Simulators in urology resident's training in retrograde intrarenal surgery

ABSTRACT Purpose: To evaluate the impact of simulators on the training of urology residents in retrograde intrarenal surgery (RIRS). Methods: The study involved training eight urology residents, using two artificial simulators; one developed by the Universidade Estadual do Pará, using three-dimensional printing technology, and the other one patented by the medical equipment manufacturer Boston Scientific The qualification of residents took place through a training course, consisting of an adaptation phase (S0), followed by three training sessions, with weekly breaks between them (S1, S2 and S3). Study members should carry out a RIRS in a standardized way, with step-by-step supervision by the evaluator using a checklist. The participants' individual performance was verified through a theoretical assessment, before and after training (pre- and post-training), as well as by the score achieved in each session on a scale called global psychomotor skill score. In S3, residents performed an analysis of the performance and quality of the simulation, by completing the scale of student satisfaction and self confidence in learning (SSSCL). Results: At the end of the course, everyone was able to perform the procedure in accordance with the standard. The training provided a learning gain and a considerable improvement in skills and competencies in RIRS, with p < 0.05. SSSCL demonstrated positive feedback, with an overall approval rating of 96%. Conclusions: Artificial simulators proved to be excellent auxiliary tools in the training of urology residents in RIRS.

End-to-side neurorrhaphy in the reconstruction of peripheral segmental neural loss: an experimental study

Purpose: To evaluate the effects on peripheral neural regeneration of the end-to-side embracing repair technique compared to the autograft repair technique in Wistar rats. Methods: Fifteen male Wistar rats were divided into three groups with five animals each: denervated group (GD), autograft group (GA), and embracing group (EG). For the evaluation, the grasping test, electroneuromyography (ENMG), and muscle weight assessment were used. Results: Muscle weight assessment and ENMG did not show significant neural regeneration at the end of 12 weeks in the DG and GE groups, but only in GA. The grasping test showed an increase in strength between the surgery and the fourth week in all groups, and only the GA maintained this trend until the 12th week. Conclusions: The present study indicates that the neural regeneration observed in the end-to-side embracing neurorrhaphy technique, in the repair of segmental neural loss, is inferior to autograft repair in Wistar rats.

Do good things really come to those who wait?: an analysis of the average time of acceptance in Brazilian surgery journals

Purpose: To analyze the average time between submission and acceptance of national journals in seven Brazilian surgery journals from 2017 to 2022. Methods: It consists of a cross-sectional and observational study with a quantitative approach to analyze the acceptance time of articles approved by Brazilian journals on general surgery and its subspecialties, including Acta Cirúrgica Brasileira, Jornal Vascular Brasileiro, Arquivos Brasileiros de Cirurgia de Digestiva, Revista do Colégio Brasileiro de Cirurgiões, Journal of Coloproctology, Revista Brasileira de Cirurgia Plástica, and International Brazilian Journal of Urology. Results: The journals with the lowest average waiting times were Revista do Colégio Brasileiro de Cirurgiões, Acta Cirúrgica Brasileira, and Journal of Coloproctology, respectively, and, with the lowest interquartile range there is Acta Cirúrgica Brasileira. There was no significant difference between the pre-pandemic and pandemic periods. The study designs with the highest and lowest means were, respectively, ideas and innovations - also with the highest interquartile range - and expert opinion, while with the lowest interquartile range was technical skill. Conclusions: The acceptance time for articles in Brazilian surgery journals is extremely variable. Identifying these discrepancies highlights the importance of understanding editorial processes and seeking ways to improve consistency and efficiency in reviewing articles.

