Culture, Sports, Science and Technology (MEXT) in Japan, we established a simulation work of whole liver transplantation using laboratory pigs in the context of interinstitutional frame called the Six National University Consortium in Liver Transplant Professionals Training (SNUC-LT) Program. For this purpose, in this procedure, to guarantee stable circulatory dynamics during the anhepatic phase of pigs, we created a porto-caval-jugular shunt which is followed by addressing liver dysfunction, portal hypertension and intestinal congestion. Here, we describe the precise practical procedure. We believe that our procedure enables young transplant surgeons to gain surgical skills efficiently and effectively in addition to making a model animal in an experimental field.

Medicolegal Issues in Maxillofacial Surgery

Every profession is governed by a set of rules and regulations, and the same applies to the field of maxillofacial surgery. The young surgeon must therefore be aware of what legal requirements he/she must fulfil while practising the profession. Maxillofacial surgery is a challenging field that straddles both medicine and surgery, and therefore surgeons must be very aware of the legal scope of this field. Record keeping such as the informed consent and procedure notes are important legal requirements and must be maintained to provide legal proof of service and respect patient’s rights Maxillofacial surgeons play an important role as expert witnesses in cases of violence that have affected the head and neck region. In addition to all these legal requirements, the maxillofacial surgeon is also extremely vulnerable to civil or criminal litigation in the form of negligence. Surgeons must be aware of their duties and rights. They must also be familiar with legal issues like negligence and how to deal with it.

Orbital Fractures

Surgery for orbital trauma is challenging. A good understanding of the orbit, its normal form, function, and the varying patterns of its disruption due to trauma is essential for its proper management. The aim of this chapter is to provide a comprehensive clinical overview of all facets of orbital trauma for the young surgeon. The chapter has been structured to include the basics of (i) anatomy, (ii) biomechanics of injury, (iii) classification and their clinical implications, (iv) surgical approaches and (v) management options available for individual types of fractures. Special features of this chapter include descriptions of clinical features exclusive to orbital trauma with a section for management of orbital emergencies. A detailed note is provided for the management of fractures of the orbital floor including guidelines for deep orbital dissection and elaboration of the principles of reconstruction. The role of computer assisted surgery, intra-operative navigation and patient specific implants has also been added to explain the recent advances in this field of surgery.

The Great Inoculator

Smallpox was the scourge of the eighteenth century: it showed no mercy, almost wiping out whole societies. Young and old, poor and royalty were equally at risk — unless they had survived a previous attack. Daniel Sutton, a young surgeon from Suffolk, used this knowledge to pioneer a simple and effective inoculation method to counter the disease. His technique paved the way for Edward Jenner's discovery of vaccination — but, while Jenner is revered, Sutton has been vilified for not widely revealing his methods until later in life. This book reclaims Sutton's importance, showing how the clinician's practical and observational discoveries advanced understanding of the nature of disease. The book explores Sutton's personal and professional development, and the wider world of eighteenth-century health in which he practised inoculation. Sutton's brilliant and exacting mind had a significant impact on medicine — the effects of which can still be seen today.

Directly read

In Directly read John Challenor briefly explores the writing of the surgeon and author Gabriel Weston, who wrote about her life as a medical student and young surgeon.