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Updated: Apr 16, 2026

A Training and Testing System for Performing Vascular Reconstruction In Vitro
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Vessel ligation training via an adaptive simulation curriculum.

Yinin Hu1, Robyn N Goodrich1, Ivy A Le1

  • 1Division of General Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.

The Journal of Surgical Research
|March 23, 2015
PubMed
Summary

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A new, affordable surgical simulator called VesselBox effectively trains medical students in vessel ligation. This low-fidelity model significantly improves surgical skills and proficiency for novice trainees.

Area of Science:

  • Surgical Education
  • Medical Simulation
  • Surgical Skills Training

Background:

  • A cost-effective and accessible model for open vessel ligation training is needed.
  • Current training methods may not adequately impart essential surgical skills to novice trainees.
  • Novel simulation approaches are required to bridge the gap in surgical competency.

Purpose of the Study:

  • To develop and evaluate a novel, inexpensive vessel ligation simulator (VesselBox).
  • To assess the efficacy of VesselBox in imparting transferrable surgical skills to novice trainees.
  • To determine if adaptive practice using cumulative sum improves surgical performance.

Main Methods:

  • VesselBox was designed using surgical gloves as surrogate vessels for ligation practice.
Keywords:
MedicalProficiency metricsSimulationStudentSurgical educationSurgical trainingVascular surgery techniques

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  • Fourth-year medical students were evaluated using Objective Structured Assessments of Technical Skills (OSATS) and a checklist.
  • Students underwent adaptive practice with VesselBox guided by cumulative sum, followed by blinded cadaveric posttesting.

    • Main Results:

    • VesselBox practice significantly improved OSATS scores (2.29 to 3.23, P < 0.001) and checklist performance (4.83 to 7.33, P < 0.001).
    • Ligation speed improved significantly post-training (128.2s to 97.5s per vessel, P = 0.001).
    • Practice volume did not correlate with posttest performance after adaptive training.

    Conclusions:

    • VesselBox is a cost-effective, low-fidelity simulator suitable for graduating medical students and junior residents.
    • The simulator effectively imparts essential vessel ligation skills.
    • Cumulative sum-guided adaptive training offers an individualized curriculum for simulation.