The role of structured training in learning microsurgery: a narrative review

Background and introduction. Microsurgery has transformed reconstructive surgery, offering superior aesthetic and functional outcomes, particularly in complex cases. Mastery of microsurgery is challenging due to the intricate nature of procedures and the precision required, leading to a steep learning curve. Various training methods, including traditional animal models and emerging synthetic alternatives, have been developed to enhance skill acquisition. Structured training programs, supported by national and international societies, are crucial for improving competency, with emphasis on both objective and subjective measures of performance. Material and methods. This review utilized the PubMed database to analyze literature on microsurgery training, employing search terms like “Microsurgery” AND “training resident”. After systematic filtering, 15 relevant articles were included, encompassing studies evaluating improvements in anastomosis time and patency rates, along with resident confidence. Results. Key findings included a 2022 study revealing a 41% patency rate among 1.792 anastomoses performed by residents after a 7-month training course with Wistar rats. Training duration significantly influenced performance. A virtual training program in low-resource settings demonstrated improved confidence in microsurgical skills, although statistical significance was limited by sample size. An Italian study indicated that structured long-term training led to significant improvements in Global Rating Scale (GRS) scores and reduced procedure times. Discussion and conclusions. The findings emphasize the effectiveness of structured, hands-on training in enhancing microsurgical skills. While remote training offers valuable introductory knowledge, in-person practice remains essential for developing the precision required in microsurgery. An integrated training approach combining both methods could improve global access to microsurgical education, equipping practitioners with necessary skills for success in the field. Overall, structured training enhances residents’ confidence and technical competence.