Microsurgical training using an ex-vivo model: microscope vs 3D exoscope

Objective. The aim of this study is to evaluate the feasibility of the 3D exoscope in a mi-crovascular anastomosis training setting and compare it with the gold-standard technique using the operating microscope (OM). Methods. Participants were recruited among otorhinolaryngology head and neck surgery (OHNS) residents of two tertiary care hospitals. Trainees were asked to complete 4 micro-vascular end-to-end anastomoses on chicken thighs with the OM and VITOM 3D exoscope. The performances were scored by experienced microvascular surgeons; an objective evaluation of the anastomosis and a subjective assessment of the workload were conducted. Results. 8 OHNS residents were recruited. Considering the amount of time needed to complete (TTC) the anastomosis, an improvement was shown by all the participants throughout the training program. The objective evaluation of the anastomosis did not show a significant difference. No significant differences were found by analyzing the subjective workload with the different tools. Conclusions. This article represents the first attempt to compare the use of the OM and the 3D exoscope during training for microsurgery. The results of our study demonstrate the noninferiori-ty of microsurgical training obtained using the 3D exoscope compared to that offered by the OM.