vascularised fibular graft harvesting workshop

Vascularised Fibular Graft Harvesting – Hands-on Cadaver Workshop
The Hands-on Cadaver Workshop on Vascularised Fibular Graft (VFG / FVFG) Harvesting is an intensive surgical masterclass jointly organized by the Department of Plastic & Reconstructive Surgery, Department of Orthopaedics, and Department of Anatomy. Widely considered the gold standard for long-span osseous reconstruction, the vascularised fibula provides structural cortical strength, predictable vascularity via the peroneal vessels, and optional chimeric skin paddles for complex oncological and trauma defects.

This specialized workshop provides reconstructive microsurgeons, orthopedic oncologists, and surgical residents with hands-on workstation practice, fresh cadaveric specimens, surgical loupes, micro-instrumentation, and step-by-step mentoring from senior reconstructive and orthopedic faculty.

Key Workshop Highlights & Objectives
Delegates master precision lateral approach corridors, peroneal pedicle skeletonization, preservation of ankle and knee stability (the “6 cm rule”), osteotomy techniques, and chimeric skin paddle design.

  • Gold Standard Osseous Reconstruction – Mandibular reconstruction, extremity tumor resection, and post-traumatic segmental bone defects
  • Peroneal Pedicle Dissection – Complete retrograde mobilization of the peroneal artery and venae comitantes
  • Multi-Disciplinary Synergy – Jointly conducted by Reconstructive Surgery, Orthopaedics, and Anatomy
  • Small Batch Training – Limited participant seats ensuring extensive station time, individual specimen work, and table proctoring
  • Donor Site Stability – Strict adherence to proximal and distal bony margins to protect common peroneal nerve and syndesmosis
All cadaveric dissections are performed adhering strictly to ethical guidelines and institutional protocols, offering surgeons realistic tissue resistance, intermuscular plane development, and osteotomy tactile feedback vital for live microvascular transfers.
Structured Hands-on Dissection Curriculum
The program bridges lower limb vascular topography with operative case analysis, live surgical demonstrations, and uninterrupted wet-lab cadaveric harvesting.
The curriculum systematically advances from surface landmark markings (fibular head, lateral malleolus, common peroneal nerve trajectory) through lateral compartment release, posterior flexor muscle cuff preservation, proximal/distal osteotomies, to final vascular pedicle division at the tibiofibular trunk.

Stepwise Workshop Matrix

Session 1: Surface Anatomy & Approach | Session 2: Muscle Release & Bone Cuts | Session 3: Pedicle & Chimeric Design
Fibular head to lateral malleolus marking | Anterior/lateral compartment detachment (peroneus muscles) | Distal peroneal vessel ligation & retrograde tracking
Common peroneal nerve (CPN) safe zone | Muscle cuff preservation (flexor hallucis longus & tibialis posterior) | Proximal pedicle dissection to tibiofibular trunk
Marking distal 6-8 cm ankle stability margin | Proximal and distal osteotomy execution with Gigli/oscillating saw | Chimeric skin paddle harvest & donor site closure

Core Surgical Modules & Syllabus
Guided by experienced reconstructive and orthopedic faculty, delegates perform sequential operative dissections on cadaveric lower limbs:

Palpation and marking of the fibular head, lateral malleolus, course of the common peroneal nerve winding around the fibular neck, and delineating the critical distal 6 to 8 cm margin required to preserve distal tibiofibular syndesmosis and ankle joint biomechanics.

Incision along the posterior border of the fibula, incising the crural fascia, developing the interval between the peroneus longus/brevis anteriorly and soleus posteriorly, and elevating the periosteal cuffs while preserving septocutaneous perforators for chimeric skin paddles.

Detachment of the extensor digitorum longus, extensor hallucis longus, and peroneus tertius from the anterior fibular border with anterior intermuscular septum release, followed by controlled release of the soleus along the posterior border.

Subperiosteal tunnel creation at the planned bone resection levels using right-angle clamps, protective Hohmann retractor placement to shield deep neurovascular structures, and execution of osteotomies using Gigli saws or reciprocating bone saws.

Retracting the osteotomized fibular segment laterally, transecting the interosseous membrane, elevating the flexor hallucis longus and tibialis posterior muscle cuff (protecting endosteal and periosteal blood supply), distal ligation of the peroneal vessels, and retrograde dissection up to the takeoff from the posterior tibial/tibiofibular trunk.
Faculty from the Department of Anatomy demonstrate axial and cross-sectional leg relations, highlighting variations in trifurcation anatomy, the nutrient artery foramen of the fibula, and motor nerve courses.
Eligibility & Workstation Infrastructure
Designed for reconstructive surgeons, orthopedic oncologists, and head & neck oncosurgeons seeking to develop confidence and speed in vascularized bone flap harvesting.

Target Audience

Plastic Surgeons, Orthopaedic Surgeons, Head & Neck Oncosurgeons, and Senior Residents (M.Ch / DNB / MS).
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Equipment Standard

Gigli saws, bone holding forceps, Langenbeck and Hohmann retractors, micro-dissection sets, and vascular clips.
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Certification

Joint certificate awarded by Department of Plastic Surgery, Department of Orthopaedics, and Department of Anatomy with CME credit hours.
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Each dissection table receives comprehensive instructions regarding subperiosteal bone dissection, preventing injury to the deep peroneal nerve and anterior tibial artery, and safely managing the peroneal vascular bundle.

WORKSHOP FACULTY & ORGANIZERS

PLASTIC SURGERY LEAD
PLASTIC SURGERY LEADMicrovascular Reconstructive Faculty
Senior Reconstructive Microsurgeon demonstrating free vascularised fibula harvesting, pedicle dissection, and microvascular anastomoses.
DEPARTMENT OF ORTHOPAEDICS
DEPARTMENT OF ORTHOPAEDICSOrthopaedic Oncology Lead
Guiding safe osteotomy cuts, donor extremity stability, preservation of the distal tibiofibular joint, and structural fixation.
DEPARTMENT OF ANATOMY
DEPARTMENT OF ANATOMYAnatomical Director
Managing leg cross-sectional specimen preparation, fascial boundary dissection, and vascular tree mapping.

Specialized Masterclass: Fibular Graft Harvest • Hands-On Cadaver Workshop

Hands-on Cadaver Workshop on Free Vascularised Fibular Graft (FVFG) Harvesting organized jointly by the Department of Plastic Surgery, Department of Orthopaedics, and Department of Anatomy.

0 Bone Flap
Vascularised Fibula (FVFG)
0%
Hands-On Cadaver Dissection
0 Masterclass
Microvascular & Ortho Reconstruction

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