Perfil das cirurgias oncológicas e reparadoras de mama no norte do Brasil: Análise da última década / Profile of oncological and breast repair surgeries in northern Brazil: Analysis of the last decade

Introdução: O diagnóstico tardio do câncer de mama eleva o número de cirurgias, resultando em alta mortalidade e resultado pouco estético. Assim, é fundamental a instituição de procedimentos de reconstrução mamária. Método: Estudo descritivo, quantitativo e retrospectivo sobre as autorizações de internação hospitalar de pacientes submetidos a procedimentos cirúrgicos de mama em oncologia, no período de 2011 a 2020, cujo dados foram obtidos na plataforma DATASUS. Resultados: 7.529 cirurgias de câncer de mama e 1.949 cirurgias reparadoras foram realizadas na Região Norte. Houve aumento do número de procedimentos ao longo da década. Em todos os estados é possível perceber a diferença no número de municípios de residência, comparado aos municípios de internação. Conclusão: Necessita-se instituir centros de referência oncológica, garantindo tratamento individualizado e a reconstrução mamária.

Introduction: Late breast cancer diagnosis increases the number of surgeries, resulting in high mortality and unsightly results. Therefore, the institution of breast reconstruction procedures is essential. Method: Descriptive, quantitative, and retrospective study on authorizations for hospital admission of patients undergoing breast surgical procedures in oncology from 2011 to 2020, whose data were obtained from the DATASUS platform. Results: 7,529 breast cancer surgeries and 1,949 reconstructive surgeries were performed in the North Region. There was an increase in the number of procedures throughout the decade. In all states, it is possible to notice the difference in the number of municipalities of residence compared to the municipalities of hospitalization. Conclusion: It is necessary to establish oncological reference centers, guaranteeing individualized treatment and breast reconstruction.

Profile of thyroidectomies in Brazil from 2010 to 2020 from a macro-regional perspective

ABSTRACT Objective: To describe the distribution profile of thyroidectomies in Brazil from 2010 to 2020 from a macro-regional perspective. Materials and methods: This is a retrospective, detailed and descriptive study built on secondary data obtained from the Hospital Information System of the Unified Health System (SIH/SUS). We organized the data in tables and grouped them according to the federative unit, macro-region, type of procedure, mortality rate, and year of performance. We performed statistical analysis using the χ2 test to assess the association between the variables, observing a P value of < 0.05 and a confidence interval of 95%. Results: From 2010 to 2020, 160 219 thyroidectomy surgeries were performed, of which 77 812 (48.56%) were total, 38 064 (23.76%) partial and 41 191 (25.70%) oncological.The Southeast was responsible for the largest share of procedures, with 70 745 (44.15%), followed by the Northeast with 43 887 (27.39%). In 2020, the procedure was less performed, with 9226 (5.75%) surgeries. The total mortality rate was 0.16% during the study period. Conclusion: We found that thyroidectomies are carried out mainly in the Southeastern, Northeastern, and Southern regions, and showed a downward trend in 2020, which may be related to the COVID-19 pandemic. In addition, total thyroidectomy is the most performed surgery, and the Northern region had the highest mortality rate.

The Effects of Hydrolyzed Collagen and Collagen Peptide in the Treatment of Superficial Chondral Lesions: An Experimental Study / Os efeitos do colágeno hidrolisado e do peptídeo de colágeno no tratamento de lesões condrais superficiais: Um estudo experimental

Abstract Objective To evaluate the effects of hydrolyzed collagen and collagen peptide in the treatment of superficial chondral lesions in rats. Method This research employed 18 Rattus norvegicus. A single intraarticular infiltration of sodium iodoacetate (2 mg solution) through the patellar ligament induced joint damage in previously anesthetized animals. We divided the animals into three groups: a control group, a collagen peptide group, and a hydrolyzed collagen group. Treatment consisted of oral administration of collagen peptide or hydrolyzed collagen for 30 days. Afterwards, we euthanized the animals and studied the joint chondral changes. We evaluated the results according to the chondrocyte clusters count and a histological evaluation, as per Pritzker et al. Results There was no statistical significance in injury stages between the control, hydrolyzed collagen, and collagen peptide groups (p= 0.11). Regarding scores, there was a statistical significance between the groups treated with hydrolyzed collagen and collagen peptide (p< 0.05), but not in comparison with the control group. Conclusion The proposed treatments of the induced chondral lesion with the oral administration of hydrolyzed collagen or collagen peptides were effective, resulting in lesion stabilization or regression, and warranting further experimental research to understand and improve the primary outcome of this study.

