Microsurgery Workout: A Novel Simulation Training Curriculum Based on Nonliving Models

Rodríguez, José Ramón; Yáñez, R.; Cifuentes, Ignacio; Varas, Julián; Dagnino, Bruno

doi:10.1097/prs.0000000000002456

Cited by 43 publications

(31 citation statements)

References 26 publications

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“…Each participant was given a desktop microscope (45X zoom, 10 cm working distance, www.worldmicrotraining.com), microsurgical instruments (micro-needle holder, microscissors, microsurgical forceps, vessel dilator), 3 ml syringe filled with water for injection and an 8.0 ethilon TM suture to complete their task. A pre-dissected non-living, chicken thigh femoral vessel model was used for the purpose of our study (24). The vessel was mounted on a display pad, free of tension and an arteriotomy performed in the center of the vessel.…”

Section: Methodsmentioning

confidence: 99%

Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

et al. 2020

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Introduction: Microsurgery is an essential element of Plastic Surgery practice. There is a paucity of studies assessing the impact of stress and cognitive distraction on technical microsurgical performance. The ability to complete cognitive and technical skills in parallel has not been assessed in a microsurgical setting. Aim: To test the hypothesis that cognitive distraction and external stressors negatively affect microsurgical performance in a high fidelity simulation setting. Materials/Methods: Fourteen surgeons across all levels of training undertook 2 microsurgical skills sessions, 1 month apart. Session one established baseline microsurgical skill. In session two, skills were assessed with the introduction of realistic operative room cognitive distractions (ORDIs). Outcome measures were efficiency and accuracy, measured by Time to Completion (TTC) and Anastomosis Lapse Index (ALI), respectively. Key Results: Fourteen participants (6 novices, 5 plastic surgery specialist trainees and 3 consultants) completed both microsurgical skills sessions. In total, 28-microvascular anastomosis were analyzed. Mean baseline TTC for the group was 20.36 min. With cognitive distraction and external stress mean TTC decreased to 17.87 min. Mean baseline ALI score for the group was 3.32 errors per anastomosis. The introduction of cognitive distraction and external stress increased the mean to 4.86 errors per anastomosis. Total errors per anastomosis increased from 91 errors at baseline to 137 errors with cognitive distraction and external stress. Under stress, participants were more efficient but had reduced anastomotic accuracy. Conclusion: Under stress, surgeons were more efficient, this translated into faster completion of a microsurgical anastomosis. Efficiency, however, came at the expense of accuracy.

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Section: Methodsmentioning

confidence: 99%

Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

et al. 2020

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“…We demonstrated that the principal advantage of the model using latex balloons is the possibility of using it to teach several different vascular suture techniques, in contrast to what is described in the majority of studies in the literature, which only tested end-to-end anastomosis. 2,3,6,19,20 Some studies used mononylon sutures to perform anastomoses. 6,19,20 In our model, anastomoses were constructed using fine polypropylene sutures and two needles, to make the model more realistic and help familiarize the students with the vascular technique.…”

Section: Discussionmentioning

confidence: 99%

“…There are descriptions in the literature of using synthetic materials, such as silicone and rubber gloves, animal tissues, and vegetable tissues, and of gaining practical experience using small animals (pigs, rats, and rabbits), as part of teaching of vascular anastomosis and development of the skills needed. [1][2][3][4][5] However, use of animal models is the most common objection raised by the public and by the students themselves, who question the practice of sacrificing animals for educational purposes. 6 The strict rules mandated by the Institutional Committees on Care and Utilization of Animals also make using such animal models in medical training difficult, contributing to the need to develop alternatives.…”

Section: Introductionmentioning

confidence: 99%

Balões de látex: um modelo alternativo e de baixo custo para treinamento de anastomoses vasculares no ensino médico

et al. 2018

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Resumo O uso de simuladores na educação médica tem sido cada vez mais frequente, porém pouco acessíveis devido ao custo elevado. Foi desenvolvido para tal um modelo acessível e de baixo custo para o aprendizado e o treinamento de suturas e anastomoses vasculares em Laboratório de Bases das Técnicas Cirúrgicas. Foram utilizados balões de látex de cores variadas, fio de polipropileno 6.0 e outros materiais específicos para sutura vascular (porta-agulhas e pinças). Para facilitar o reparo dos balões, eles foram fixados em parafusos sobre placas de madeira. Foram feitas anastomoses terminoterminal, terminolateral e laterolateral e construção de patch. A perviedade da anastomose foi testada a partir da injeção de água em uma extremidade do balão e a observação da saída do conteúdo líquido na extremidade oposta. As vantagens observadas nesse modelo de treinamento para anastomoses foram a maleabilidade, a resistência à passagem do fio e o fato de ser inorgânico. Os balões de látex são uma alternativa barata, viável, não perecível e de uso prolongado no ensino e treinamento das suturas e anastomoses arteriais.

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“…The first cohort of residents received a conventional microsurgery training at our Simulation Center Laboratory which has been previously validated and is a part of our residency program curriculum. 22 This was the control group and was called the “MicroLab group.” Their training was performed in 17 practice sessions of progressive difficulty, with six of them focusing on performing complete end-to-end arterial anastomosis on a 1-mm chicken wing. They were tutored in all the training sessions by an expert in our laboratory.…”

Section: Methodsmentioning

confidence: 99%

MicrosimUC: Validation of a Low-Cost, Portable, Do-It-Yourself Microsurgery Training Kit

Navia

Tejos

Canahuate

et al. 2021

J Reconstr Microsurg

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Background Microsurgery depends largely on simulated training to acquire skills. Courses offered worldwide are usually short and intensive and depend on a physical laboratory. Our objective was to develop and validate a portable, low-cost microsurgery training kit. Methods We modified a miniature microscope. Twenty general surgery residents were selected and divided into two groups: (1) home-based training with the portable microscope (MicrosimUC, n = 10) and (2) the traditional validated microsurgery course at our laboratory (MicroLab, n = 10). Before the intervention, they were assessed making an end-to-end anastomosis in a chicken wing artery. Then, each member of the MicrosimUC group took a portable kit for remote skill training and completed an eight-session curriculum. The laboratory group was trained at the laboratory. After completion of training, they were all reassessed. Pre- and posttraining procedures were recorded and rated by two blind experts using time, basic, and specific scales. Wilcoxon's and Mann–Whitney tests were used to compare scores. The model was tested by experts (n = 10) and a survey was applied to evaluate face and content validity. Results MicrosimUC residents significantly improved their median performance scores after completion of training (p < 0.05), with no significant differences compared with the MicroLab group. The model was rated very useful for acquiring skills with 100% of experts considering it for training. Each kit had a cost of U.S. $92, excluding shipping expenses. Conclusion We developed a low-cost, portable microsurgical training kit and curriculum with significant acquisition of skills in a group of residents, comparable to a formal microsurgery course.

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Microsurgery Workout: A Novel Simulation Training Curriculum Based on Nonliving Models

Abstract: Significant acquisition of microsurgical skills was achieved by trainees to a level similar to that of experienced surgeons. Acquired skills were transferred to a more complex live model.

Cited by 43 publications

References 26 publications

Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance

Balões de látex: um modelo alternativo e de baixo custo para treinamento de anastomoses vasculares no ensino médico

MicrosimUC: Validation of a Low-Cost, Portable, Do-It-Yourself Microsurgery Training Kit

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