Society for Surgery of the Alimentary Tract

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VALIDATION OF A STRUCTURED HANDS-ON SURGICAL SKILLS TRAINING MODULE FOR HEPATICOJEJUNOSTOMY
Rajesh Panwar, Sujoy Pal*, Hemanga K. Bhattacharjee, Ambuj Roy, Vuthaluru Seenu, Peush Sahni
Gastrointestinal Surgery & Liver Transplantation, All India Institute of Medical Sciences, New Delhi, Delhi, India

Background: There is dearth of task or procedure specific simulation modules for open surgical procedures. Hepaticojejunostomy is an integral part of several surgical procedures such as Whipple’s procedure, Choledochal cyst excision and surgeries for biliary tumors. We developed a two-day training module for teaching hepaticojejunostomy to the surgical trainees on an animal tissue-based simulation model. We conducted this study to validate the module.
Methods: We enrolled surgical trainees from Gastrointestinal surgery and General Surgery departments to participate in the two-day course. Each participant performed as well as assisted five hepaticojejunostomies on the simulation model during the course. Participants also performed a follow-up (sixth) hepatico-jejunostomy on the same model at-least three months after the course. The performance in the first case was considered baseline, the performance in the fifth case was considered as post-training and the performance in the sixth case was considered as follow-up. The performance of the trainees was assessed on recorded and coded videos of the procedures in a blinded manner as per the modified Objective Structured Assessment of Technical Skills (OSATS) global rating scale. (Figure 1)
Results: Eighteen trainees participated in the study from April 2022 to January 2023. The mean modified OSATS global score of the trainees significantly improved from 20.8 ± 2.1 in the first (baseline) case to 27.9 ± 2.4 in the fifth (post-training) case (p<0.001). The mean score for the sixth (follow-up) case was 28.1 ± 2.4. The follow-up score was significantly higher than the first case (p<0.001) but there was no significant change as compared to the score in the fifth case (p=0.775).
Conclusion: The structured hands-on surgical skills training module significantly improved the surgical skills of the trainees. The trainees retained these skills at 3-months follow-up.


Figure 1. Modified Objective Structured Assessment of Technical Skills (OSATS) global rating scale for assessing skills on hepaticojejunostomy simulation model.
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