Development of a model for training and evaluation in subfascial endoscopic perforator surgery (SEPS)

We describe a training method with objective evaluation that enhances video -assisted surgical skills. Training is via a simulator for subfascial endos copic perforator surgery (SEPS) and can assess whether specific training ex ercises are helpful in the acquisition of skills for video-assisted surgica l techniques. Twenty-five surgeons, with or without experience in video-ass isted surgical techniques, were asked to perform standardised drills connec ted with the SEPS technique. The SEPS simulator consisted of an artificiall y constructed subfascial space in a leg, in which false perforator veins ha d to be localised, clipped and cut. The participants performed two sequence s of actions three times, in order to improve their dexterity. The time req uired to perform each sequence was recorded. All trainees showed a steady i mprovement in skill-acquisition of the SEPS technique; the difference was s tatistically significant (p < 0.004). Despite its obvious importance in tea ching programmes, the assessment and training of technical ability has not been fully developed. If virtual reality simulators are to become more impo rtant in the future, simulation models will have to approximate more closel y the real operating theatre, and thus will become more valid in the traini ng and evaluation of surgical technique.