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Enhancing Vascular Surgery Training through Supervised Dissection of Postamputation Specimens
Max Murray-Ramcharan1, Ryan Bird1, Amarseen Mikael1
1Department of Vascular Surgery, Englewood Health, Englewood, NJ.
Background:
Over recent years, the practice of surgery has seen a dramatic shift to minimally invasive approaches and techniques, with decreased surgical trainee exposure to open procedures, and less experience and confidence of junior surgeons. In vascular surgery specifically, endovascular procedures now dominate surgical management. Simulation labs attempt to address this deficit but fail to accurately replicate anatomical dissections and exposures. This study aims to evaluate the educational impact of incorporating lower extremity vascular dissections from amputated limbs into the training of surgical residents and fellows.
Methods:
With Institutional Review Board approval, a single-center cross-sectional observational study enrolled 22 trainees in general, vascular and podiatric surgical programs to participate in supervised back-table dissection of amputated lower extremities. Following these dissections, participants completed questionnaires pertaining to satisfaction and perceived benefit of this intervention.
Results:
21 amputations were performed with 57 critical vascular exposures, including the popliteal artery, major infrapopliteal arteries and great saphenous vein. The chi-squared analysis of questionnaire responses demonstrated favorable feedback, with statistically significant perceived benefit of this initiative across multiple domains, and unanimous advocacy for increased opportunities and formal integration into the surgical education curriculum.
Conclusion:
This study demonstrates statistically significant qualitative benefit in surgical education and training outcomes and overwhelmingly positive feedback following postoperative guided dissection of amputation specimens. While further studies are required to determine long-term benefits and educational endpoints, authors advocate that similar initiatives integrated into surgical residency curricula may improve trainee comfort, confidence, and surgical knowledge with open vascular and surgical procedures.
