Alternative ways to train surgical skills: from a simple anastomosis towards complicated experimental techniques

Results of many experiments depend on the technical skill and experience of the investigator. Possibilities to master or refine these skills should therefore be offered. For this reason, adequate education of researchers and technicians plays a key-role in the futhering of refinement and reduction of animal experiments. Training in (micro)surgical techniques is by tradition often animal-based. Worldwide a large number of animals is involved in training. Within the initial training phase students encounter many difficulties such as unfamiliar eye-tohand co-ordination under the microscope, handling of microsurgical instruments, anaesthesia etc. It is often very hard for them to split their attention between mastering a new technique and the proper care to be taken of the animal. Lack of attention for the animal may easily lead to its untimely death. Due to this and other factors, the number of animals needed in the initial training phase is often very high and in the Iight of the 3R the use of living animals is not desirable. By using non-animal training devices we are able to drastically reduce the number of animals needed. An anastomosis device is used to practice basic surgical skills such as the making of running and interrupted sutures and suturing and knotting procedures in Standard end-to-end and end-to-side anastomosis. The development rat, a true-to-life rat model, is used to train advanced microsurgical and various experimental techniques e.g. cannulation of portal, renal and jugular vein, making of portocaval shunts (button and suture technique) and transplantation of vessels, kidney, heart and liver. Currently, a computer-based model for the training of the perioperative care is under development.