*Purpose: We sought to increase the opportunities for general surgery residents to hone their vascular anastomosis skills. Accordingly, we created a kidney transplant model using porcine kidneys to simulate the anastomotic experience during their renal transplant rotation.

*Methods: Porcine kidneys were procured en-bloc with the vena cava and abdominal aorta. These were dissected preserving the hilar structures and aorta. A model was set up using boxes to mimic operating in the iliac fossa. The aorta and a Penrose drain were used as recipient arteries and veins respectively to which the renal vessels were anastomosed. General surgery residents participated in the simulation; filling out pre and post-simulation surveys to elicit comfort levels with the procedure on a scale from 0 (not comfortable) to 100 (very comfortable) as well as perceived usefulness as a tool to improve resident training in renal transplantation. PGY 1 and 2 participants were classified as junior, others as senior residents and an attending transplant surgeon proctored the session.

*Results: The pre-simulation survey had 22 respondents at varying levels of training,19 of whom completed the post-simulation survey. 100% of respondents (19 of 19) found the model useful for training, learning to assist, and learning steps of renal transplantation. Juniors compared to seniors started with a lower comfort level at creating (8 vs 59 P = 0.017) and assisting anastomosis (40 vs 75 P= 0.049). Following the simulation, comfort levels for Junior residents significantly improved with performing the vascular anastomosis (8 vs 44 p= 0.014). Both seniors and juniors trended towards an increased comfort level assisting post-simulation. (Table 1)

*Conclusions: We demonstrated that surgery residents at varying levels of training regarded the use of porcine tissue for renovascular anastomosis simulation as a useful tool. Performing the simulation early on in training may help prepare residents for their vascular or transplant experience

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