Resumo Objetivo Avaliar os efeitos do colágeno hidrolisado e do peptídeo de colágeno no tratamento de lesões condrais superficiais de ratos. Método Foram utilizados 18 Rattus norvegicus nesta pesquisa. O dano articular foi induzido por uma única infiltração intra-articular de iodoacetato de sódio (solução 2 mg), injetada através do ligamento patelar da articulação dos animais previamente anestesiados. Os animais foram distribuídos em três grupos: grupo controle, grupo peptídeo de colágeno e grupo colágeno hidrolisado. O tratamento foi realizado por 30 dias com a administração via oral do peptídeo de colágeno ou do colágeno hidrolisado. Posteriormente, foi realizada a eutanásia dos experimentos e seguiu-se para o estudo das alterações condrais articulares. Os resultados foram avaliados conforme contagem de condrócitos por cluster e através da avaliação histológica segundo Pritzker et al. Resultados Ao observar os estágios de lesão, não foi observada significância estatística entre os grupos controle, colágeno hidrolisado e peptídeo de colágeno (p= 0,11). Ao observar os escores, houve significância estatística na comparação do grupo tratado com colágeno hidrolisado e o grupo peptídeo colágeno (p< 0,05), porém sem diferença estatística em relação ao grupo controle. Conclusão Os tratamentos propostos da lesão condral induzida com uso de colágeno hidrolisado ou peptídeos de colágeno via oral mostraram-se eficazes, com estabilização ou regressão da lesão apresentada em ratos, merecendo novas pesquisas experimentais com o intuito de compreender e melhorar o desfecho primário deste trabalho.

Low-fidelity simulation models in urology resident's microsurgery training

Purpose: To evaluate the gain of microsurgical skills and competencies by urology residents, using low-fidelity experimental models. Methods: The study involved the use of training boards, together with a low-fidelity microsurgery simulator, developed using a 3D printer. The model consists in two silicone tubes, coated with a resin, measuring 10 cm in length and with internal and external diameters of 0.5 and 1.5 mm. The support for the ducts is composed by a small box, developed with polylactic acid. The evaluation of the gain of skills and competencies in microsurgery occurred throughout a training course consisting of five training sessions. The first sessions (S1-S4) took place at weekly intervals and the last session (S5) was performed three months after S4. During sessions, were analyzed: the speed of performing microsurgical sutures in the pre and post-training and the performance of each resident through the Objective Structure Assessment of Technical Skill (OSATS) and Student Satisfaction Self-Confidence tools in Learning (SSSCL). Results: There was a decrease in the time needed to perform the anastomosis (p=0.0019), as well as a progressive increase in the score in the OSATS over during sessions S1 to S4. At S5, there was a slightly decrease in performance (p<0.0001), however, remaining within the expected plateau for the gain of skills and competences. The SSSCL satisfaction scale showed an overall approval rating of 96.9%, with a Cronback alpha coefficient of 83%. Conclusions: The low-fidelity simulation was able to guarantee urology residents a solid gain in skills and competencies in microsurgery.

O que os olhos não veem a microcirurgia ensina: modelo de treinamento oftalmológico com olho de boi / What the eye cannot see, microsurgery teaches: a model of ophthalmological training with a bull's eye

RESUMO Objetivo Descrever e validar um modelo oftalmológico para treinamento de transplante e microssutura de córnea utilizando globo ocular bovino. Métodos Para a montagem do modelo de treinamento, o globo ocular foi disposto sob o campo cirúrgico, apoiado sobre um recipiente plástico cilíndrico comum de 3,5cm de diâmetro, para a retirada da córnea. Foi realizada uma incisão circular superficial, e, posteriormente, uma tesoura Castroviejo curva de 9 cm foi utilizada para remoção completa da córnea, que foi recolocada em sua posição original, para que, em seguida, fossem confeccionados nove pontos equidistantes, usando fio de nylon 10-0. Por fim, foram avaliados os seguintes critérios: tempo de realização das suturas; evolução do tempo e da qualidade a cada teste; e destreza e aperfeiçoamento da realização das suturas. Resultados O modelo descrito demonstrou-se viável e adequado para o treinamento de microssuturas na córnea, possibilitando aperfeiçoamento e ganho de habilidades cirúrgicas. Conclusão O modelo de treinamento microcirúrgico apresentado possui alta viabilidade para a simulação de cirurgias oftalmológicas e textura semelhante à do olho humano real, o que o torna próximo à realidade.

