Effective instruction of vascular anastomosis in the surgical skills laboratory

Background: A greater emphasis has recently been placed on laboratory-based training of core surgical skills and tasks, such as vascular anastomosis. Despite this emphasis, little objective data exist regarding the effectiveness of vascular anastomosis instruction in the laboratory setting. Methods: Residents of all postgraduate levels received laboratory-based vascular anastomosis training. Each individual fashioned an end-to-side anastomosis between synthetic graft and porcine aorta before instruction (pretest). All subjects then received standardized anastomosis training with practice time. After training, the anastomosis was then repeated (posttest). Metrics included time to completion, anastomotic leakage, and visual characteristics of the completed product. Results: Postteaching improvement was demonstrated by all residents (n = 32). Posthoc analysis showed statistically significant improvements in junior residents only. Conclusions: Laboratory-based training can effectively improve the ability of residents to perform vascular anastomosis immediately after training. Junior residents may !gain a greater advantage from laboratory teaching. (C) 2008 Excerpta Medica Inc. All rights reserved.