Comparative Prospective Study of Microvascular Anastomosis Training by Self-Learning or with Expert Instruction

Sakamoto, Yusuke; Okamoto, Sho; Shimizu, Kenzo; Araki, Yoshio; Hirakawa, Akihiro; Wakabayashi, Toshihiko

doi:10.1016/j.wneu.2018.07.061

Cited by 5 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 articles concerned analysis of neurosurgery residents 43,44,54,[56][57][58][59][60][61][62][63][64] . 12 others studied senior neurosurgeons 33,35,58,62,[64][65][66][67][68][69][70][71] and 3 others directors of training (also senior neurosurgeons) 44,58,61 . Six others dealt with the whole team of a neurosurgery operating theatre 35,65,66,[68][69][70] and one article studied the whole team of a neurosurgery department 33 .…”

Section: Populations Studiedmentioning

confidence: 99%

“…7 were experimental studies 56,57,59,60,63,64,71 , 7 were surveys 43,44,54,58,61,62,66 , 5 were interventional studies 33,35,65,67,69 , and 2 were observational studies 68,70 .…”

Section: Study Designsmentioning

confidence: 99%

“…in a real environment in 11 cases : 10 in the operating theatre 33,35,44,58,61,65,66,[68][69][70] , 1 in a neurosurgery department 33 , and 4 in consultation 44,58,61,67 , -in a simulated environment in 9 cases 54,56,57,59,60,[62][63][64]71 , -during theoretical teaching in 1 case 43 .…”

Section: Environmentmentioning

confidence: 99%

“…Non-technical surgical skills assessed Interpersonal NTS were specifically assessed in 9 studies 33,43,44,59,60,63,67,68,71 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

See 3 more Smart Citations

Nontechnical Skills in Neurosurgery: A Systematic Review of the Literature

2019

View full text Add to dashboard Cite

BackgroundUndesirable events in the neurosurgery operating theatre are surprisingly less often the result of a technical error than of a dysfunction linked to non-technical skills (NTS). The essential aim of our study was a systematic literature study published on NTS in neurosurgery. The secondary objective was identification of a list of NTS more specific to neurosurgery in order to define on that basis the training needs of neurosurgery trainees. Methods MEDLINE andThe Cochrane Database of Systematic Reviews were searched according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement.Research initially identified 2132 articles. 21 were eligible for systematic study. Data were extracted from the articles regarding study design, sample size, NTS assessed, assessment tools and the key results were collected. ResultsInterpersonal skills (communication, teamwork), cognitive skills (decision making, situation awareness) and personal resource factors (coping with stress or fatigue) were specifically identified. No article used assessment tools such as NOTECHS, NOTSS or OTAS. They were carried out in a real environment in 11 cases, in a simulated environment in 9 cases and during theoretical teaching in 1 case. ConclusionsVery few studies have been carried out concerning neurosurgical NTS, despite increasing numbers of articles over the last few years on NTS in other domains of surgery. Society today is concentrating more and more on the quality and safety of medical care. The development and 14-15Conclusions 26 Provide a general interpretation of the results in the context of other evidence, and implications for future research. FUNDINGFunding 27 Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

show abstract

Section: Populations Studiedmentioning

confidence: 99%

“…7 were experimental studies 56,57,59,60,63,64,71 , 7 were surveys 43,44,54,58,61,62,66 , 5 were interventional studies 33,35,65,67,69 , and 2 were observational studies 68,70 .…”

Section: Study Designsmentioning

confidence: 99%

Section: Environmentmentioning

confidence: 99%

“…Non-technical surgical skills assessed Interpersonal NTS were specifically assessed in 9 studies 33,43,44,59,60,63,67,68,71 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

See 2 more Smart Citations

Nontechnical Skills in Neurosurgery: A Systematic Review of the Literature

2019

View full text Add to dashboard Cite

show abstract

“…15 Further, Nagoya University Microvascular Anastomosis Assessment System takes into account instrument handling skills and external characteristics of the anastomosis, such as the general outer appearance, back-wall stitching, orifice, pitching accuracy (suture spacing), intraluminal adaptation, and suture ends. 16 Another tool is the University of Western Ontario Microsurgical Skills Acquisition/Assessment Instrument instrument. This tool takes into account the preparatory work, suturing, the quality of the knot, instrument handling, efficiency of movements with motion analysis, and the final patency.…”

mentioning

confidence: 99%

The Benefits of Expert Instruction in Microsurgery Courses

Paladino

Gasteratos

Akelina

et al. 2020

J Reconstr Microsurg

View full text Add to dashboard Cite

Background Microsurgery requires repeated practice and training to achieve proficiency, and there are a variety of curriculums available. This study aims to determine the importance of an expert instructor to guide students through procedures. We compared student proficiency across two microsurgery courses: one with (Columbia University, United States [CU] cohort) and one without a dedicated microsurgery instructor (University of Thessaloniki, Greece [UT] cohort). Methods Students were divided into two cohorts of 22 students (UT cohort) and 25 students (CU cohort). Student progress was evaluated by examining patency (lift-up and milking tests), anastomotic timing, and quality (Anastomosis Lapse Index [ALI]) of end-to-end arterial and venous anastomoses on day 1 and again on day 5. Chi-squared tests evaluated patency immediately and 30 minutes postoperation. t-Tests evaluated anastomotic timing and ALI scores. p-Values < 0.05 were considered significant. Results We evaluated progress within and between each cohort. Within the CU cohort, the quality of the arterial and venous anastomosis improved, respectively (by 54%, p = 0.0059 and by 43%, p = 0.0027), the patency of both the arterial and venous anastomosis improved, respectively (by 44%, p = 0.0002 and by 40%, p = 0.0019), and timing of arterial and venous anastomosis reduced respectively (by 36%, p = 0.0002 and by 33%, p = 0.0010). The UT cohort improved the quality of their arterial anastomoses (by 29%, p = 0.0312). The UT cohort did not demonstrate significant improvement in the other above-mentioned parameters. The CU cohort improved materially over the UT cohort across categories of quality, patency, and timing. Conclusion There are clear benefits of an expert instructor when examining the rate of progress and proficiency level attained at the conclusion of the course. We suggest students who are seeking to maximize proficiency in microsurgical procedures enroll in courses with an expert instructor.

show abstract