ABSTRACT Objective To describe and validate an ophthalmic model for corneal transplantation and micro suture training using a bovine eyeball as a model. Methods For the training model, the eyeball was placed under the sanitary field placed on the ends of a common 3.5cm diameter cylindrical plastic container for corneal removal. A superficial circular incision was made, then 9cm curved Castroviejo scissors were used for complete corneal removal. The cornea was replaced in its original position, and 10-0 nylon thread was used to perform the sutures, with 9 equidistant stitches. Finally, the following criteria were evaluated: suturing time, time and quality progression in each attempt, dexterity and suturing improvement. Results The described model proved to be feasible and suitable for corneal micro suture training, allowing improvement and gain of dexterity in the sport. Conclusion The presented microsurgical training model has a high feasibility for the simulation of ophthalmic surgeries, in addition to a texture similar to the real human eye, which makes it close to reality.

Low-cost suture simulator to gain basic surgical skills

ABSTRACT Purpose: To introduce a new low-cost simulation model for training basic surgical skills. Methods: The training model was made from a mixture of 20 g of acetic silicone with 11 g of maize starch. Validation consisted of serial training sessions, evaluating the mean pre- and post-training time and the mean final score according to the global rating scale. Results: A decrease in the time required to perform the sutures was observed, comparing the average post and pre-training time of each training day, with a significant correlation between the order of training and the time for performing the simulation. Conclusions: The presented model proved to be capable of simulating the basic suture training skills. It is easy to make, has low cost, and can be easily reproduced in educational institutions.

Women in surgery: do surgical specialties keep up with the feminization of medicine in Brazil? / Mulheres na cirurgia: as especialidades cirúrgicas acompanham a feminização da medicina no Brasil?

ABSTRACT Introduction: historically, surgical medical specialties are mostly male, a scenario which, in recent years, has undergone changes. In this sense, despite the relevance of the growth of female participation in the medical career, little is discussed about the distribution between genders of the main surgical medical specialties in the country. Objective: discuss the process of feminization in surgical specialties in Brazil over the last few years, tracing a distribution profile of these specialties. Methods: this is a retrospective and cross-sectional study with secondary data from the Censuses of Medical Demography in Brazil in the years 2011, 2013, 2015, 2018, 2020 and 2023, including the surgical specialties: Urology, Orthopedics and Traumatology, Thoracic Surgery, Neurosurgery, Digestive System Surgery, Cardiovascular Surgery, Hand Surgery, General Surgery, Head and Neck Surgery, Vascular Surgery, Plastic Surgery, Ophthalmology, Coloproctology, Otorhinolaryngology, Pediatric Surgery, and Gynecology and Obstetrics. Results: males prevails in numbers, among the surgical specialties, however, with a lower growth rate compared to females. Specialties such as urology, orthopedics and traumatology and neurosurgery are mostly male, while gynecology and obstetrics are female. Conclusion: it is evident that female participation in the surgical medical field has increased significantly over the last few years.

