A New Vascular Anastomosis Model: Relation between Outcome and Experience

Abstract

Vascular anastomosis is a complex task that requires multiple skills. Existing training methods lack the ability to objectively quantify surgical skill. In this study we tested a new vascular anastomosis model for bench training. Surgical performance was assessed based on the new vascular anastomosis training model. Thirty- eight subjects were asked to (1) close the end of a 6-mm polytetrafluoroethylene (PTFE) graft, using a continuous suturing technique with 6-0 polypropylene; (2) perform end-to-end and (3) end-to-side anastomosis using the same materials and techniques. The mean age (sd) of all participants was 28.3 (2.1) years. More surgically experienced trainees did better in all measures of technical skill. Although there was a tendency for those with previous experience with the training model to do better in terms of the technical outcomes, these differences were not statistically significant. Multivariable analysis revealed that level of surgical training and type of anastomosis were the only significant factors related to completion time. Our study confirmed the impact of increasing surgical experience on the technical skills of surgical trainees. Trainees with higher levels of training made fewer errors and completed the procedures faster than those with lower levels of training.