Lazy Glass Microsurgical Trainer: A Frugal Solution for Microsurgical Training.

Abstract

The art of surgery is becoming increasingly complex and dependent on scopes, screens, and technology, inviting a complex learning curve and development of hand-eye coordination and dexterity among other skills. We introduce an affordable, do-it-yourself microsurgical simulator that can be set up using a smartphone and a pair of reflective prism glasses. The glasses employ periscopic prisms on either side that reflect light perpendicularly. When the visual input is combined with the magnification of a smartphone camera, a real-time microsurgical experience can be simulated. We analyzed the performance of 2 trainee residents in performing their first 5 successful sutures with 5-0 polypropylene thread on the cut ends of a glove over the course of 3 months. The module was also assessed in a survey at an international conference of neurosurgeons. A significant improvement was observed in both residents at the end of each month versus baseline (P < 0.05). Of 27 survey participants, 3 (11%) reported access to a training laboratory in their institute. The module was rated 4/5 in terms of hand-eye coordination, 3.5/5 in management of microsurgical field, and 3.5/5 in depth perception. The microsurgical simulation technique proved to be useful in performing complex microsurgical tasks. A significant improvement in microsurgical skills was observed among our trainees. The cost of building the module can be as low as U.S. $5. We endorse the use of this technique for resident training and skill development, especially in resource-challenged environments.