Wu, Elizabeth P.

Background Microsurgery is a critical component of plastic and reconstructive surgery. However, the high cost of training and equipment pose significant barriers, particularly in resource-limited settings. To address this challenge, the Microsurgery and Regenerative Medicine Lab within the Division of Plastic Surgery at the University of Wisconsin developed a low-cost, 3D-printed surgical microscope. This study qualitatively appraised the use of this novel microscope for microsurgery training by surveying surgeons about their experiences using this tool relative to traditional magnification methods. Methods In this prospective, multi-institutional appraisal study, surgical residents, fellows, and attending surgeons with varying microsurgical experience performed a single end-to-end microsurgical anastomosis on chicken thigh femoral arteries using the 3D-printed microscope. Participants then completed a survey assessing ease of use, adequacy for microsurgical training, educational value, and perceived impact on teaching capacity in local and global settings. Results Over 80% of participants reported that performing an end-to-end anastomosis was easier or equivalent using the 3D-printed microscope compared to surgical loupes. All respondents expressed willingness to use the device for microsurgery teaching and practice. Additionally, 91.7% (33/36) believed access to the microscope would enhance microsurgical teaching at their home institutions, and 97.1% (34/35) felt it would improve teaching capacity in globally. Qualitative feedback was overwhelmingly positive, with suggestions primarily related to ergonomics and lighting. Conclusion This study supports that this low-cost, 3D-printed microscope is an effective microsurgical training tool. Ongoing design refinements informed by user feedback may further optimize its role in expanding access to microsurgery education worldwide.

Summary: Microsurgery is a specialized field within plastic surgery constrained by the high cost and limited availability of surgical microscopes, particularly in resource-limited settings. This lack of access hinders trainees from developing essential microsurgical skills. Previous efforts have explored smartphone-based alternatives, but there remains a need for high-fidelity, accessible training microscopes. This study presents a novel, low-cost, travel-friendly surgical microscope designed for microsurgery training. Modified binocular objective lenses enable near-field stereoscopic viewing using a dual-mirror array. A 3D-printed chassis provides the correct top-down orientation, and an integrated light source operates on standard or battery power, ensuring usability in low-resource environments. Initial testing demonstrated a fixed 6.5× magnification, allowing trainees to perform end-to-end anastomoses on 2-mm vessels. Prototypes were deployed for microsurgery training in the United States, Rwanda, Ethiopia, and Vietnam through the SHARE (Surgeons in Humanitarian Alliance for Reconstruction, Research and Education) plastic surgery organization, Nuoy Reconstructive International, and the senior author’s home institution. The authors’ investigation continues to assess the effectiveness of the microscope compared with state-of-the-art surgical microscopes. By offering a low-cost, portable solution without compromising image quality, this innovation has begun to transform microsurgical education and operating room–based microscopy worldwide, increasing accessibility for trainees and patients in diverse settings.