RESUMO Introdução: historicamente, as especialidades médicas cirúrgicas são, majoritariamente, masculinas, cenário o qual, nos últimos anos, passa por mudanças. Nesse sentido, apesar da relevância do crescimento da participação feminina na carreira médica, pouco se debate sobre a distribuição entre sexos das principais especialidades médicas cirúrgicas no país. Objetivo: discutir o processo de feminização nas especialidades cirúrgicas no Brasil ao longo dos últimos anos, traçando um perfil de distribuição dessas especialidades. Métodos: Trata-se de um estudo retrospectivo e transversal com dados secundários oriundos dos Censos de Demografia Médica no Brasil dos anos de 2011, 2013, 2015, 2018, 2020 e 2023, incluindo as especialidades cirúrgicas:Urologia, Ortopedia e Traumatologia, Cirurgia Torácica, Neurocirurgia, Cirurgia do Aparelho Digestivo, Cirurgia Cardiovascular, Cirurgia da Mão, Cirurgia Geral, Cirurgia de Cabeça e Pescoço, Cirurgia Vascular, Cirurgia Plástica, Oftalmologia, Coloproctologia, Otorrinolaringologia, Cirurgia Pediátrica e Ginecologia e Obstetrícia. Resultados: O sexo masculino prevalece em números, dentre as especialidades cirúrgicas, porém, com menor taxa de crescimento em comparação ao sexo feminino. Especialidades como a urologia, ortopedia e traumatologia e neurocirurgia são majoritariamente masculinas, enquanto a ginecologia e obstetrícia, feminina. Conclusão: evidencia-se que a participação feminina na área médica cirúrgica aumentou significativamente ao longo dos últimos anos.

Low cost and easy acquisition: corn grain in microsurgery training / Baixo custo e fácil aquisição: grãos de milho no treinamento microcirúrgico

ABSTRACT Objectives: develop an easily accessible model for training the initial motor practice in microsurgery using corn kernels. Methods: ten corn kernels (Zea mays) were used. A 7mm longitudinal cut was made on one side of the corn grain. The training consisted of performing 4 simple knots between the edges of the incision, using 10-0 mononylon thread. The parameters analyzed were 1) cost of the model; 2) assembly time of the model test system; 3) time for performing the knots; 4) distance between the knots. Results: in all corn kernels tested, it was possible to perform the proposed microsurgical suture training, without any difficulty in the procedure. The average time to perform the 4 knots was 6.51±1.18 minutes. The total cost of the simulator model was R$3.59. The average distance between the knots was 1.7±0.3mm. The model developed from corn grains has an extremely low cost when compared to the use of animals or high-tech simulators. Other advantages are the easy availability of canned corn kernels and the possibility of making more than four knots along the 7mm incision. Conclusion: the training model developed has low cost, is easy to acquire and viable for training basic manual skills in microsurgery.

RESUMO Objetivo: desenvolver um modelo facilmente acessível para o treinamento da prática motora inicial em microcirurgia a partir da utilização de grãos de milho. Métodos: foram utilizados dez grãos de milho (Zea mays). Realizou-se um corte longitudinal de 7mm em uma das faces do grão de milho. O treinamento consistiu na realização de 4 pontos simples entre as bordas da incisão, utilizando fio de mononáilon 10-0. Os parâmetros analisados foram 1) custo do modelo; 2) tempo de montagem do sistema de teste do modelo; 3) tempo de realização dos nós; 4) distância entre os pontos. Resultados: em todos os grãos testados foi possível realizar o treinamento de sutura microcirúrgica proposto, sem dificuldade ao procedimento. O tempo médio para a realização dos 4 pontos foi de 6,51±1,18 minutos. O custo total do modelo simulatório foi de R$3,59. A distância média entre os pontos foi de 1,7±0,3mm. O modelo desenvolvido a partir de grãos de milhos apresenta custo extremamente baixo quando comparado ao uso de animais ou de simuladores de alta tecnologia. Outras vantagens são fácil disponibilidade de grãos de milho em conserva e possibilidade de serem realizados mais de quatro pontos ao longo da incisão de 7mm. Conclusão: o modelo de treinamento desenvolvido é de baixo custo, de fácil aquisição e viável para o treinamento de habilidades manuais básicas em microcirurgia.

