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Sufianov A, Ovalle CS, Cruz O, Contreras J, Begagić E, Kannan S, Rosario Rosario A, Chmutin G, Askatovna GN, Lafuente J, Sanchez JS, Nurmukhametov R, Soto García ME, Peev N, Pojskić M, Reyes-Soto G, Bozkurt I, Encarnación Ramírez MDJ. Low-Cost 3D Models for Cervical Spine Tumor Removal Training for Neurosurgery Residents. Brain Sci 2024; 14:547. [PMID: 38928547 PMCID: PMC11201732 DOI: 10.3390/brainsci14060547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Spinal surgery, particularly for cervical pathologies such as myelopathy and radiculopathy, requires a blend of theoretical knowledge and practical skill. The complexity of these conditions, often necessitating surgical intervention, underscores the need for intricate understanding and precision in execution. Advancements in neurosurgical training, especially with the use of low-cost 3D models for simulating cervical spine tumor removal, are revolutionizing this field. These models provide the realistic and hands-on experience crucial for mastering complex neurosurgical techniques, filling gaps left by traditional educational methods. MATERIALS AND METHODS This study aimed to assess the effectiveness of 3D-printed cervical vertebrae models in enhancing surgical skills, focusing on tumor removal, and involving 20 young neurosurgery residents. These models, featuring silicone materials to simulate the spinal cord and tumor tissues, provided a realistic training experience. The training protocol included a laminectomy, dural incision, and tumor resection, using a range of microsurgical tools, focusing on steps usually performed by senior surgeons. RESULTS The training program received high satisfaction rates, with 85% of participants extremely satisfied and 15% satisfied. The 3D models were deemed very realistic by 85% of participants, effectively replicating real-life scenarios. A total of 80% found that the simulated pathologies were varied and accurate, and 90% appreciated the models' accurate tactile feedback. The training was extremely useful for 85% of the participants in developing surgical skills, with significant post-training confidence boosts and a strong willingness to recommend the program to peers. CONCLUSIONS Continuing laboratory training for residents is crucial. Our model offers essential, accessible training for all hospitals, regardless of their resources, promising improved surgical quality and patient outcomes across various pathologies.
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Affiliation(s)
- Albert Sufianov
- Federal State Budgetary Institution the Federal Center of Neurosurgery of the Ministry of Health of the Russian Federation, 625062 Tyumen, Russia
- Department of Neurosurgery, State Medical University (Sechenov University), 119991 Moscow, Russia
- Educational and Scientific Institute of Neurosurgery, Peoples’ Friendship University of Russia RUDN University, 117198 Moscow, Russia
| | - Carlos Salvador Ovalle
- Department of Neurosurgery, National University of Mexico Hospital General, Durango 34030, Mexico
| | - Omar Cruz
- Department of Neurosurgery, National University of Mexico Hospital General, Durango 34030, Mexico
| | - Javier Contreras
- Department of Neurosurgery, National University of Mexico Hospital General, Durango 34030, Mexico
| | - Emir Begagić
- Department of General Medicine, School of Medicine, University of Zenica, 72000 Zenica, Bosnia and Herzegovina
| | - Siddarth Kannan
- School of Medicine, University of Central Lancashire, Preston PR02AG, UK
| | | | - Gennady Chmutin
- Petrovsky Russian Scientific Center of Surgery, 121359 Moscow, Russia
| | - Garifullina Nargiza Askatovna
- Federal State Budgetary Institution the Federal Center of Neurosurgery of the Ministry of Health of the Russian Federation, 625062 Tyumen, Russia
| | - Jesus Lafuente
- Spine Center Hospital del Mar, Sagrat Cor University Hospital, 08029 Barcelona, Spain
| | - Jose Soriano Sanchez
- Instituto Soriano de Cirugía de Columna Mínimamente Invasiva at ABC Hospital, Neurological Center, Santa Fe Campus, Mexico City 05100, Mexico
| | - Renat Nurmukhametov
- NCC No. 2 Federal State Budgetary Scientific Institution Russian Scientific Center Named after. Acad. B.V. Petrovsky (Central Clinical Hospital Russian Academy of Sciences), 121359 Moscow, Russia
| | | | - Nikolay Peev
- Department of Neurosurgery, Russian People’s Friendship University, 117198 Moscow, Russia
| | - Mirza Pojskić
- Department of Neurosurgery, University Hospital Marburg, Baldingerstr., 35033 Marburg, Germany
| | - Gervith Reyes-Soto
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Ismail Bozkurt
- Department of Neurosurgery, Medical Park Ankara Hospital, Kent Koop Mah 1868. Sok, Batıkent Blv. No:15, 06680 Ankara, Turkey
