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Analyzing Procedural Time and Its Relationship to Performance in Microsurgical Training: A Pilot Study.

Pablo J Villanueva1, Taku Sugiyama2, Yelena Akelina3

  • 1Microsurgical Laboratory, University of Buenos Aires, Buenos Aires, ARG.

Cureus
|September 22, 2025
PubMed
Summary

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This summary is machine-generated.

Skill assessment in microsurgery is complex; faster procedures do not always mean better performance. This study introduces a "Safe Pace" benchmark, a speed range where errors decrease, offering a more reliable indicator for training and evaluation.

Area of Science:

  • Microsurgery skill assessment
  • Surgical training and performance metrics
  • Biomedical engineering and data analysis

Background:

  • Traditional microsurgery skill assessment often equates speed with proficiency, overlooking quality.
  • Objective measures and precise variable selection are crucial for accurate skill evaluation.
  • Existing methods struggle to differentiate true skill improvement from mere acceleration.

Purpose of the Study:

  • To analyze the progression of time variables during microsurgical skill training.
  • To develop new tools for thorough assessment and evaluation of temporal performance.
  • To challenge the notion that faster procedures equate to improved microsurgical skill.

Main Methods:

  • A microsurgical protocol was used, chronologically recording procedures and time/error data.
Keywords:
computer platform for surgical evaluationmicrosurgery simulatormicrosurgical trainingsuper microsurgerysurgical skill assessment

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  • Data collected via Misat-APP®, exported to PostgreSQL®, and analyzed using Python® scripts.
  • Statistical analysis included regression modeling (R²), standard deviation (±2 SD) for outlier removal, and calculation of an average-zero (AVO) index and 'Safe Pace' range.

    • Main Results:

    • 150 procedures were analyzed, revealing significant fluctuations in Time to Complete the Task (TCT) (R² = 0.601).
    • Longer inter-session gaps (>10 days) correlated with increased TCT in subsequent sessions (p = 0.009).
    • A significant 'Safe Pace' range (±0.2 SD from AVO) was identified (1,362.88-1,563.67 seconds; p = 0.012), indicating reduced errors within this speed.
    • Excessively fast procedures in experienced operators were linked to a higher error risk.

    Conclusions:

    • Time alone is a low-reliability indicator for microsurgical skill assessment due to sensitivity to external factors.
    • The 'Safe Pace' concept provides a valuable benchmark for guiding trainees and evaluating performance.
    • Further research is needed to confirm these findings, which suggest that optimal speed, not maximum speed, is key to skill mastery.