Enhancement of vascular anastomosis training using a novel simulation model with integrated leakage testing

BACKGROUND: Mastery of vascular anastomosis is a fundamental skill for surgical trainees, yet opportunities for hands-on practice are often limited by equipment availability and concerns regarding patient safety. Simulation-based training offers an effective solution; however, many existing models lack objective performance assessment. This study evaluated a novel vascular anastomosis simulation model incorporating an integrated leakage testing system designed to provide immediate structured feedback. METHODS: A prospective pre-post interventional study was conducted involving 39 general surgery residents (postgraduate years 1-4). Participants initially performed an end-to-end vascular anastomosis on the simulation model without prior instruction. They subsequently received standardized video-based instruction followed by supervised practice and repeated the procedure. Performance outcomes included anastomosis completion time and leakage grading assessed under controlled pressure conditions. Trainee satisfaction was evaluated using a validated simulation-based learning questionnaire. RESULTS: Following the educational intervention, the proportion of procedures demonstrating severe leakage (Grade 3) decreased significantly from 69.3% to 28.1% (p = 0.001). Mean anastomosis completion time improved from 22.18 ± 8.45 min to 18.42 ± 6.88 min. Second- and third-year residents demonstrated statistically significant reductions in procedural time. All participants (100%) agreed that simulation-based learning was a useful educational strategy, and 70% reported a perceived improvement in psychomotor skills. CONCLUSIONS: This novel vascular anastomosis simulation model, with integrated leakage testing, was associated with improved simulator-based performance outcomes and procedural efficiency among surgical residents. The model provides a reproducible and low-cost platform for vascular anastomosis practice and structured performance assessment. Further studies are needed to establish its validity, long-term retention of simulator-based performance outcomes, and the potential relationship between simulator and operative performance.