- Department of Neurosurgery, School of Medicine, Yuksek Ihtisas University, 06520 Ankara, Turkey
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Ramirez MDJE, Montemurro N, Musa G, Chmutin GE, Nurmukhametov R, Rosario AR, Barza JL, Kaprovoy S, Konovalov N, Kudriavtsev D, Mukengeshay JN, Kalangu KK, Kachinga S, Sufianov A, Simfukwe K, Baeza-Antón L, Kutty RK, El-Ghandour NMF, Garozzo D. On the balance beam: facing the challenges of neurosurgical education in the third millennium. Surg Neurol Int 2024; 15:102. [PMID: 38628530 PMCID: PMC11021083 DOI: 10.25259/sni_1014_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
Background Neurosurgery is one of the most complex and challenging areas of medicine, and it requires an ongoing commitment to education and expertise. Preparing young neurosurgeons with comprehensive education that can allow them to achieve high professional standards is a pivotal aspect of our profession. Methods This paper aims to analyze the current scenario in neurosurgical training identifying innovative methods that can guarantee the highest level of proficiency in our specialty. Results Given the inherent high-stakes nature of neurosurgical procedures, there is a significant burden of responsibility in ensuring that neurosurgical training is of the highest caliber, capable of producing practitioners who possess not just theoretical knowledge but also practical skills and well-tuned judgment. Conclusion Providing high-quality training is one of the major challenges that the neurosurgical community has to face nowadays, especially in low- and middle-income countries; one of the main issues to implementing neurosurgery worldwide is that the majority of African countries and many areas in Southeast Asia still have few neurosurgeons who encounter enormous daily difficulties to guarantee the appropriate neurosurgical care to their population.
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Affiliation(s)
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Gerald Musa
- Department of Neurological Diseases and Neurosurgery, Peoples Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Gennady E. Chmutin
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Renat Nurmukhametov
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Andreina Rosario Rosario
- Department of Neurosurgery, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
| | - Jesus Lafuente Barza
- Department of Neurosurgery, Spine Center Hospital del Mar, Sagrat Cor University Hospital, Barcelona, Spain
| | - Stanislav Kaprovoy
- Department of Neurosurgery, N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Nikolay Konovalov
- Department of Neurosurgery, N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Dmitry Kudriavtsev
- Department of Neurosurgery, Podolsk Regional Hospital, Moscow, Russian Federation
| | | | - Kazadi Kelvin Kalangu
- Department of Neurosurgery, University of Zimbabwe, College of Health Sciences, Zimbabwe
| | - Sichizya Kachinga
- Department of Neurosurgery, University Teaching Hospital, Lusaka, Zambia
| | - Albert Sufianov
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
- Federal Centre of Neurosurgery, Tyumen, Russia
- Department of Neurosurgery, State Medical University (Sechenov University), Moscow, Russia
| | - Keith Simfukwe
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Laura Baeza-Antón
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork Presbyterian Hospital, New York, United States
| | - Raja K. Kutty
- Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India
| | | | - Debora Garozzo
- Department of Neurosurgery, Mediclinic Parkview Hospital, Dubai, United Arab Emirates
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Jalolova M, Jankovic D, Sasaki K, Tanaka R, Kato Y. Simulation-Based Bypass Training and Learning Curves-Resident Experience. Asian J Neurosurg 2023; 18:773-776. [PMID: 38161618 PMCID: PMC10756769 DOI: 10.1055/s-0043-1775859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Introduction Bypass surgery is a challenging operative procedure that requires surgical excellence. Achieving the skills required for vascular surgery is difficult to master in the operating room without intensive microsurgical training. Various models have been developed to provide training to young neurosurgeons and increase dexterity and patient safety. Bypass surgery requires complex microsurgical techniques. Methods Microanastomosis training was performed on plastic tubes and chicken wings for 2 months. Each microanastomosis was evaluated by a senior author. Results An improvement in the quality and patency of microanastomosis was observed. Conclusion Microsurgical simulation training can contribute to the improvement of surgical skills and dexterity.
