MAGA SURGICAL SIMULATOR 2.0: International Pilot Evaluation of a Portable Active-Flow Vascular Trainer
Paolo Magagna, Domenico Mangino, James Reese Parada Lorenzana, Elenilson Mauricio Mejía Melgar, Francisco José Gamero Alfaro, Guillermo Rodríguez Funes, Kevin Ariel Rivas Campos, Vélveth Beborly Jeannice Duque García, Lorenzo Mingozzi, Yuvraj Juttla, Byron Pontón Guajala, Serhii Kuchma, Juan David Romero, Roger Yoel Conde Moncada, Pietro Permon, Said Ismail Bariș, Faizus SazzadBackground: Access to cardiovascular surgical simulation remains limited by cost, logistical complexity, and dependence on dedicated facilities. MAGA SURGICAL SIMULATOR 2.0 was developed as a portable, modular, suitcase-based platform combining open and endoscopic training with active fluid circulation and immediate leakage assessment. Methods: The simulator supports multiple vascular anastomotic configurations, purse-string suturing, and aortic cannulation. After unrestricted use of the open configuration, an anonymous international questionnaire assessed feasibility, usability, realism, perceived educational value, and perceived transferability using 5-point Likert scales and open-ended questions. A subsequent exploratory follow-up assessed continued use and self-reported changes over time. Results: Twenty-two participants from eight countries completed the initial questionnaire: 14 residents, five attending surgeons, two medical students, and one junior doctor. All respondents considered the simulator useful, effective for reproducing surgical gestures, and valuable for practicing with active circulation. Mean scores were 4.71 ± 0.64 for ease of use and 4.55 ± 0.60 for perceived realism. Self-reported improvement scores were 4.77 ± 0.69 for instrument handling and 4.64 ± 0.79 for manual dexterity. Six of 22 initial participants (27.3%) completed the exploratory follow-up. Four reported regular continued use, and five reported shorter completion times; recorded rather than perceived task times were available for only two respondents. Recurrent strengths were portability, independent practice, real-time leakage detection, and immediate corrective feedback. Conclusions: MAGA SURGICAL SIMULATOR 2.0 appears feasible, usable, and acceptable across heterogeneous international settings. The findings support further prospective validation using standardized tasks and objective performance measures; they do not establish clinical effectiveness.