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A Training and Testing System for Performing Vascular Reconstruction In Vitro
Published on: October 26, 2019
Vascular anastomosis model: relation between competency in a laboratory-based model and surgical competency.
C Wilasrusmee1, P Lertsithichai, D S Kittur
1Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand. racwl@mahidol.ac.th
Summary
Laboratory vascular anastomosis model outcomes predict surgical skill in the operating room (OR). Poor anastomosis leakage in the lab correlated with worse OR performance, indicating the model
Area of Science:
- Surgical Education
- Vascular Surgery
- Medical Simulation
Background:
- A novel laboratory-based vascular anastomosis model was developed to objectively assess surgical skill.
- Previous work established this model as a tool for surgical skill quantification.
Purpose of the Study:
- To investigate the correlation between laboratory-based vascular anastomosis outcomes and technical competency in the operating room (OR).
- To validate the predictive utility of the laboratory model for real-world surgical performance.
Main Methods:
- Twenty-nine surgical residents participated after laboratory training.
- Forearm arterio-venous bridge grafts were performed in the OR.
- Outcomes measured included completion time, leakage grade, and mini-objective structured assessment of technical skills (MOSAT) score.
- Multiple linear and ordinal logistic regression analyses were employed.
Main Results:
- Worse laboratory anastomosis leakage predicted worse OR leakage, longer completion time, and lower MOSAT scores.
- Longer laboratory completion times correlated with longer OR completion times but reduced leakage.
- Higher training year and greater laboratory exposure were associated with improved OR MOSAT scores and shorter OR completion times, respectively.
Conclusions:
- Laboratory measurements of anastomosis completion time and leakage grade predict technical competency in the OR.
- The vascular anastomosis model shows potential as an effective training tool for clinical surgery.
