Use of a Contest Format for Objective Assessment of Microsurgical Technique: An Observational Study

Abstract

Background: Considering the lack of studies on the long-term evaluation of improvements in microsurgical techniques using simulation models, we determined whether technical improvements in surgical techniques could be assessed based on an increase in the score of contest-style continuous and objective evaluation systems involving the same microsurgical task.Methods: Since 2014, neurosurgeons with 1-10 years of experience participated in a biannual competition-style test. The task involved suturing as many times as possible within 5 min after arteriotomy of 1-mm artificial vessels. A modified version of the Objective Structured Assessment of Technical Skills examination was created and used. Changes and differences in scoring results over time were examined for each evaluator.Results: Overall, 103 neurosurgeons participated in the study at least once, and those who participated more than once were divided into two groups: those who obtained the highest score in each contest and those who obtained the lowest score. The linear regression equations for the highest and lowest scorer groups were y=7.62x+81.56 (R 2 =0.628) and y=1.94x+67.93 (R 2 =0.0433), respectively. The high-scoring group had high scores from the first time they participated, and their scores tended to increase further, while the low-scoring group did not show any tendency of score increases after gaining experience. No significant differences were found in scores according to four evaluators. Conclusions:Our study showed the possibility of assessing technical improvements in surgery through long-term and continuous microsurgical technique evaluation. A surgical technique evaluation system was established, and its potential to contribute to surgical safety was demonstrated.

Experience Using Gentian Violet-Free Dyes for Tissue Visualization

“…4,5 In neurosurgery, gentian violet ink is used for marking skin incisions and bone cutting lines and for coloring recipient and donor arteries during anastomosis. 6 Thus, many institutes use gentian violet ink during anastomoses. The walls of the recipient and donor arteries, such as the STA and MCA, are very thin and transparent, and their diameters are very small, that is, 1 to 2 mm.…”