Evaluation tool for a gastroenterostomy simulated training

Experimental longitudinal study of a quantitative character. The sample consisted of twelve general surgery residents. The training was divided into 5 sessions and consisted of participation in 20 gastroenterostomys in synthetic organs. The training was accompanied by an experienced surgeon who was responsible for the feedback and the anastomoses evaluation. The anastomoses evaluated were the first, fourth, sixth, eighth and tenth. A 10 item checklist and the time to evaluate performance were used.

Results:

Residents showed a reduction in operative time and evolution in the surgical technique statistically significant (p<0.01). The correlation index of 0.545 and 0,295 showed a high linear correlation between time variables and Checklist. The average Checklist score went from 6.8 to 9 points.

Conclusion:

The proposed checklist can be used to evaluate the performance and systematization of a simulated training aimed at configuring a gastroenterostomy.

Key words:
Education, Medical; Simulation Training; Anastomosis, Surgical; Laparoscopy; hecklist

Questions evaluated	Incorrect	Correct
Fitted firm knots and external to the anastomosis (First double and two simple ones).
Needle positioning on the Needle Holder (1 \ 3 distal with 90 degree angle).
Needle penetration (90° skin tissue inlet making the curvature at the exit, with smooth movements and without damaging the tissue).
Use both hands in a coordinated way (Skin tissue presentation and needle assembly).
Skin tissue amount (Penetrate the needle in the same skin tissue amount on both sides of the anastomosis, avoiding picking up too much or too little).
Handling the surgical thread (It draws the thread in its most proximal portion to the tissue. It does not break or damage the thread and removes its remains from the simulator).
Equivalent distance between points (4 to 6 mm, leaving no redundancy between the angles).
It uses the wizard (tissue exposure, suture pull and camera manipulation).
Operation flow (Starts with posterior anastomosis and ends with anterior anastomosis using appropriate tweezers and 2 wires).
Persistent and intact anastomosis (Diameter greater than 3cm and absence of visible fenestrations).
Total of points:

Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia https://actacirbras.com.br/ - São Paulo - SP - Brazil
E-mail: actacirbras@gmail.com

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[1] Correspondence:
Márcio Alencar Barreira Avenida Beira Mar, 2780/201 60165121 Fortaleza - CE Brasil Tel.: (55 85)99151-4975 drmarciobarreira@gmail.com