Journal de médecine vasculaire et de chirurgie

Abstrait

Need Cost Effective Surgical Simulation, Send a Resident to the Hardware Store

Charles L Rodriguez-Feo, Colleen M Brophy and Kevin W Sexton

Background: The purpose of this project was to design a novel, cost-effective simulator for a vascular surgery skills workshop. The simulator had to be realistic, durable, cost less than $10 per unit to produce, and allow for practicing multiple vascular techniques. Vascular Surgery has a unique challenge in that vascular anastomoses are constructed at various apertures in body cavities making the surgeon constantly adapt.
Methods: After interviewing two vascular surgeons, the unifying themes identified were that the learner needed to practice multiple techniques (an end to side anastomosis, an end to end anastomosis, and the sewing of a patch) at various depths. Using these criteria, 18 simulators were created and 25 surgical interns attended a 2-hour workshop during which they were asked to perform the tasks mentioned above. Post-workshop, an online survey was administered.
Results: The number of vascular anastomoses performed prior to the workshop was 0 for 86%of respondents. During the workshop participants performed an average of 3 anastomoses and participated in an average of 6 anastomoses. On a visual analog scale, residents rated their ability to complete a vascular anastomosis subjectively higher after the workshop (p= .009, Wilcoxon matched-pairs rank sum test). 100% of respondents would like to have the simulator for personal use and 71% were willing to pay for the simulator. 86% reported they would be comfortable demonstrating competency on the simulator prior to being able to perform the skill in the operating room.
Conclusions: This study demonstrates viability of inexpensive, durable, open vascular simulation with varying degrees of difficulty and techniques. Subjectively, the simulator led to an increased ability of residents to perform an anastomosis. All residents wished for a personal simulator to use in their home for practice, indicating that there is a market for personal simulators to be used as the learner desires.