Experience of General Surgery Residents in the Creation of Small Bowel and Colon Anastomoses

Németh, Zoltán; Lazar, Eric L.; Paglinco, Samantha R.; Hicks, Addison S.; Lei, Jason; Barratt-Stopper, Patricia; Rolandelli, Rolando H.

doi:10.1016/j.jsurg.2016.04.011

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…However, learners may not always have the opportunity to practise hand-sewn anastomosis in the operating room. 6 Resident work-hour restrictions 3 and emphasis on novel techniques such as stapling have decreased practical exposure to hand-sewn bowel anastomoses. 6 This decrease in exposure is unfavourable, as the handsewn small bowel anastomosis is one of the "most basic and fundamental skills burgeoning young surgeons must learn."…”

Section: E485mentioning

confidence: 99%

“…6 Resident work-hour restrictions 3 and emphasis on novel techniques such as stapling have decreased practical exposure to hand-sewn bowel anastomoses. 6 This decrease in exposure is unfavourable, as the handsewn small bowel anastomosis is one of the "most basic and fundamental skills burgeoning young surgeons must learn." 7 In recent years, many surgical skills have been taught with the use of simulators created by 3-dimensional (3D) printing.…”

Section: E485mentioning

confidence: 99%

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Development, manufacture and initial assessment of validity of a 3-dimensional-printed bowel anastomosis simulation training model

Oxford

Walsh

Bungay

et al. 2021

cjs

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Background: It is critical that junior residents be given opportunities to practise bowel anastomosis before performing the procedure in patients. Three-dimensional (3D) printing is an affordable way to provide realistic, reusable intestinal simulators. The aim of this study was to test the face and content validity of a 3D-printed simulator for bowel anastomosis. Methods:The bowel anastomosis simulator was designed and assembled with the use of desktop 3D printers and silicone solutions. The production cost ranges from $2.67 to $131, depending on which aspects of the model one prefers to include. We incorporated input from a general surgeon regarding design modifications to improve the realism of the model. Nine experts in general surgery (6 staff surgeons and 3 senior residents) were asked to perform an anastomosis with the model and then complete 2 surveys regarding face and content validity. Items were rated on a 5-point Likert scale ranging from 1 ("strongly disagree") to 5 ("strongly agree"). Results:The overall average score for product quality was 3.58, indicating good face validity. The average score for realism (e.g., flexibility and texture of the model) was 3.77. The simulator was rated as being useful for training, with an overall average score of 3.98. In general, the participants agreed that the simulator would be a valuable addition to current simulation-based medical education (average score 4.11). They commented that the model would be improved by adding extra layers to simulate mucosa. Conclusion:Experts found the 3D-printed bowel anastomosis simulator to be an appropriate tool for the education of surgical residents, based on the model's texture, appearance and ability to undergo an anastomosis. This model provides an affordable way for surgical residents to learn bowel anastomosis. Future research will focus on proving educational efficacy, effectiveness and transfer that can be adapted for laparoscopic anastomosis training, hand-sewing and stapling procedures. Contexte :Il est crucial que les résidents juniors aient l'occasion de s'exercer à l'anastomose intestinale avant d'intervenir sur des patients. L'impression en 3 dimensions (3D) est une façon abordable de produire des simulateurs intestinaux réalistes et réuti lisables. Le but de cette étude était de vérifier la validité apparente et de contenu des simulateurs obtenus par impression 3D pour l'anastomose intestinale.Méthodes : Le simulateur d'anastomose intestinale est conçu et assemblé avec des imprimantes de bureau 3D et des solutions de silicone. Le coût de fabrication varie de 2,67 $ à 131 $, selon le nombre de composants désiré. Suite aux commentaires d'un chirurgien général nous avons modifié le modèle afin de le rendre plus réaliste. Nous avons demandé à 9 experts en chirurgie générale (6 chirurgiens en poste et 3 résidents séniors) d'effectuer une anastomose sur le modèle, puis de répondre à 2 questionnaires sur sa validité apparente et de contenu. Les questions étaient notées sur une échelle de Likert en 5 points, allant de 1 ...

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Section: E485mentioning

confidence: 99%

Section: E485mentioning

confidence: 99%

Development, manufacture and initial assessment of validity of a 3-dimensional-printed bowel anastomosis simulation training model

Oxford

Walsh

Bungay

et al. 2021

cjs

View full text Add to dashboard Cite

show abstract

“…They practice on various models of bowel anastomosis (life-like artificial models, and pig gut and human cadaver intestinal samples). 4 We believe residents should conduct more than the minimum number of intestinal operations required by the Accreditation Council for Graduate Medical Education, and they should supplement their skills by practicing outside of the operating room too.…”

Section: Surgeon Case Volume and Intestinal Anastomotic Leaksmentioning

confidence: 99%

Surgeon Case Volume and Intestinal Anastomotic Leaks

Hakakian

Kong

Bogdanovski

et al. 2020

The American Surgeon

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“…7,12 We have shown in a previous study that the rate of creation of HS-As by general surgery residents is drastically decreasing. 18 An enteroenterostomy (the reversal of an ileostomy) is an ideal indication for a HS-A, which can add to the experience of surgeons and residents alike. This shift in practices in conjunction with the increase in associated costs as demonstrated in this study must be considered, especially in an era of rising healthcare costs.…”

Section: No 5 Outcome and Cost Analysis Of Anastomosesmentioning

confidence: 99%

Outcome and Cost Analysis of Hand-Sewn and Stapled Anastomoses in the Reversal of Loop Ileostomy

Németh

Bogdanovski

Hicks

et al. 2018

The American Surgeon

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Diverting loop ileostomies are common procedures for protecting high-risk anastomoses. There is little consensus on the most ideal technique both in terms of cost efficiency and outcome. Data for this study were collected from 101 patients who underwent loop ileostomy reversal between 2009 and 2014 at Morristown Medical Center. Of the 101 patients included in the review, 57 received a hand-sewn anastomosis (HS-A) and 44 received a stapled anastomosis (S-A). Average total hospital charges for stapled anastomoses were significantly greater than that for hand-sewn anastomoses, as were total operating room supply costs. When the total cost of the operation itself was considered, S-A cases were still found to be significantly greater than HS-A cases. Hospital room charges, total lab charges, pathology charges, and EKG/ECG charges were all greater for S-A cases than HS-A cases. Overall costs were greater for S-As than hand-sewn anastomoses and because of a lack of difference in procedure length, stapler supply costs were not offset. Complication rates and length of stay were also similar between the techniques. We found S-A cases to be more costly and have a greater cost/hour than HS-A cases.

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Experience of General Surgery Residents in the Creation of Small Bowel and Colon Anastomoses

Cited by 10 publications

References 30 publications

Development, manufacture and initial assessment of validity of a 3-dimensional-printed bowel anastomosis simulation training model

Development, manufacture and initial assessment of validity of a 3-dimensional-printed bowel anastomosis simulation training model

Surgeon Case Volume and Intestinal Anastomotic Leaks

Outcome and Cost Analysis of Hand-Sewn and Stapled Anastomoses in the Reversal of Loop Ileostomy

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