A novel perfused porcine simulator for teaching aortic anastomosis increases resident interest in vascular surgery.
J Vasc Surg
; 66(2): 642-648.e4, 2017 08.
Article
en En
| MEDLINE
| ID: mdl-28506475
ABSTRACT
OBJECTIVE:
This report describes a novel simulator, euthanized pigs on cardiopulmonary bypass, and validates this simulator with a controlled trial in general surgery residents learning aortic anastomosis. We evaluated this novel simulator with the followinghypothesis:
our porcine perfused simulator is as good as or better than the standard rubber tubing, low-fidelity models used for vascular anastomotic training.METHODS:
Euthanized pigs were placed on cardiopulmonary bypass, creating a perfused, ex vivo model on which to perform surgical procedures. The participants in the study were postgraduate year 2, 3, and 4 general surgery residents. Residents were randomized to practice aortic anastomosis in the pig laboratory (PL) simulator or in a dry laboratory. The PL residents and control residents performed a first vascular anastomosis on the rubber tube model. Anastomosis creation was filmed. The anastomosis and video were stored for later grading. Next, all residents underwent an ungraded, one-on-one training session with the attending vascular surgeon. After the training session, all residents completed a second videotaped rubber tubing anastomosis. The grading scales used were validated by other authors Global Assessment Score, Final Product Score, and Checklist Scoring Instrument. Survey data describing this experience were collected using a 13-question prelaboratory and 16-question postlaboratory questionnaires consisting of yes/no, multiple selection, and 5-point Likert-type scale questions.RESULTS:
All residents had a statistically significant improvement in time to completion and in the Global Assessment Score with tutored practice. The PL residents showed statistically significant improvement in completion time between the first and second videotaped anastomosis; however, there was no statistically significant improvement in the scoring metrics. The control residents showed statistically significant improvement in all three scoring metrics, but no statistically significant difference was found in completion time. The survey data showed a statistically significant shift in considering vascular surgery as a career after the experience in the PL group (P = .05) compared with the control group, who had no change in interest (P = .91).CONCLUSIONS:
Our prospective, randomized clinical trial shows that the porcine cardiopulmonary bypass model achieves similar results to a previously validated bench top model while improving general surgery resident interest in vascular surgery as a career.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Aorta
/
Cirugía General
/
Procedimientos Quirúrgicos Vasculares
/
Puente Cardiopulmonar
/
Selección de Profesión
/
Educación de Postgrado en Medicina
/
Enseñanza Mediante Simulación de Alta Fidelidad
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Límite:
Animals
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Vasc Surg
Asunto de la revista:
ANGIOLOGIA
Año:
2017
Tipo del documento:
Article