Background:
Circulation in Thiel embalmed bodies is still absent. A long-term revascularization in Thiel embalmed pigs was developed and assessed for surgical training.

Material and Methods:
Fresh pig cadavers were split into two specimens via thoracotomy. In every specimen, the thoracic aorta and inferior vena cava were cannulated. Thiel embalming solution was then pumped through the arterial cannula. Further embalming was done by immersion in an embalming solution. Dehydration was established through immersion in concentrated salt solution. Subsequently, both arterial and venous cannulas were connected with the pump that installed a circulation with Paraffinum Perliquideum (PP). This reperfusion was visualized on computed tomography. Later, several surgical procedures were tested on this model. Additionally, the course of PP in isolated embalmed small intestines was evaluated using in-vivo microscopy.

Result:
Vascular embalming was performed under low arterial pressures (<70 mmHg). Dehydration almost reestablished the specimens’ original weight. Circulation with PP was initiated in the vessels under low arterial pressures (<30 mmHg) during 80 minutes. Every organ was reperfused but moderate lung edema, collections in the retroperitoneal space and in the small intestines were observed. Coronary artery bypass grafting; vascular anastomoses; resections on reperfused lungs, liver, kidneys, and spleen were performed. In-vivo microscopy showed that PP reached the smallest vessels explaining the observed leaks.

Conclusion:
Thiel embalmed dehydrated pigs are feasible to establish prolonged vascular reperfusion. Vascular anastomoses and operations on reperfused organs in-situ can be trained under realistic circumstances. Further elaboration is needed to minimalize leak in some fragile organs.