Introducing the VasoChip: A Modular Training Tool for Objective Assessment of Microsurgical Skills

Summary: The widespread utility of microsurgery has spurred its rapid global development. With the emergence of supermicrosurgery on structures as small as 0.1 mm in diameter, the already high skill ceiling of the practice continues to increase. This is especially relevant for new surgical trainees, who benefit from early practice of microsurgery-specific fine motor and visuospatial skills. To this end, surgical training programs have designed specialized microsurgical curricula. These programs use diverse tools to practice microvascular anastomoses, including live animal models, chicken thighs, synthetic tubes, and augmented reality. Despite the plethora of available models, each has inherent limitations. For example, artificial models lack functional circulatory systems, whereas augmented reality remains computationally limited. A shared shortcoming among all models is the absence of a quantitative assessment of anastomotic quality. To address this limitation, our group designed the VasoChip, which uses a modular network of motors, tubing, and reservoirs to transport fluid through an interchangeable anastomotic element. This device can simulate a wide range of physiological conditions, including hydrostatic pressures and pulse rates. Notably, the VasoChip provides objective measures of anastomotic quality by quantifying the amount of leakage. In a cohort of resident and attending physicians, the VasoChip identified experience-dependent differences in anastomotic leakage across multiple physiological conditions.