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Affiliation(s)
- Mohira Jalolova
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
- Republican Scientific Center of Neurosurgery, Tashkent Medical Academy, Uzbekistan
| | - Dragan Jankovic
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
- Department of Neurosurgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
| | - Kento Sasaki
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
| | - Riki Tanaka
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
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Weber M, Backhaus J, Lutz R, Nobis CP, Zeichner S, Koenig S, Kesting M, Olmos M. A novel approach to microsurgical teaching in head and neck surgery leveraging modern 3D technologies. Sci Rep 2023; 13:20341. [PMID: 37990073 PMCID: PMC10663471 DOI: 10.1038/s41598-023-47225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023] Open
Abstract
The anatomically complex and often spatially restricted conditions of anastomosis in the head and neck region cannot be adequately reproduced by training exercises on current ex vivo or small animal models. With the development of a Realistic Anatomical Condition Experience (RACE) model, complex spatial-anatomical surgical areas and the associated intraoperative complexities could be transferred into a realistic training situation in head and neck surgery. The RACE model is based on a stereolithography file generated by intraoperative use of a three-dimensional surface scanner after neck dissection and before microvascular anastomosis. Modelling of the acquired STL file using three-dimensional processing software led to the model's final design. As a result, we have successfully created an economical, sustainable and realistic model for microsurgical education and provide a step-by-step workflow that can be used in surgical and general medical education to replicate and establish comparable models. We provide an open source stereolithography file of the head-and-neck RACE model for printing for educational purposes. Once implemented in other fields of surgery and general medicine, RACE models could mark a shift in medical education as a whole, away from traditional teaching principles and towards the use of realistic and individualised simulators.
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Affiliation(s)
- Manuel Weber
- Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054, Erlangen, Germany.
| | - Joy Backhaus
- Institute of Medical Teaching and Medical Education Research, University Hospital of Würzburg, Würzburg, Germany
| | - Rainer Lutz
- Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054, Erlangen, Germany
| | - Christopher-Philipp Nobis
- Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054, Erlangen, Germany
| | | | - Sarah Koenig
- Institute of Medical Teaching and Medical Education Research, University Hospital of Würzburg, Würzburg, Germany
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054, Erlangen, Germany
| | - Manuel Olmos
- Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054, Erlangen, Germany
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Jensen MA, Bhandarkar AR, Bauman MMJ, Riviere-Cazaux C, Wang K, Carlstrom LP, Graffeo CS, Spinner RJ. The LazyBox Educational Intervention Trial: Can Longitudinal Practice on a Low-Fidelity Microsurgery Simulator Improve Microsurgical Skills? Cureus 2023; 15:e49675. [PMID: 38161921 PMCID: PMC10757503 DOI: 10.7759/cureus.49675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Every surgical trainee must acquire microsurgical skills within a limited timeframe. Therefore, identifying effective educational strategies to help learners attain these skills is crucial. Objective Establish the effectiveness of a low-fidelity microsurgery simulator to improve the execution and one's perception of the difficulty of basic surgical techniques. Methods From 2021 to 2022, 24 medical students were randomized to either (1) a treatment group (n=12) that engaged in longitudinal practice on a low-fidelity microsurgery simulator (the LazyBox) or (2) a control group (n=12) that did not practice. Students performed vessel loop ligation, catheter macroanastomosis, and synthetic vessel microanastomosis prior to and six weeks after intervention. Both objective metrics and subjective metrics (Swedish Occupational Fatigue Inventory (SOFI) and Surgery Task Load Index (SURG-TLX)) were obtained. Results The treatment and control arms had 1.2 (SD = 2.6) and 2.1 (SD = 2.4) points increase in the vessel loop ligation, respectively (p = 0.39). The treatment and control arms had a 3.4 (SD = 4.1) and 2.9 (SD = 3.6) points increase in the macroanastomosis task, respectively (p = 0.74). In the synthetic vessel microanastomosis task training, the experimental and control arms showed a 5.4 (SD = 8.3) and a 2.9 (SD = 5.6) points increase, respectively (p = 0.30). No differences were found between the groups regarding survey metrics of mental (p = 0.82), temporal (p = 0.23), and physical demands (p = 0.48). Conclusion In our randomized educational intervention, we found no significant difference in objective and subjective metrics of microsurgical task performance between learners who did and did not use the LazyBox simulator.
