Teaching the technique of microsurgical intraneural neurolysis

Internal neurolysis (intraneural neurolysis) remains controversial. While it seems that operating within a nerve might be detrimental, because of the possibility of creating increased scarring, there are both clinical and experimental reports suggesting that where significant intraneural fibrosis already exists, e.g. in chronic compression neuropathies, internal neurolysis improves nerve function. It is anticipated that the number of surgeons using internal neurolysis as a therapeutic adjunct will be increasing. Although the techniques for teaching microvascular anastomoses have been extensively worked out, a technique for teaching microsurgical intraneural neurolysis has not been described. The goal of this paper is to present an acceptable animal model for practicing the techniques of intraneural neurolysis in the laboratory rather than in the operating room.