Relevance of a simulation model to microsurgery for military surgical residents

Abstract

IntroductionMicrosurgical training is an asset for military orthopedic surgeons who frequently treat hand or nerve injuries in external operations. The objective of this study was to evaluate a microvascular surgery simulation model intended to prepare residents prior to their enrolment in conventional degree training.Materials and MethodsAn experimental study was conducted to evaluate technical progress and satisfaction of military surgical residents using a model based on Japanese noodles with four tests of increasing difficulty. Objective endpoints included: instrument handling, distribution and quality of stitches, duration of anastomoses and responses to the Structured Assesment of MicrosurgerySkill (SAMS) self-assessment questionnaire were also analyzed.ResultsNine residents from different specialties participated in the study. The quality of their anastomoses and their average satisfaction were significantly increased between the first and the last session: respectively 7.2 / 15 versus 10.7 / 15 (p < 0.05) and 37.5 / 70 versus 47.5 / 70 (p < 0.05). Conversely, the average operating time decreased significantly over the sessions (92 min versus 52 min, p < 0.001).ConclusionsThis simulation model seems to constitute a satisfactory initiation to microsurgery which could limit the use of the animal model. It could also be included in the continuing education of military surgeons who perform microsurgery only occasionally in external operations.