DOI QR코드

DOI QR Code

Evaluation of the Microvascular Research Center Training Program for Assessing Microsurgical Skills in Trainee Surgeons

  • Komatsu, Seiji (Department of Plastic and Reconstructive Surgery, Okayama University Hospital) ;
  • Yamada, Kiyoshi (Department of Plastic and Reconstructive Surgery, Okayama University Hospital) ;
  • Yamashita, Shuji (Department of Plastic and Reconstructive Surgery, Okayama Saiseikai General Hospital) ;
  • Sugiyama, Narushi (Department of Plastic and Reconstructive Surgery, Okayama University Hospital) ;
  • Tokuyama, Eijiro (Department of Plastic and Reconstructive Surgery, Okayama University Hospital) ;
  • Matsumoto, Kumiko (Department of Plastic and Reconstructive Surgery, Okayama University Hospital) ;
  • Takara, Ayumi (Department of Plastic and Reconstructive Surgery, Okayama University Hospital) ;
  • Kimata, Yoshihiro (Department of Plastic and Reconstructive Surgery, Okayama University Hospital)
  • Received : 2013.01.26
  • Accepted : 2013.02.26
  • Published : 2013.05.15

Abstract

Background We established the Microvascular Research Center Training Program (MRCP) to help trainee surgeons acquire and develop microsurgical skills. Medical students were recruited to undergo the MRCP to assess the effectiveness of the MRCP for trainee surgeons. Methods Twenty-two medical students with no prior microsurgical experience, who completed the course from 2005 to 2012, were included. The MRCP comprises 5 stages of training, each with specific passing requirements. Stages 1 and 2 involve anastomosing silicone tubes and blood vessels of chicken carcasses, respectively, within 20 minutes. Stage 3 involves anastomosing the femoral artery and vein of live rats with a 1-day patency rate of >80%. Stage 4 requires replantation of free superficial inferior epigastric artery flaps in rats with a 7-day success rate of >80%. Stage 5 involves successful completion of one case of rat replantation/transplantation. We calculated the passing rate for each stage and recorded the number of anastomoses required to pass stages 3 and 4. Results The passing rates were 100% (22/22) for stages 1 and 2, 86.4% (19/22) for stage 3, 59.1% (13/22) for stage 4, and 55.0% (11/20) for stage 5. The number of anastomoses performed was $17.2{\pm}12.2$ in stage 3 and $11.3{\pm}8.1$ in stage 4. Conclusions Majority of the medical students who undertook the MRCP acquired basic microsurgical skills. Thus, we conclude that the MRCP is an effective microsurgery training program for trainee surgeons.