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Affiliation(s)
- Michael A Jensen
- Neurosurgery, Mayo Clinic Alix School of Medicine, Rochester, USA
| | | | - Megan M J Bauman
- Neurosurgery, Mayo Clinic Alix School of Medicine, Rochester, USA
| | | | - Kimberly Wang
- Neurosurgery, Mayo Clinic Alix School of Medicine, Rochester, USA
| | | | | | - Robert J Spinner
- Neurosurgery, Mayo Clinic Alix School of Medicine, Rochester, USA
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Núñez RYG, Córdova KRG, de Carvalho YK. Tridimensional models and radiographic study of dorsal laminectomy and thoracolumbar hemilaminectomy in dogs. Acta Cir Bras 2023; 38:e382623. [PMID: 37556719 PMCID: PMC10403244 DOI: 10.1590/acb382623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/07/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE To create three-dimensional anatomical models of the thoracic and lumbar portions of the canine spine that reproduce the vertebral surgical approaches of dorsal laminectomy and hemilaminectomy, and to perform the respective radiographic evaluations of each approach. METHODS In a digital archive of the canine spine, digitally replicate the dorsal laminectomy and hemilaminectomy in the thoracic and lumbar portions and, then, make tridimensional prints of the vertebral models and obtain radiographs in three dorsoventral, ventrodorsal and laterolateral projections. RESULTS The anatomical models of the surgical spinal canal accesses of the thoracic and lumbar portions showed great fidelity to the natural bones. The created accesses have the proper shape, location and size, and their radiographic images showed similar radiodensities. CONCLUSIONS The replicas of the dorsal laminectomy and hemilaminectomy developed in the anatomical models in the thoracic and lumbar portions are able to represent the technical recommendations of the specialized literature, as well as their respective radiographic images, which have certain radiological properties that allow to make a deep radiological study. Therefore, the models are useful for neurosurgical training.
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Affiliation(s)
- Ricardo Ysaac García Núñez
- Universidade Federal do Acre – Graduate Program in Animal Health and Production – Rio Branco (AC), Brazil
| | | | - Yuri Karaccas de Carvalho
- Universidade Federal do Acre – Centro de Ciências Biológicas e da Natureza – Rio Branco (AC), Brazil
- Universidade Federal Fluminense – Faculdade de Medicina Veterinária – Departamento de Patologia e Clínica Veterinária – Niterói (RJ), Brazil
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Belykh E, Abramov I, Bardonova L, Patel R, McBryan S, Enriquez Bouza L, Majmundar N, Zhao X, Byvaltsev VA, Johnson SA, Singla A, Gupta G, Sun H, Liu JK, Nanda A, Preul MC, Lawton MT. Seven bypasses simulation set: description and validity assessment of novel models for microneurosurgical training. J Neurosurg 2023; 138:732-739. [PMID: 35932275 DOI: 10.3171/2022.5.jns22465] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Microsurgical training remains indispensable to master cerebrovascular bypass procedures, but simulation models for training that accurately replicate microanastomosis in narrow, deep-operating corridors are lacking. Seven simulation bypass scenarios were developed that included head models in various surgical positions with premade approaches, simulating the restrictions of the surgical corridors and hand positions for microvascular bypass training. This study describes these models and assesses their validity. METHODS Simulation models were created using 3D printing of the skull with a designed craniotomy. Brain and external soft tissues were cast using a silicone molding technique from the clay-sculptured prototypes. The 7 simulation scenarios included: 1) temporal craniotomy for a superficial temporal artery (STA)-middle cerebral artery (MCA) bypass using the M4 branch of the MCA; 2) pterional craniotomy and transsylvian approach for STA-M2 bypass; 3) bifrontal craniotomy and interhemispheric approach for side-to-side bypass using the A3 branches of the anterior cerebral artery; 4) far lateral craniotomy and transcerebellomedullary approach for a posterior inferior cerebellar artery (PICA)-PICA bypass or 5) PICA reanastomosis; 6) orbitozygomatic craniotomy and transsylvian-subtemporal approach for a posterior cerebral artery bypass; and 7) extended retrosigmoid craniotomy and transcerebellopontine approach for an occipital artery-anterior inferior cerebellar artery bypass. Experienced neurosurgeons evaluated each model by practicing the aforementioned bypasses on the models. Face and content validities were assessed using the bypass participant survey. RESULTS A workflow for model production was developed, and these models were used during microsurgical courses at 2 neurosurgical institutions. Each model is accompanied by a corresponding prototypical case and surgical video, creating a simulation scenario. Seven experienced cerebrovascular neurosurgeons practiced microvascular anastomoses on each of the models and completed surveys. They reported that actual anastomosis within a specific approach was well replicated by the models, and difficulty was comparable to that for real surgery, which confirms the face validity of the models. All experts stated that practice using these models may improve bypass technique, instrument handling, and surgical technique when applied to patients, confirming the content validity of the models. CONCLUSIONS The 7 bypasses simulation set includes novel models that effectively simulate surgical scenarios of a bypass within distinct deep anatomical corridors, as well as hand and operator positions. These models use artificial materials, are reusable, and can be implemented for personal training and during microsurgical courses.
