Impact of High-Fidelity Microvascular Surgery Simulation on Resident Training

Joy, Matthew T.; Applebaum, Matthew A; Anderson, William M.; Serletti, Joseph M.; Capito, Anthony E.

doi:10.1055/a-2110-0271

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…In addition, it is not suitable for practicing vascular dissection. 15 In the actual clinical setting, microsurgeries are intricate procedures because of variable factors including a narrow surgical region, unusual patient positioning, and the patient's medical history. Oral cavity reconstruction and neurosurgery demand delicate operations in small, deep spaces.…”

Section: Discussionmentioning

confidence: 99%

Innovative Clinical Scenario Simulator for Step-by-Step Microsurgical Training

Cui,

Han,

Liu

et al. 2024

J Reconstr Microsurg

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Background Microsurgical training should be implemented with consideration of operative difficulties that occur in actual clinical situations. We evaluated the effectiveness of a novel clinical scenario simulator for step-by-step microsurgical training that progressed from conventional training to escalated training with additional obstacles. Methods A training device was designed according to multiple and intricate clinical microsurgery scenarios. Twenty surgical residents with no experience in microsurgery were randomly assigned to either the control group (conventional training curricula, n = 10) or the experimental group (step-by-step training courses, n = 10). After 4 weeks of laboratory practice, the participants were scheduled to perform their first microvascular anastomoses on patients in an operating room. The Global Rating Scale (GRS) scores and operative duration were used to compare microsurgical skills between the two groups. Results There were no significant differences in the participants’ baseline characteristics before microsurgical training between the groups with respect to age, sex, postgraduate year, surgical specialty, or mean GRS score (p < 0.05). There were also no significant differences in recipient sites between the two groups (p = 0.735). After training, the GRS scores in both groups were significantly improved (p = 0.000). However, in the actual microsurgical situations, the GRS scores were significantly higher in the experimental than control group (p < 0.05). There was no significant difference in the operative duration between the two groups (p < 0.13). Conclusion Compared with a traditional training program, this step-by-step microsurgical curriculum based on our clinical scenario simulator results in significant improvement in acquisition of microsurgical skills.

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Section: Discussionmentioning

confidence: 99%

Innovative Clinical Scenario Simulator for Step-by-Step Microsurgical Training

Cui,

Han,

Liu

et al. 2024

J Reconstr Microsurg

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Impact of Resident and Attending Surgeon Training Level on Free Tissue Transfer Ischemia Time and Complications

Porter,

Anderson,

Ash

et al. 2024

J Reconstr Microsurg

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Background: Microsurgical free tissue transfer has become an essential method for reconstruction of complex surgical defects, making the level of training an important factor to consider. There is little published regarding the impact of training level on microsurgical outcomes. This study investigates microsurgical free tissue transfer ischemia time and post-operative complications based on resident and attending surgeon experience level. Methods: A retrospective review of all free flaps at a single institution from 1/1/2013 to 12/31/2021 was performed. Linear regression was performed analyzing ischemia time of 497 free flaps and attending surgeon experience defined by years in practice and resident level defined as post graduate year (PGY). Logistic regression model was used to analyze complications based on attending experience and resident level. Results: The average resident PGY was 3.5 +/- 0.8; the average attending has been practicing 6.4 +/- 5.1 years. There was no statistically significant difference in ischemia time or complication rates based on resident PGY or attending surgeon experience level. Conclusion: Lower PGY residents were not found to increase ischemia time or increase complication rates. Lower attending surgeon year was not found to increase ischemia time or increase complication rates compared to surgeons who had been practicing for longer. Microsurgical free tissue transfer is considered a safe procedure in residency training and trainee involvement should be encouraged to improve resident education and enhance technical skills.

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Neurosurgical Microvascular Anastomosis: Systematic Review of the Existing Simulators and Proposal of a New Training Classification System

Guida,

Sebök,

Oliveira

et al. 2024

Brain Sciences

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Background: The literature lacks a combined analysis of neurosurgical microvascular anastomosis training models. We performed a systematic literature search to provide an overview of the existing models and proposed a classification system based on the level of simulation and reproducibility of the microvascular anastomosis. Methods: The systematic literature search followed the PRISMA guidelines. We consulted MEDLINE, Web of Knowledge, and EMBASE independently for papers about bypass training models. Every training model was analyzed according to six tasks supposed to esteem their fidelity to the real operative setting by using a scoring system from zero to two. Finally, authors classified the models into five classes, from A to E, by summing the individual scores. Results: This study included 109 papers for analysis. Training models were grouped into synthetic tubes, ex vivo models (animal vessels, fresh human cadavers, human placentas) and in vivo simulators (live animals—rats, rabbits, pigs). By applying the proposed classification system, live animals and placentas obtained the highest scores, falling into class A (excellent simulators). Human cadavers and animal vessels (ex vivo) were categorized in class B (good simulators), followed by synthetic tubes (class C, reasonable simulators). Conclusions: The proposed classification system helps the neurosurgeon to analyze the available training models for microvascular anastomosis critically, and to choose the most appropriate one according to the skills they need to improve

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Impact of High-Fidelity Microvascular Surgery Simulation on Resident Training

Cited by 3 publications

References 18 publications

Innovative Clinical Scenario Simulator for Step-by-Step Microsurgical Training

Innovative Clinical Scenario Simulator for Step-by-Step Microsurgical Training

Impact of Resident and Attending Surgeon Training Level on Free Tissue Transfer Ischemia Time and Complications

Neurosurgical Microvascular Anastomosis: Systematic Review of the Existing Simulators and Proposal of a New Training Classification System

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