CREST Trial: Endoscopic vein harvesting Structured vs current Training
Research type
Research Study
Full title
A multicentre Cluster Randomised pilot study comparing current Endoscopic (keyhole) vein harvesting training with Structured Training - The CREST trial.
IRAS ID
260083
Contact name
Bhuvaneswari Krishnamoorthy
Contact email
Sponsor organisation
Manchester University NHS Foundation Trust
Duration of Study in the UK
1 years, 8 months, 30 days
Research summary
Coronary Artery Bypass Graft (CABG) surgery is a commonly performed surgical procedure for coronary artery disease. A blood vessel (vein) from the leg is removed and used to bypass the blocked coronary arteries. The new vein takes over the job of supplying blood to the heart muscles and patients need to live with their vein graft for many years (typically 10 to15 years). If the vein is mishandled or damaged during removal, it can become blocked. This can affect the patient’s quality of life and cause repeated chest pain. Harvesting veins using keyhole surgery, has been shown to reduce wound complications and improve patient satisfaction compared to traditional open vein harvesting. Current training for keyhole vein removal in cardiac surgery typically involves a limited number of practice sessions on a leg model and one week’s training in the operating room, provided by a commercial trainer. However, a structured training programme is required for this procedure, to make sure vein quality is better and to minimise problems for patients. A recent survey of 151 health care professionals in 15 European countries found that 99% of specialists would like to have a structured keyhole training programme.
The Manchester Endoscopic Learning Tool (MELT) is a structured training programme that consists of four sections (introducing the trainees to the theory, surgical video, gradual introduction to clinical practice and vein harvesting), with a minimum pass mark of 80%. The first two phases of the MELT are skill-based e-learning and the second two phases are learning in clinical settings with patients. The training programme will seek to optimise patient outcomes, improved cost effectiveness and reduction of variation in global training practices. This will ensure that practitioners are delivering good surgical techniques under minimally stressful conditions so that patients directly benefit from a structured training programme.REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
21/NW/0250
Date of REC Opinion
26 Nov 2021
REC opinion
Further Information Unfavourable Opinion