Videos

Table of Contents


Objective: Welcome to PennMicro!
Materials: None


Objective: learn to hold your instrument for maximal stability, maneuverability, and fine motor control.
Materials:
  • 1 pencil or pen
  • 1 micro forceps (optional)
 blue ink marks show exactly where your fingers should be in contact with your instruments
The blue ink marks show exactly where your fingers should be in contact with your instrument. Maintaining this position gives you the highest level of stability and control for microsurgical movements.

Objective: practice moving precisely in space to hit targets in different locations in appropriate position: with a good grip on your instruments, and keeping your hypothenars stabilized to avoid activating larger, less precise muscle groups
Materials:
  • 2 pencils or pens
  • ruler
  • sheet of plain paper


Objective: now that you can hit the dots, increase your challenge level by practicing hitting the dots with the metronome.
Materials:
  • 2 pencils or pens
  • ruler
  • sheet of plain paper
  • metronome


Objective: train up your nondominant hand by practicing hitting the dots with the metronome. 
Materials:
  • 2 pencils or pens
  • ruler
  • sheet of plain paper
  • metronome


Objective: alternate right and left to get more comfortable alternating your focus (as you would when passing a needle from hand to hand) while still maintaining a high level of precision and control.
Materials:
  • 2 pencils or pens
  • ruler
  • sheet of plain paper
  • metronome


Objective: work on improving your control with rotational movement. This will help you pass your needle through the vessel with minimal trauma by following the curve.
Materials:
  • Pen or pencil
  • Sheet of plain paper
  • Micro forceps and driver (optional)


Objective: Loading and reloading your microneedle can be clumsy and slow when you are first learning, and can lead to distraction and wasted time during micro. Practice loading your needle from the pack as well as grabbing and reloading from various positions.
Materials:
  • Micro stitch (8-0 nylon is standard)
  • Micro forceps and driver
  • Loupes


Objective: Practice throwing a perfect stitch with even spacing and good follow through by running a baseball stitch on the Styrofoam of your suture pack. 
Materials:
  • Micro stitch (8-0 nylon is standard)
  • Micro forceps and driver
  • Pen or marker
  • Loupes


Objective: Grabbing the tail of the suture can be an annoyance and a source of wasted time. You can practice finding and gripping your tail consistently with this simple exercise.
Materials:
  • Micro stitch (8-0 nylon is standard)
  • Micro forceps, driver, and scissors
  • Cottonball
Set up instructions:
  • Use your fingers to pull apart and break up the cotton ball so it has lots of fuzzy edges that will catch on your suture.
  • Place the shredded cotton ball in the plastic tray from your suture pack.
  • Hold the suture can be a used suture from a prior exercise since you won’t need the needle for this one) over the cotton and cut it into lots of tiny segments so that they fall at random angles and locations into the cotton.
shredding the cotton balls
Set up: shred a cotton ball with your fingers so that it has lots of fuzzy edges that will catch on your suture. This helps simulate the common problem that residents face of getting stuck on bits of adventitia or other tissue in your field, slowing you down and potentially putting additional stress on delicate tissues.
 
shredded cotton balls and suture
Set up: Shredded cotton ball with cut up pieces of micro suture inside a plastic suture pack.


Objective: Learn how to tie a perfect microsurgical knot
Materials:
  • Micro stitch (8-0 nylon is standard)
  • Micro forceps, driver, and scissors


Objective: Challenge your knot tying skills and develop a sense for how much tension to apply to cinch your knot down without cheesewiring through the tissue or breaking your stitch.
Materials:
  • Micro stitch (8-0 nylon is standard)
  • Micro forceps, driver, and scissors
  • Sticky tack
  • Paperclip


Objective: This is your PennMicro final exam! How many knots can you tie without pulling through the wax? This exercise leaves no room for error: any imprecise movement or extra force will pull your knot out of the wax. This will also help you learn to use visual feedback alone to know when your knot is tight, since there is essentially no haptic feedback in microsurgery.
Materials:
  • Micro stitch (8-0 nylon is standard)
  • Micro forceps, driver, and scissors
  • Sticky tack
  • Bone wax
  • Paperclip

Objective: Putting it all together, this intraoperative video shows a complete arterial anastomosis, with tips along the way for perfecting your setup and translating your PennMicro skills for the operating room.
Materials: none