Microsurgery Arena: A New Device to Develop Microsurgical Skills.

Simulation in microsurgery is an important pillar of training and maintenance of surgical skills. Between learning microsurgical skills and mastering them in clinical practice, the usefulness of low-fidelity simulators for improving microsurgery skills has been well documented. Nowadays the in vivo models represent the gold standard of microsurgical training; however, their use implies difficulties and limitations. We developed a portable, low-cost, and modern device to help trainees to practice at their convenience to maintain their microsurgical suturing skills. By using CAD and 3D printer designs, we developed a "microsurgery trainer" that contains a middle section with eight projections with holes, arranged as a circle. The idea is to pass the microsuture-preferably 7/0 or 8/0 sutures-in a clockwise manner-with the needle passing from "out to in" and "in to out" through each hole. This allows the trainee to use his/her wrist to be flexible and achieve better control over the micro needle. Studies evaluating the potential of such a device in shortening the learning curve are needed and will be crucial to define whether the "microsurgery arena" will help trainees to obtain better outcomes in microsurgical practice.