Does Surgical Simulation Improve Hand-Sewn Bowel Anastomosis Skill Acquisition? A Systematic Review

Area of Science:

• Surgical Education
• Medical Simulation
• Gastrointestinal Surgery

Background:

• Hand-sewn bowel anastomosis (HSBA) is a critical skill for surgeons, especially when stapler technology fails or anatomical challenges exist.
• Despite stapler prevalence, HSBA remains essential, necessitating effective training methods for general surgery trainees and practitioners.

Purpose of the Study:

• To systematically review the evidence on the effectiveness of open and laparoscopic simulators in improving HSBA skills.
• To evaluate the impact of simulators on technical performance, operative time, and self-perceived skill acquisition.

Main Methods:

• A systematic review adhering to PRISMA guidelines was conducted across major databases (MEDLINE, EMBASE, Scopus, Cochrane).
• Fifteen studies were included after initial screening and full-text review, with quality assessed using established instruments.
• Data extraction focused on technical scores, operative times, perceived competency, and cost.

Main Results:

• Both open and laparoscopic HSBA simulators demonstrated improvements in technical performance scores.
• A majority of simulators showed a reduction in operative time.
• Participants consistently reported enhanced self-perceived skill acquisition across all simulator types.

Conclusions:

• Open and laparoscopic HSBA simulators are effective tools for enhancing surgical trainees' technical skills, operative efficiency, and confidence.
• Further research is needed to confirm the transferability of these simulator-acquired skills to actual patient procedures (in vivo).