1
|
Engelhardt M, Schmid R, Kölbel B, Hyhlik-Dürr A, Zerwes S, Zischek C. Training in vascular trauma surgery for non-vascular surgeons: Vascular trauma surgery skills course. Eur Surg 2023; 55:89-93. [PMID: 37206194 PMCID: PMC10123566 DOI: 10.1007/s10353-023-00800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/15/2023] [Indexed: 05/21/2023]
Abstract
Background The experience of general and trauma surgeons in vascular trauma management has decreased with sub-specialization of surgery and working hours restrictions. We introduce a vascular trauma surgery skills course established to train German military surgeons prior to their deployment to conflict areas. Methods The intention and implementation of the vascular trauma course for non-vascular surgeons is described in detail. Results In hands-on courses, participants learn and train basic vascular surgical techniques on more realistic extremity, neck, and abdominal models with pulsatile vessels. A fundamental and an advanced course each provide military as well as civilian surgeons from different non-vascular specialties with a surgical skill set including direct vessel sutures, patch angioplasty, anastomosis, thrombectomy, and resuscitative endovascular balloon occlusion of the aorta (REBOA) in order to render them capable of managing major vascular injuries. Conclusion The experiences of this vascular trauma surgical skills course, initially established for military surgeons, can also be of use to all civilian general, visceral, and trauma surgeons occasionally facing traumatic or iatrogenic vascular injuries. Thus, the introduced vascular trauma course is valuable for all surgeons working in trauma centers.
Collapse
Affiliation(s)
- M. Engelhardt
- Department of Vascular and Endovascular Surgery, Centre for Vascular Medicine, Military Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - R. Schmid
- Department of Vascular and Endovascular Surgery, Centre for Vascular Medicine, Military Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - B. Kölbel
- Department of Vascular and Endovascular Surgery, Centre for Vascular Medicine, Military Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - A. Hyhlik-Dürr
- Medical Faculty, University of Augsburg, Augsburg, Germany
| | - S. Zerwes
- Medical Faculty, University of Augsburg, Augsburg, Germany
| | - C. Zischek
- Department of Vascular and Endovascular Surgery, Centre for Vascular Medicine, Military Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| |
Collapse
|
2
|
Boudin L, de Lesquen H, Patient M, Romeo E, Rivière D, Cungi PJ, Savoie PH, Avaro JP, Dagain A, Bladé JS, Balandraud P, Bourgouin S. Role of Cancer Surgery in the Improvement of the Operative Skills of Military Surgeons During Deployment: A Single-Center Study. Mil Med 2021; 186:e469-e473. [PMID: 33135732 DOI: 10.1093/milmed/usaa327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 07/29/2020] [Accepted: 08/20/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The maintenance of military surgeons' operative skills is challenging. Different and specific training strategies have been implemented in this context; however, little has been evaluated with regard to their effectiveness. Cancer surgery is a part of military surgeons' activities in their home hospitals. This study aimed to assess the role of oncological surgery in the improvement of military surgeons' operative skills. METHODS Between January and June 2019, the surgical activities of the departments of visceral, ear, nose, and throat, urological, and thoracic surgery were retrospectively reviewed and assessed in terms of the operative time (OT). All surgeons working at the Sainte Anne Military Teaching Hospital were sent a survey to rate on a 5-point scale the current surgical practices on their usefulness in improving surgical skills required for treating war injuries during deployment (primary endpoint) and to compare on a 10-point visual analog scale the influence of cancer surgery and specific training on surgical fluency (secondary endpoint). RESULTS Over the study period, 2,571 hours of OT was analyzed. Oncological surgery represented 52.5% of the surgical activity and almost 1,350 hours of cumulative OT. Considering the primary endpoint, the mean rating allocated to cancer surgery was 4.53 ± 0.84, which was not statistically different than that allocated to trauma surgery (4.42 ± 1.02, P = 0.98) but higher than other surgery (2.47 ± 1.00, P < 0.001). Considering the secondary endpoint, cancer surgery was rated higher than specific training by all surgeons, without statistically significant difference (positive mean score of + 2.00; 95% IC: 0.85-3.14). CONCLUSION This study demonstrates the usefulness of cancer surgery in improving the operative skills of military surgeons.
Collapse
Affiliation(s)
- Laurys Boudin
- Department of Oncology and Haematology, Sainte Anne Military Hospital, Toulon 83000, Var, France
| | - Henri de Lesquen
- Department of Thoracic and Vascular Surgery, Sainte Anne Military Hospital, Toulon 83000, France
| | - Matthieu Patient
- Department of Oncology and Haematology, Sainte Anne Military Hospital, Toulon 83000, Var, France
| | - Emilie Romeo
- Department of Oncology and Haematology, Sainte Anne Military Hospital, Toulon 83000, Var, France
| | - Damien Rivière
- Head and Neck Surgery Department, Sainte Anne Military Hospital, Toulon 83000, France
| | - Pierre-Julien Cungi
- Department of Anaesthesia and Critical Care, Sainte Anne Military Hospital, Toulon 83000, France
| | - Pierre-Henri Savoie
- Department of Urology, Sainte Anne Military Hospital, Toulon 83000, France.,French Military Health Service Academy, Val-de-Grâce Academy, Paris 75005, France
| | - Jean-Philippe Avaro
- Department of Thoracic and Vascular Surgery, Sainte Anne Military Hospital, Toulon 83000, France.,French Military Health Service Academy, Val-de-Grâce Academy, Paris 75005, France
| | - Arnaud Dagain
- French Military Health Service Academy, Val-de-Grâce Academy, Paris 75005, France.,Department of Neurosurgery, Sainte Anne Military Hospital, Toulon 83000, France
| | - Jean-Sébastien Bladé
- Department of Oncology and Haematology, Sainte Anne Military Hospital, Toulon 83000, Var, France
| | - Paul Balandraud
- French Military Health Service Academy, Val-de-Grâce Academy, Paris 75005, France.,Department of Digestive Surgery, Sainte Anne Military Hospital, Toulon 83000, Var, France
| | - Stéphane Bourgouin
- Department of Digestive Surgery, Sainte Anne Military Hospital, Toulon 83000, Var, France
| |
Collapse
|