Using Engineering Methods (Kaizen and Micromovements Science) to Improve and Provide Evidence Regarding Microsurgical Hand Skills.
World Neurosurg
; 189: e380-e390, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38906471
ABSTRACT
OBJECTIVE:
Microsurgical interventions involve the interaction of numerous variables, making objective analysis of skill proficiency challenging. This difficulty is even more pronounced in low-resource contexts. Continuous improvement methodologies such as Kaizen-planning, doing, checking, acting (PDCA) and micromovements science (MMS) can address this issue. This study aimed to demonstrate the advantages of designing and implementing microsurgical training programs using these methodologies.METHODS:
Following an extensive literature review of Kaizen-PDCA and MMS, and under the guidance of experienced neurosurgeons and engineers, a microvascular bypass training program was developed using the human placenta. Subsequently, the training program was used to analyze and describe the process of a trainee neurosurgeon in Argentina with no prior experience in microvascular anastomosis, as the operator gained proficiency.RESULTS:
The trainee required 12 attempts to achieve the program goals. The longest procedural time was during the first attempt (1 hour 49 minutes 05 seconds with 2 mistakes), while the shortest time was during the fourth attempt (53 minutes 29 seconds with 3 mistakes). After 12 attempts, the trainee made no mistakes, and the procedural time was reduced to 57 minutes 37 seconds. The final learning curve demonstrated a regular pattern and reached a plateau after 7 attempts.CONCLUSIONS:
The training program and methodology effectively assessed, facilitated, and demonstrated the acquisition of microsurgical skills. Kaizen-PDCA and MMS enabled the effective use of expert experience, detailed evaluation of microsurgical procedures, and integration into a continuous improvement cycle. The program structure could also be valuable for teaching, evaluating, and enhancing similar surgical procedures.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Clinical Competence
/
Microsurgery
Limits:
Female
/
Humans
Language:
En
Journal:
World Neurosurg
/
World neurosurgery (Online)
Journal subject:
NEUROCIRURGIA
Year:
2024
Document type:
Article
Country of publication: