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Kaizen: Engineering tools for development, evaluation, certification and continuous improvement of microsurgical abilities and procedures

Villanueva PJ;
Villanueva BM;
Sanmarco CT;
Rodriguez HI;
Arciénaga A;
Lagier ME;
Cherian I;
Formento HR

Pablo Javier Villanueva

Bárbara Magdalena Villanueva

Constanza Torres Sanmarco

Hector Ivan Rodriguez

Antonio Arciénaga

Maria Eugenia Lagier

Iype Cherian

Hector Ricardo Formento


Resumen

Introduction: microsurgical procedures are multi-variable situations, difficult to objectively analyse. Procedures evaluation-improvement-certification is a strong and developed science for engineers. Kaizen is a renamed methodology in this area. This study aims to use Kaizen tools and politics to design a protocol for hand-skills training at a microsurgical scenario, with continuous improvement ability and objective evaluation capabilities.

Materials and methods: a step-by-step hand-skills training protocol was designed using Kaizen method and an experienced microvascular team opinion. It was performed by one surgeon, using a biological sample (placenta) as a surgical simulator. PDCA Kaizen protocol helped to define variables (time elapsed and mistake committed while performing a precise task) and a mistakes-score building to evaluate every single step of the procedure. The scenario was fully controlled to avoid bias. Results were statistically analysed.

Results: twelve placentas were used to achieve the goals. Total working time was 13h47m03s. Longest attempt was the first one (1h49m05s/2mistakes). Shorter attempt was the fourth one (53m29sec/3mistakes). Average time was 1h15m11sec. After 7 attempts, learning curve achieves a plateau. After 12 attempts, no mistakes level was achieved, (57min37sec).

Conclusion: Kaizen application to microsurgery results in a training programme that shows significant impact reducing time-needed and mistake-committed levels. Kaizen helped to use an experienced team expertise, identify useful variables, evaluate a complex procedure, data processing, and continuous-improvement-politic inclusion. Learning curves were precisely built, and teaching progress objectively measured. This method could also be applied to analyse and evaluate surgical procedures.

 

DOI:https://doi.org/10.56238/medfocoexplconheci-049


Creative Commons License

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.

Derechos de autor 2023 Pablo Javier Villanueva, Bárbara Magdalena Villanueva, Constanza Torres Sanmarco, Hector Ivan Rodriguez, Antonio Arciénaga, Maria Eugenia Lagier, Iype Cherian, Hector Ricardo Formento

##plugins.themes.gdThemes.article.Authors##

  • Pablo Javier Villanueva
  • Bárbara Magdalena Villanueva
  • Constanza Torres Sanmarco
  • Hector Ivan Rodriguez
  • Antonio Arciénaga
  • Maria Eugenia Lagier
  • Iype Cherian
  • Hector Ricardo Formento