The Impact of Operating Surgeon Experience, Supervised Trainee vs. Trained Surgeon, in Vascular Surgery Procedures: A...

Area of Science:

• Vascular Surgery
• Surgical Education
• Patient Outcomes

Background:

• Surgeon's operative experience directly impacts post-operative outcomes.
• Maximizing operating room exposure is critical for surgical trainee development.
• Vascular surgery requires specialized training and extensive practice.

Purpose of the Study:

• To compare post-operative outcomes of supervised trainee-led versus expert surgeon-led vascular procedures.
• To analyze outcomes across three common vascular operations: lower limb amputation, fistula formation, and carotid endarterectomy (CEA).
• To determine if trainees performing procedures under supervision affect patient care.

Main Methods:

• Literature search of MEDLINE, Web of Science, and Cochrane databases up to January 2018.
• Inclusion of studies directly comparing supervised trainee-led and expert surgeon-led procedures.
• Meta-analysis using the Mantel-Haenszel method to calculate odds ratios for primary outcomes (amputation revision, fistula patency, CEA stroke rate).

Main Results:

• Sixteen studies were reviewed, with trainees performing 34.5% of analyzed procedures.
• No significant difference in primary patency for fistula formation between trainees and experts (OR 1.68, 95% CI 0.42-6.75).
• No significant difference in 30-day stroke rates for carotid endarterectomy (CEA) between trainees and experts (OR 0.89, 95% CI 0.59-1.32).

Conclusions:

• Supervised trainees can perform select vascular procedures effectively without adverse patient outcomes.
• Appropriate training and experience enable trainees to achieve comparable results to experts.
• Supported training programs are vital for maintaining high standards in surgical education and patient care.