Reply to the editor: Microsurgery training with smartphone.

With great interest we have read the article written by Capkin S. concerning the use of a smartphone for microsurgery training [1].

The idea of using a smartphone was first described by Kim D. in 2014 [2], but to our knowledge this is the first article properly describing the possibilities and advantages of this training model while using magnifications of up to a tenfold.

Availability of a training microscope and its accessibility is the most important obstacle in simulation training for microsurgery. In this training model, no additional financial investment has to be made since almost everyone has its own smartphone. As an innovation of developing technology, smartphones have become indispensable in our daily lives and an increasing use of smartphones is seen in health care context. Also smartphone camera quality has increased tremendously over the last years.

The use of a smartphone to train microsurgery has been adopted by residents and students in our department for over half a year now, and we are using a similar set up for training. However we encountered a major drawback which has not been reported by the authors but should be mentioned. When using a microscope, a stereoscopic or binocular vision is obtained, resulting in a depth perception. Using a smartphone camera results in a two-dimensional output or monoscopic vision on the smartphone screen. The absence of depth perception makes microsurgery much more difficult at first. Some kind of adaptation to this monoscopic vision is to be expected after initial difficulty, however this remains a major drawback to this training model limiting its possibilities. We believe this training model can be used for the acquisition and maintenance of basic microsurgical skills as an adjunct to training with a surgical microscope. But in its current modality it cannot replace decent microsurgical courses and laboratory training. Since the latest smartphone models are equipped with two or more cameras, a solution to this disadvantage might be at hand.

• References

• 1 Capkin S, Cavit A, Kaleli T. Microsurgery training with smartphone. Handchir Mikrochir Plast Chir 2018; 50 (06) 443-445 doi:10.1055/a-0661–6015
• 2 Kim DM, Kang JW, Kim JK. et al. Microsurgery training using a smartphone. Microsurgery 2015; 35 (06) 500-501 doi:10.1002/micr.22369. Epub 2014 Dec 26