V9-08: Male Infertility Microsurgery Training – Tricks of the Trade
Male infertility microsurgery (MIM) is physically, technically and mentally challenging, with surgical outcomes that are heavily dependent on the surgeon&[prime]s skills. MIM training programs that incorporate systematic evaluation protocols offer an excellent platform to teach microsurgical skills while avoiding the acquisition of bad habits. In this report, we describe the most common mistakes made by trainees who attended our MIM training program.
We conducted a retrospective review of prospectively collected data from five trainees who attended the MIM training program between July 2015 and December 2015. _x000D_ _x000D_ Briefly, the IRB-approved MIM training program at Weill Cornell Medicine is a two-week training course offered to urologists of all levels that is held in a dedicated MIM training lab. During the first week, trainees are introduced to the operating microscope, microsurgical instruments and sutures, and focus on developing basic microsurgical suturing skills. During the second week, the trainees start to perform live MIM procedures (vasovasostomy and vasoepididymostomy) on a rodent model. Instructors provide intense supervision and continuous evaluation throughout all phases of the training. Trainees are also able to observe surgical cases performed at our institution. Evaluations are conducted four times throughout the training course using a structured score form measuring 18 items, each on a 5-point Likert scale._x000D_ _x000D_ Trainee scores were assessed and compared for improvement over the course of the training course._x000D_
The most common mistakes made by our trainees revolved around sitting position, hand tremor, instrument handling, needle control, suture placement, and knot tying. The errors were most prevalent early on and there were statistically significant improvements across all domains by the end of the MIM training course (Table).
A MIM training program is an effective tool for teaching MIM skills. By incorporating intense supervision and continuous evaluation into an MIM training program, MIM trainees can avoid the development of bad habits that may be difficult to overcome and potentially have a negative impact on surgical outcomes.
Funding: Supported by The Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust.