EDUCATIONAL PROGRAM

Two years educational program
in search of excellence in reconstructive microsurgery.

Theoretical introduction to the basic concepts of microsurgery:

  • History of microsurgery
  • Microscope and microsurgical instruments
  • Selection of suture material for microsurgical procedures
  • Basic & advanced skills in microsurgery
  • Preoperative microsurgical planning
  • Microsurgical flap monitoring
  • Selection of right flap
  • Microsurgical flap salvage
  • Refinements in microsurgical reconstruction
  • Fundamentals in research metodology for microsurgery

Flap dissection training using a fresh cadaver model:

  • Head and neck:
    Submental flap / Temporo-parietal flap / Supraclavicular flap / Free Helix Flap.
  • Upper limb and shoulder:
    Lateral arm flap / Radial forearm flap
  • Lower limb and pelvis:
    PAP / Lumbar perforator flap (LPF) / Inferior gluteal artery perforator flap (IGAP) / Superior gluteal artery perforator flap (SGAP) / Thigh: anterolateral thigh flap (ALTF), medial thigh flap. Gracilis (ATMG) / Osteocutaneous peroneal artery perforator flap / Propeller flaps based on peroneal and tibial perforators / Medial plantar flap
  • Trunk:
    Internal mammary fascio-cutaneous flaps / Intercostal flaps / Scapulo-dorsal flaps: latissimus dorsi, thoracodorsal artery perforator flap (TDAP), scapular flap, parascapular flap and chimeric flaps / Internal Iliac crest: Groin flap, superficial circumflex inguinal perforator flap (SCIP), iliac crest flap / Abdominal wall flaps: musculo-cutaneous rectus abdominis flap (TRAM), deep inferior epigastric perforator flap (DIEP) and Taylor, superficial inferior epigastric artery flap (SIEA) / Free lymphonode transfer
  • Basic management of experimental animal, microscope and instrumentation
  • Microsurgical suture practice on surgical gloves
  • Epineural and perineural suture of the sciatic nerve
  • End-to-end suture of the carotid artery and femoral artery
  • End-to-end suture of jugular and femoral vein
  • Aorto-iliac end-to-end suture
  • End-to-side suture of femoral artery and vein
  • Jugular vein graft to carotid artery
  • “In situ” groin flap
  • Distant groin flap to the neck
  • Perforator flap anatomy
  • Preoperative planning of perforator flaps
  • Dissection technique of perforator flaps
  • Fundamentals of microsurgical techniques
  • Head and Neck Reconstruction with Microsurgical Flaps
  • Perforator Flaps in Breast Reconstruction
  • Perforator Flaps in Limb Reconstruction
  • Perforator Flaps in Trunk Reconstruction
  • “Hands on”. Dissection session:
    Gluteal and dorsal perforator flaps. Free style perforator flaps. Transferring the flaps to the recipient vessels. Super microsurgical flaps. Lymphatic channel dissection. Lymph node transfer
  • Anterolateral thigh perforator flap (ALTF)
  • Thoracodorsal artery perforator flap (TAP) with scapula
  • Oncological criteria in head and neck tumors
  • Reconstructive alternatives in head and neck surgery: form, function and aesthetics
  • Evaluation and indications for pedicled flap versus free flap
  • Selection of the right flap and recipient vessels
  • Deep inferior epigastric perforator flap (DIEP) with Taylor extension
  • Free fibula flap and free osteocutaneous peroneal flap for bone reconstruction
  • Deep circumflex iliac artery perforator flap with iliac crest for bone reconstruction
  • Radial forearm flap
  • Racial reanimation

Head and neck microsurgical reconstruction procedures will be performed. The program will include live webcast surgery and students interactive participation will be encouraged.

  • Oncological management in breast tumors
  • Reconstructive planning in breast tumors
  • Breast reconstruction with implant vs autologous tissue reconstruction
  • Immediate and delayed reconstruction
  • Oncoplastic breast surgery: glandular and perforator flap techniques
  • Partial breast reconstruction: Oncoplastic and perforator flap techniques
  • Breast reconstruction:
    DIEP flap. SIEA flap. TAP flap. SGAP flap. IGAP flap. Fat grafting. Transverse myocutaneous gracilis flap (TMG). Extended TAP. PAP. Lumbar perforator flap. Latissimus Dorsi
  • Autologus flap reconstruction with fat grafting
  • Thoracic wall reconstruction
  • Live webcast surgery will also be shown and students’ interactive participation will be encouraged
  • Oncological management of limb tumors
  • Reconstructive alternatives in lower limb surgery: form, function and aesthetics
  • Reconstruction following high energy lower limb trauma
  • Reconstructive approaches in chronic osteomyelitis of the lower limb
  • Avoiding complications in lower limb reconstruction
  • Reconstruction of the lower limb defects:
    Latissimus Dorsi flap. ALT flap. TAP flap. Radial forearm flap. Osteocutaneus fibular flap. SCIP flap
  • Lower limb nonunion. Microsurgical bone reconstruction
  • Reconstruction of the lower limb defects:
  • Latissimus Dorsi flap. ALT flap. TAP flap. Radial forearm flap. Osteocutaneus fibular flap. SCIP flap
  • Reconstruction with epiphyseal flaps and joint transfer
  • Lower limb nonunion. Microsurgical bone reconstruction
  • Reconstruction with epiphyseal flaps and joint transfer

Small groups of students will have the opportunity to observe live microsurgical reconstruction of the lower limb. Live webcast surgery will beshown and interactive participation will be facilitated

  • Brachial plexus. Introduction and surgical anatomy
  • Reconstructive alternatives in brachial plexus injuries. Neurotizations. Nerve grafts. Nerve transfers
  • Obstetric plexus
  • Surgical approach of the peripheral nerves injuries
  • Reconstructive options in upper limb surgery: form, function and aesthetics
  • Upper limb nonunion. Microsurgical bone reconstruction. Special locations: humerus, scaphoid
  • Oncological management of upper limb tumors
  • Reconstruction of the upper limb defects:
    Latissimus Dorsi flap. ALT flap. TAP flap. Radial forearm flap. Osteocutaneus fibular flap. SCIP flap
  • Replantation and revascularization in upper limb
  • Toe-to-hand transfer
  • Congenital hand
  • Allotransplantation

Small groups of students will have the opportunity to observe live microsurgical reconstruction of the upper limb. Live webcast surgery will beshown and interactive participation will be facilitated

  • Anatomy and physiology of genitourinary system
  • Gender reassignment approach
  • Microsurgical techniques in penile reconstruction
  • Reconstruction of penile defects:
    Radial forearm flap. Groin flap. Sensate osteocutaneous fibula flap. ALT flap. Functional phalloplasty. Combined flaps: phalloplasty
  • Refinements and resolution of complications after total phallopasty
  • Penile prosthesis implantation after total phalloplasty
  • Bladder functional reconstruction
  • Reconstruction after perineopelvic oncological resections
    Abdominoperineal. Gynecological. Urological recections
  • Functional pelvic floor reconstruction
    Reverse vasectomy (vaso-vasostomosy) anastomosis
  • Microsurgery of the seminal tract
  • Perineum disease repair
  • Abdominal wall and gluteal reconstruction

The students will attend live microsurgical reconstruction of external genitalia and functional bladder reconstruction

  • Acritical evaluation of results conservative treatment of Lymphedema
  • Anatomy and physiology of the lymphatic system
  • Assessment and surgical treatment of lymphedema
  • Vascularised lymphatic node transfer
  • Lympho-venous anastomosis
  • Combined surgical treatment for lymhedema
  • Lymphangiogenesis and the role of growth factors in lymphedema
  • Free vascularised nerve flaps
  • Microsurgical nanoflaps
  • Patient selection to different methods
  • Perforator to perforator flap surgery

Small groups of students will have the opportunity to observe live microsurgical techniques in lymphedema treatment. Live webcast surgery will be shown and interactive participation will be facilitated

The program includes a practical training module with feedback from facilitators. During this period, students will be involved in clinical cases focused on reconstructive microsurgery and assist in surgery, following preoperative and postoperative clinics. They will present cases to the other students and faculty to clarify doubts and evaluate the surgery.

From 6 weeks to 12 months before the end of the second year.

  • Joint review of the microsurgical technique
  • Presentation and discussion of complex clinical cases
  • Resolution of immediate and delayed post-surgical complications involving the flaps
  • Optimization of technique tailored to each student

Preparation of a comprehensive written research report is an essential part of a valid research experience, and the student should be aware of this requirement at the outset of the project.

Interim reports may also be required. Sufficient time should be allowed for satisfactory completion of reports, taking into account that initial drafts should be supervised and corrected
by your tutor.