Impact of a Structured Ex Vivo Training on Performance Improvement in the Acquisition of Vascular and Cardiac Suturing Fundamental Skills Among Novice Trainees in Surgery: A Prospective Experimental Study

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Introduction Vascular and cardiac suturing requires high precision and a limited execution time. The aim of this study was to evaluate the impact of a structured ex-vivo training on performance improvement in the acquisition of vascular and cardiac suturing fundamental skills among novice trainees in surgery. Materials and Methods This was a prospective, interventional, and analytical experimental study (October 2024 to May 2025) involving 15 pre-doctoral medical students (13 men) with a mean age of 26.23 ± 1.23 years (range: 24–28 years). Each participant performed 30 sessions of 80 stitches per session using Biotix® brand elastic rubber bands arranged in a hexagonal shape. The sutures were performed according to the fundamental techniques of vascular and cardiac suturing, including a 90° needle angle, tissue bite, stitch spacing, and the use of a needle holder and dissecting forceps. Each performance criterion was scored from 1 to 5, and the time spent performing each suture was recorded per session. Analyses were performed using SPSS 26.0 software. Results Longitudinal analysis showed a significant and continuous progression of technical performance (p < 0.001) from an overall mean performance score of 6.17 ± 2.24 at the first session (S1), to 24.20 ± 0.90 at the final session (S30); i.e. a 4x technical performance score. In parallel, the execution time of the 80 stitches decreased significantly from 52 ± 8 minutes at session 1 to 22 ± 3 minutes at session 30 (p < 0.001): i.e. a relative reduction in execution time of 61.75% (p < 0.001) with a reduction in inter-individual variability, and a progressive increase in technical efficiency. Conclusion This study demonstrates that repeated ex-vivo surgical training allows for a progressive, homogeneous and measurable acquisition of the fundamental techniques in vascular and cardiac suturing.

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