Development of a pulsatile, tissue-based, versatile vascular surgery simulation laboratory for resident training

Abstract

Simulation in surgery is becoming an important component of surgical education. Training on bench top models has been demonstrated to improve technical skills. The objective of our project was to create a vascular surgery simulation model. The simulation model consists of a platform, artificial blood reservoir, artificial blood, inflow and outflow limbs, electric motor, battery, pulse generator, and cryopreserved vessel. Three different vascular surgery simulation stations were created: carotid endarterectomy with shunting and patch angioplasty, arterial bypass, and arteriovenous graft formation. A scientific study involving surgical residents will need to be undertaken to determine whether this simulator has intermodal transferability.

Role of Simulated Training for Carotid Endarterectomy: A Systematic Review

“…However, the study by Black did not conclude anything, 19) whereas in one by Fletcher et al, the efficacy of the simulator used was found to be inconclusive. 17) The mean NIH score 23) of all included studies was 7.2 (ranging from 5 to 8). According to AHRQ grading, 24) two studies were found to be of ʻpoorʼ quality, 15,17) whereas the rest of the studies were scored as ʻfairʼ or ʻgood.ʼ…”

“…One of these studies describes the development of the simulation model and did not involve any subjects for model validation. 17) Eight out of 10 focused on technical skills as their major outcome. 3,5,16,[18][19][20][21]27) Two studies focused on anatomical knowledge and non-technical skills such as ʻcrisis managementʼ in addition to procedural skills.…”

“…ʻCryopreserved pulsatile benchtop modelʼ described by Fletcher et al is a portable, cost-effective and relatively easy-to-make model. 17) It requires cryopreserved vessels as the main component, which can affect its widespread availability since the process for cryopreservation does not exist in many countries. Sigounas et al used a plastic benchtop model called ʻVirtual Reality Simulatorʼ.…”

“…Various simulation models, both bench top and bovine, have been described for the training of CEA with varying results. 3,5,[15][16][17][18][19][20][21] Given the limited opportunity for trainees to perform CEA and the delicate nature of the procedure, we decided to conduct this systematic review to look at the different models available and assess their benefits. The main objective of this systematic review was to identify different types of simulators used for the training of CEA and to assess the usefulness of all such simulators considered for simulated training on CEA.…”

Achieving Consensus to Define Curricular Content for Simulation Based Education in Vascular Surgery: A Europe Wide Needs Assessment Initiative

“…Low cost models, advanced open simulators with lifelike pulsatile flow, animal models, and human cadavers are being used for training open procedures such as open abdominal aortic aneurysm (AAA) repair or carotid endarterectomy. 19,26 Endovascular procedures can be trained using a variety of models and simulators: glass models, advanced virtual reality simulators, anaesthetised pigs and sheep, as well as cadavers. 22,27e30 Acquisition of a simulator is only one small step to offer simulation based training, it is crucial to set clear objectives, use efficient educational strategies, and have dedicated, experienced surgeons to provide formative feedback.…”