AB187. 156. Trainee experience of a cost-effective DIY model for simulation of surgical excision of sebaceous cyst

Background: The landscape of surgical training is changing. The use of simulation in surgical training is growing in the European Work Time Directive (EWTD) era. Furthermore, the cost of surgical training is increasing. We describe a low-cost DIY (do it yourself) model for simulation of sebaceous cyst surgical excision training.

Methods: This model was constructed for simulation of sebaceous cyst excision as part of an Association of Surgeons in Training (ASiT) Foundation in Surgical Skills (FSS) convened at University Hospital Limerick. A protocol for specimen disposal was approved by the Department of Infection Control. The sebaceous cyst was artificially created using finger tips of commercially available disposable gloves, filled with tooth paste and tied at the base to make a spherical ball. These ‘cysts’ were then inserted in the subcutaneous plane of the fresh pig trotters. An artificial punctum was created and a very small amount of glue was injected via the punctum to stick the ‘skin’ to the ‘cyst’. Toothpaste leakage demonstrated a real-life experience of a ‘burst’ sebaceous cyst during excision to delegates. Course tutors demonstrated the technique of excision to candidates in small groups then each candidate performed a supervised excision.

Results: Seventeen candidates and five tutors (General Surgery Registrars) participated. A total of 22 excisions were performed. Ten were removed intact, twelve ‘cysts’ ruptured during removal. Candidates included 7 females and 10 males. Three medical students, 13 interns and one SHO. Delegate feedback highlighted this model to be realistic, highly engaging, and immersive. The total cost per model was (2.33 Euro, Including price of toothpaste tube and one totter). Tutors found this model to be reflective of real-life simulation.

Conclusions: This described DIY technique for simulating excision of a sebaceous cyst is a cost-effective and close to real-life model that can easily be created for surgical training simulation.

Keywords: Association of Surgeons in training (ASiT); simulation; DIY; trainee; sebaceous cyst