Perfil epidemiológico do tratamento cirúrgico de varizes no Brasil no período de 2010 a 2020 / Epidemiological profile of surgical treatment of varicose veins in Brazil from 2010 to 2020

Resumo Contexto As varizes são um agravo que vêm aumentando nos últimos anos e, nos casos mais graves, necessitam de tratamento cirúrgico para a resolução do quadro clínico do paciente. Apesar da sua importância, não há trabalhos epidemiológicos que englobem todo o território brasileiro de modo a demonstrar como está a distribuição das cirurgias para a correção desse agravo pelo Sistema Único de Saúde. Objetivos Descrever o perfil ecológico do tratamento cirúrgico para a correção de varizes no Brasil no período de 2010 a 2020. Métodos O estudo caracteriza-se como descritivo-analítico, mediante a coleta de dados proveniente do Sistema de Informações Hospitalares do Sistema Único de Saúde. Os dados, disponibilizados pela própria plataforma, foram tabelados e categorizados de acordo com o estado, a região, o caráter do procedimento e o ano de realização. O programa BioEstat 5.3 foi utilizado para a realização do teste estatístico de qui-quadrado, sendo adotado o intervalo de confiança de 95% e o valor significativo de p <0,05. Resultados No período de 2010 a 2020, foram realizadas 755.752 cirurgias para o tratamento de varizes, sendo 292.538 unilaterais (38,71%) e 463.214 (61,29%) bilaterais. A região Sudeste foi responsável por 418.791 (55,41%) procedimentos, seguida pelo Sul, com 180.689 (23,91%). Foram registradas 40 mortes pelo procedimento no período analisado, das quais 26 ocorreram em cirurgias bilaterais (65%) e a maioria no Sudeste (24 óbitos). Conclusões Verificou-se que esse procedimento é realizado majoritariamente nas regiões Sudeste e Sul, com maior prevalência da cirurgia bilateral de caráter eletivo.

Abstract Background Varicose veins have become more common over recent years and in the most serious cases surgical treatment is necessary to resolve patients' clinical status. Despite their importance, there are no epidemiological studies that cover the whole of Brazil, showing how surgery to correct varicose veins conducted by the Unified Health System (SUS) is distributed in the country. Objectives To describe the ecological profile of surgical treatment to correct varicose veins in Brazil from 2010 to 2020. Methods This is a descriptive-analytical study of data obtained from the SUS Hospital Information System. These data were tabulated and categorized by state, region, type of procedure, and year. BioEstat 5.3 was used to conduct chi-square statistical tests with a 95% confidence interval and significance cutoff of p <0.05. Results From 2010 to 2020, 755,752 surgical operations to treat varicose veins were conducted; 292,538 were unilateral (38.71%) and 463,214 (61.29%) were bilateral. Of these, 418,791 (55.41%) procedures were performed in the Southeast region, followed by 180,689 (23.91%) in the South region. A total of 40 deaths were registered in connection with these procedures during the period, 26 of which (65%) were associated with bilateral surgery and the majority of which occurred in the Southeast (24 deaths). Conclusions It was observed that the majority of procedures are performed in the Southeast and South regions, and that bilateral elective surgery is the most prevalent.

Os periódicos médicos brasileiros referenciam artigos nacionais? Um estudo transversal / Do Brazilian medical journals reference Brazilian articles? A cross-sectional study

Resumo Contexto A produção científica brasileira cresce de forma quantitativa e qualitativa a cada década. Entretanto, há uma desvalorização dos periódicos brasileiros demonstrada através da baixa quantidade de citações em comparação a textos de revistas internacionais, com justificativa subentendida de que há superioridade qualitativa de artigos estrangeiros. Objetivos Verificar a diferença entre o número de citações de periódicos nacionais e internacionais em três revistas brasileiras no período de 2016 a 2020. Métodos Foram analisados todos os artigos publicados na Revista do Colégio Brasileiro de Cirurgiões, no Jornal Vascular Brasileiro e na Acta Cirúrgica Brasileira no intervalo de 2016 a 2020. Os estudos selecionados tiveram suas referências avaliadas, sendo contabilizado o número total de citações e se eram provenientes de periódicos brasileiros ou de periódicos estrangeiros. Resultados Foram analisados 902 artigos, totalizando 23.394 referências, com média de 25,81 ± 8,59 por artigo. Nesse contexto, 2.680 (11,45%) eram nacionais, correspondentes a uma média de 2,95 ± 3,79 referências brasileiras por artigo. Conclusões Faz-se necessária a maior valorização dos periódicos brasileiros, em especial por parte dos pesquisadores nacionais e das instituições responsáveis pelo fomento da ciência.

Abstract Background The quantity and quality of Brazilian scientific output increases decade by decade. However, there is a tendency to undervalue Brazilian journals, illustrated by the low number of citations compared with texts in international journals, with the tacit justification that foreign articles are of superior quality. Objectives To investigate the differences in numbers of citations of Brazilian and international periodicals in three Brazilian journals from 2016 to 2020. Methods All articles published in the Journal of the Brazilian College of Surgeons, in the Jornal Vascular Brasileiro, and in Acta Cirúrgica Brasileira from 2016 to 2020 were analyzed. The references of these studies were analyzed, summing the total number of citations and classifying them as published in Brazilian or foreign journals. Results A total of 902 articles were analyzed, totaling 23,394 references, with a mean of 25.81 ± 8.59 references per article. Of these, 2,680 (11.45%) were Brazilian, equating to a mean of 2.95 ± 3.79 Brazilian references per article. Conclusions It is necessary to improve appreciation of Brazilian periodicals, especially among Brazilian researchers and institutions responsible for science funding.

What came first: the egg or the microsurgery training? An ophthalmic model for developing basic skills in microsurgery / O que veio primeiro: o ovo ou o treinamento microcirúrgico? Um modelo oftalmológico para desenvolver habilidades básicas em microcirurgia

ABSTRACT Purpose: To describe a new accessible model of ophthalmological training using chicken eggs. Methods: With the aid of a spherical drill, the external calcified layer and the cuticle of the chicken eggshell were removed in a 2cm diameter circle. Using a video-magnification system, the film was dissected and cut to approximately 1.5 cm diameters. The film was removed and repositioned to make interrupted 12-0 nylon microsutures. The parameters analyzed were: cost, facility of acquisition and handling, time for making the model and the microsutures and number of possible uses. Results: In all simulators, it was possible to carry out separated and equidistant micro-sutures in the egg membrane, without the need for reintervention. Conclusion: The new chicken-egg model for ophthalmic surgery training is low-cost, easy to acquire and handle, and viable for the development of basic microsurgery skills.

RESUMO Objetivo: Descrever um novo modelo acessível de treinamento oftalmológico com ovo de galinha. Métodos: Com o auxílio de uma broca esférica, a camada calcificada externa e a cutícula da casca do ovo de galinha foram retiradas em um círculo 2 cm de diâmetro. Mediante um sistema de videomagnificação, a película foi dissecada e cortada em formato aproximado de 1,5 cm de diâmetro. A película foi removida e reposicionada para a confecção de microssuturas interrompidas com nylon 12-0. Os parâmetros analisados foram: custo, facilidade de aquisição e manuseio, tempo para confecção do modelo e para a confecção das microssuturas e número de utilizações possíveis. Resultados: Em todos os simuladores foi possível realizar microssuturas separadas e equidistantes na membrana do ovo, sem necessidade de reintervenção. Conclusão: O novo modelo com ovo de galinha para o treinamento de cirurgia oftalmológica é de baixo custo, fácil aquisição e manuseio, além de ser viável no desenvolvimento de habilidades básicas em microcirurgia.

Anatomical description of the extratemporal facial nerve under high-definition system: a microsurgical study in rats

Purpose: To describe the microsurgical anatomical aspects of the extratemporal facial nerve of Wistar rats under a high-definition video system. Methods: Ten male Wistar rats (12­15 weeks old), without veterinary diseases, weighing 220­280 g, were used in this study. All animals in this study were submitted to the same protocol and by the same surgeon. A 10-mm incision was made below the bony prominence of the right or left ear, and extended towards the angle of the mandible. The dissection was performed and the main branches of the facial nerve were dissected. Results: The main trunk of the facial nerve has a length of 0.88 ± 0.10 mm and a length of 3.81 ± 1.03 mm, measured from its emergence from the stylomastoid foramen to its bifurcation. Seven branches originating from the facial nerve were identified: posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic. Conclusions: The anatomy of the facial nerve is comparable to that of humans, with some variations. The most observed anatomical division was the distribution in posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic branches. There is no statistical difference between the thickness and distance of the structures compared to the contralateral side.