ARTERIOVENOUS FISTULA MODEL
The Medicines Company, USA
The model consisted of a bespoke realistic left arm made from soft silicone with skin layers (epidermis, dermis, fat and subcutaneous tissues) and all of the relevant structures including the brachial artery and the cephalic vein.
A pre-made transverse incision just below the crease in the elbow was made for the purpose of inserting a self-retaining retractor. The simulation commenced once the lead surgeon had already dissected down to the cephalic vein and brachial artery in the antecubital fossa and gained distal and proximal control of both and tied off the cephalic vein distally. The purpose of the model was for trainees to practice performing an anastomosis of the vessels and test their skills by releasing the clips to see whether they had achieved a good (non-bleeding) repair.