Basic Surgical Skill Training before a Vascular Course Improves the Quality of Vascular Anastomoses: A Randomized Controlled Trial

During the past decade, simulation has become standard in most surgical training programs, but objective evaluation of the performance has been a challenge. The optimal components of open surgery's simulation have also been questioned. The goal of this study was to evaluate the benefit of adding a hands-on exercise before a formal vascular training course. The participants' performance was objectively evaluated using computational fluid dynamics assessment of vascular anastomoses. In this study, 51 residents participated in an online surgical hands-on training course, performing 6 end-to-side anastomoses. The residents were randomly divided into 2 groups. Group 1 also underwent basic surgical skill training (BSST) before starting the vascular course. The groups were compared based on computational fluid dynamics assessment of vascular anastomoses, combined with online personalized feedback. Among measured parameters of functional assessment, the mean of 6 anastomoses showed significantly better results in group 1 when compared with control group 2 (Oscillatory Shear Index: 0.022 vs. 0.025 P = 0,002; maximum pressure: 7,939 vs. 7,971 P = 000,037; velocity: 0.12 vs. 0.12 P = 00.000; helicity: 297 vs. 393 P = 00.065; vorticity: 5,258 vs. 6,628 P = 00,019; wall shear stress: 1.83 vs. 1.97 P = 0,000,047). These results showed no significant correlation between participants' experience level, specialization, and workplace. BSST before a formal vascular simulation course positively affects the anastomosis quality, independent of experience level, specialization, and workplace. BSST is suggested before a vascular course to improve performance and progress. Further studies are needed to analyze the impact of this combined simulation training on performing anastomoses.