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Title:
The Hidden Value of a High-Fidelity 3D-Printed Endarterectomy Training Model: Results of a Pilot Study
Introduction:
Arterial endarterectomy and patch angioplasty is a common vascular surgery procedure that needs to be mastered by general surgery residents. Placement of tacking sutures is key aspect of procedure to prevent future thrombosis of the repair. We set out to assess the value of a novel 3D-printed atherosclerosis simulated model to teach this crucial skill.
Methods:
After IRB approval, general surgery residents were voluntarily enrolled in a 2-hour vascular skills session. Pre-simulation, all participants received an educational video, written materials detailing the procedure, and a survey regarding prior exposure and confidence levels. During the simulation, participants were scored by attending vascular surgeon staff based on a 20-point scale assessing individual skills of arteriotomy (4 points), endarterectomy (4 points), patch angioplasty (7 points) and overall instrumentation/tissue handling (5 points). All participants were assessed with simple PTFE grafts and then with provided a 3D-printed models (FIGURE 1A and 1B). A post-simulation survey was given to quantify satisfaction with the model and procedure confidence. Paired student’s t-test* and Fisher’s Exact test** were utilized.
Results:
Twelve residents participated in the simulation; participants ranged from PGY level 3 (16.6%), 4 (33.3%), and 5 (50%). 100% of participants completed pre- and post-simulation surveys. 91.7% of participants had performed or seen an endarterectomy intraoperatively, with 33.3% participating in approximately 3-5 pre-simulation. 41.7% rated their confidence with vascular anastomosis as average, 8.3% as below average, and 8.3% as poor. 83.3% (n=10) of residents found the 3D-printed model extremely helpful, and 91.6% found the artery very to moderately realistic. Eleven of the twelve residents completed confidence assessments with a statistically significant increase in procedural confidence levels pre-session vs. post-simulation session (respectively 2.8 ± 0.9 vs. 3.8 ± 0.3, p=0.017*). Overall scores, patch angioplasty and instrument/tissue handling scores were statistically significantly increased (TABLE1).
Conclusion:
We present the use of a novel high-fidelity 3D-printed vascular endarterectomy model that significantly shifted learner’s confidence and technical surgical skills. Future utilization of 3D-printed simulations in vascular surgery could be utilized to achieve a variety of educational goals in a larger randomized control fashion.

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