Keywords

References

  1. Martin JA, Regehr G, Reznick R, et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 1997;84:273-8. https://doi.org/10.1002/bjs.1800840237
  2. Nugent E, Joyce C, Perez-Abadia G, et al. Factors influencing microsurgical skill acquisition during a dedicated training course. Microsurgery 2012;32:649-56. https://doi.org/10.1002/micr.22047
  3. Selber JC, Chang EI, Liu J, et al. Tracking the learning curve in microsurgical skill acquisition. Plast Reconstr Surg 2012; 130:551e-8e.
  4. Balasundaram I, Aggarwal R, Darzi LA. Development of a training curriculum for microsurgery. Br J Oral Maxillofac Surg 2010;48:598-606. https://doi.org/10.1016/j.bjoms.2009.11.010
  5. Temple CL, Ross DC. A new, validated instrument to evaluate competency in microsurgery: the University of Western Ontario Microsurgical Skills Acquisition/Assessment instrument. Plast Reconstr Surg 2011;127:215-22. https://doi.org/10.1097/PRS.0b013e3181f95adb
  6. Chan W, Niranjan N, Ramakrishnan V. Structured assessment of microsurgery skills in the clinical setting. J Plast Reconstr Aesthet Surg 2010;63:1329-34. https://doi.org/10.1016/j.bjps.2009.06.024
  7. Chan WY, Matteucci P, Southern SJ. Validation of microsurgical models in microsurgery training and competence: a review. Microsurgery 2007;27:494-9. https://doi.org/10.1002/micr.20393
  8. Yamashita S, Sugiyama N, Hasegawa K, et al. A novel model for supermicrosurgery training: the superficial inferior epigastric artery flap in rats. J Reconstr Microsurg 2008;24:537-43. https://doi.org/10.1055/s-0028-1088226
  9. Demir Y, Ozmen S, Klimczak A, et al. Tolerance induction in composite facial allograft transplantation in the rat model. Plast Reconstr Surg 2004;114:1790-801. https://doi.org/10.1097/01.PRS.0000142414.92308.AB
  10. Sonmez E, Nasir S, Siemionow M. Penis allotransplantation model in the rat. Ann Plast Surg 2009;62:304-10. https://doi.org/10.1097/SAP.0b013e31817dc4d8
  11. Okayama University Department of Plastic and Reconstructive Surgery [Internet]. San Bruno, CA: YouTube, LLC; c2013 [cited 2013 Mar 13]. Available from: http://www. youtube.com/user/okayamauniversityprs.
  12. Lannon DA, Atkins JA, Butler PE. Non-vital, prosthetic, and virtual reality models of microsurgical training. Microsurgery 2001;21:389-93. https://doi.org/10.1002/micr.21709
  13. Crosby NL, Clapson JB, Buncke HJ, et al. Advanced nonanimal microsurgical exercises. Microsurgery 1995;16:655-8. https://doi.org/10.1002/micr.1920160913
  14. Klein I, Steger U, Timmermann W, et al. Microsurgical training course for clinicians and scientists at a German University hospital: a 10-year experience. Microsurgery 2003; 23:461-5. https://doi.org/10.1002/micr.10180
  15. Furka I, Brath E, Nemeth N, et al. Learning microsurgical suturing and knotting techniques: comparative data. Microsurgery 2006;26:4-7. https://doi.org/10.1002/micr.20201
  16. Peled IJ, Kaplan HY, Wexler MR. Microsilicone anastomoses. Ann Plast Surg 1983;10:331-2. https://doi.org/10.1097/00000637-198304000-00015
  17. Govila A. A simple model on which to practise microsurgical technique: a fresh chicken. Br J Plast Surg 1981;34:486-7. https://doi.org/10.1016/0007-1226(81)90065-5
  18. Hino A. Training in microvascular surgery using a chicken wing artery. Neurosurgery 2003;52:1495-7. https://doi.org/10.1227/01.NEU.0000065174.83840.62
  19. Martins PN, Montero EF. Basic microsurgery training: comments and proposal. Acta Cir Bras 2007;22:79-81. https://doi.org/10.1590/S0102-86502007000100014
  20. Lahiri A, Lim AY, Qifen Z, et al. Microsurgical skills training: a new concept for simulation of vessel-wall suturing. Microsurgery 2005;25:21-4. https://doi.org/10.1002/micr.20074
  21. Uson J, Calles MC. Design of a new suture practice card for microsurgical training. Microsurgery 2002;22:324-8. https://doi.org/10.1002/micr.10060
  22. Akyurek M, Safak T, Oztekin C, et al. Dorsal penile vein as a new training model for microvenous anastomosis in rats. Ann Plast Surg 2002;49:280-4. https://doi.org/10.1097/00000637-200209000-00007
  23. Dunn RM, Mancoll J. Flap models in the rat: a review and reappraisal. Plast Reconstr Surg 1992;90:319-28. https://doi.org/10.1097/00006534-199290020-00026
  24. Zhang F, Sones WD, Lineaweaver WC. Microsurgical flap models in the rat. J Reconstr Microsurg 2001;17:211-21. https://doi.org/10.1055/s-2001-14353

Cited by

  1. Experiences with basic microsurgical training programs and skill assessment methods at the University of Debrecen, Hungary vol.33, pp.9, 2013, https://doi.org/10.1590/s0102-865020180090000013
  2. Current status of simulation and training models in microsurgery: A systematic review vol.39, pp.7, 2013, https://doi.org/10.1002/micr.30513
  3. Fast-track teaching in microsurgery vol.106, pp.4, 2013, https://doi.org/10.1016/j.otsr.2020.02.009
  4. Microsurgery Training in Plastic Surgery vol.8, pp.7, 2013, https://doi.org/10.1097/gox.0000000000002898
  5. Designing a Masterclass in free flap surgery for head and neck surgeons: Our experience vol.40, pp.8, 2020, https://doi.org/10.1002/micr.30638
  6. Microsurgical training through laboratory experience: A step-by-step practical guideline vol.27, pp.None, 2013, https://doi.org/10.1016/j.inat.2021.101400