Assessment of Learning Curve for Radiofrequency Ablation in Twin Reversed Arterial Perfusion Sequence: A Simulation Model Study.

Abstract

Objective: This study characterized the procedural learning curve of novice practitioners in mastering radiofrequency ablation (RFA) in a simulated twin reversed arterial perfusion sequence (TRAPS) model.

Method: Twelve novices practiced RFA in a TRAPS model, which was evaluated for validity. A learning curve CUSUM analysis was performed to define the number of procedures required to achieve competency. The learning plateau of needle insertion time and the number of procedures required to surpass 90% of the learning plateau were calculated.

Results: The overall model rating of 4.26 ± 0.58 serves as validating the high learning performance. A success rate of 92.8% was achieved across 767 procedures. The average number of procedures required to achieve technical competency was 29 relative to years of experience in minimally invasive prenatal testing. After reaching this competency level, the success rate improved from 88.2% to 96.7% (P < 0.001). The needle insertion time learning curve indicated that 90% of the learning plateau was reached after 21 procedures, with the learning plateau occurring at 27.5s.

Conclusion: Performance in RFA within the simulated TRAPS model improved over time. Achieving competency enhanced technical success and shortened the needle insertion process. This simulation training provides practical skills for inexperienced surgeons.

Trial registration: TCTR20221005001.