Objective and Predictive Analysis of Anastomoses as an Educational and Benchmarking Tool

Introduction: Objective tools are limited in surgical education to analyse the quality of vascular anastomoses thus trainees and course attendees get only general suggestions regarding their performance. In clinical setting, there are only indirect signs about the potential function of anastomosis and the results can not be matched to the surgical technical features. Methods: We have developed a detailed and easy-to-understand method for anastomosis analysis. The method can be used in surgical education for trainees from all stages of training and expertise. All of anastomoses are objectively and reproducibly scored, and clear demonstrations are given to improve previous results. During training courses, surgeons can ascertain the comprehensive analysis of 3D morphology of their anastomosis. On the other hand blood flow through the anastomosis can be simulated in different conditions and long-term function of the anastomoses can be assessed. Anastomosed vessels are scanned using high precision 3D scanner following reconstruction of inner surface of vessels and anastomosis. After extensive meshing process CFD is performed for simulating pressure, velocity, turbulent flow, vorticity in vessels, furthermore wall shear stress and oscillatory shear stress analysis method are applied to prognosticate long-term behaviour of the anastomosis. Additionally, patient specific operating situations and vessel anatomies, pathologies are pretended by 3D printed simulators. The method targets the detect and solve learners-need to provide more effective skill training method. For measuring its effectivity, medical students and trainees were divided into two groups (n=40 both): Attendees of one group were informed about the results of the morphological and functional assessment, and the other received conventional hands-on training with full conventional explanation and suggestions. Results: The novel training system was proven to be more effective for surgical skill training compared to the conventional method. The attendees of courses and workshop gave more satisfied feedback and provoke more better performing anastomoses as analysed of blood flow and predicted the potential clinical results. Conclusion: The detailed, feedback-based education method can be used as an effective tool in surgical skill training. Individualised education tool can be potentially used to reduce learning curve. Disclosure: Authors are engaged in the company which started develop the above described method.