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Affiliation(s)
- Evgenii Belykh
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.,2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Irakliy Abramov
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Liudmila Bardonova
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Ruchi Patel
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Sarah McBryan
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Lara Enriquez Bouza
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Neil Majmundar
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.,2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Xiaochun Zhao
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | | | - Stephen A Johnson
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Amit Singla
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Gaurav Gupta
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Hai Sun
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - James K Liu
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Anil Nanda
- 2Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and
| | - Mark C Preul
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Michael T Lawton
- 1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
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Podkovik S, Patchana T, Farr S, Brazdzionis J, Marino M, Savla P, Kashyap S, Chin B, Crouch A, Miulli DE. External Ventricular Drain (EVD) Placement Using a Hands-On Training Session on a Simple Three-Dimensional (3D) Model. Cureus 2022; 14:e28014. [PMID: 36134074 PMCID: PMC9470865 DOI: 10.7759/cureus.28014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/14/2022] [Indexed: 11/29/2022] Open
Abstract
Neurosurgery is a demanding field with small margins of error within the operative field. Small errors can yield devastating consequences. Simulation has been proposed as a methodology for improving surgical skills within the neurosurgical realm. This study was conducted to investigate a novel realistic design for a clinical simulation based, low-cost alternative of external ventricular drain (EVD) placement, an essential basic neurosurgical procedure that is necessary for clinicians to master. A low-cost three-dimensional (3D) printed head using thermoplastic polylactic acid was designed with the tactile feedback of outer table, cancellous bone, and inner tables for drilling with replaceable frontal bones pieces for multi-use purposes. An agar gel filled with water was designed to simulate tactile passage through the cortex and into the ventricles. Neurosurgical and emergency resident physicians participated in a didactic session and then attempted placement of an EVD using the model to gauge the simulated model for accuracy and realism. Positioning, procedural time, and realism was evaluated. Improvements in procedural time and positioning were identified for both neurosurgical and emergency medicine (EM) residents. Catheter placement was within ideal position for all participants by the third attempt. All residents stated they felt more comfortable with placement with subsequent attempts. Neurosurgical residents subjectively noted similarities in tactile feedback during drilling compared to in-vivo. A low-cost realistic 3D printed model simulating basic neurosurgical procedures demonstrated improved procedural times and precision with neurosurgical and EM residents. Further, similarities between in-vivo tactile feedback and the low-cost simulation technology was noted. This low cost-model may be used as an adjunct for teaching to promote early procedural competency in neurosurgical techniques to promote learning without predisposition to patient morbidity.
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Park CK. 3D-Printed Disease Models for Neurosurgical Planning, Simulation, and Training. J Korean Neurosurg Soc 2022; 65:489-498. [PMID: 35762226 PMCID: PMC9271812 DOI: 10.3340/jkns.2021.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/17/2021] [Indexed: 11/27/2022] Open
Abstract
Spatial insight into intracranial pathology and structure is important for neurosurgeons to perform safe and successful surgeries. Three-dimensional (3D) printing technology in the medical field has made it possible to produce intuitive models that can help with spatial perception. Recent advances in 3D-printed disease models have removed barriers to entering the clinical field and medical market, such as precision and texture reality, speed of production, and cost. The 3D-printed disease model is now ready to be actively applied to daily clinical practice in neurosurgical planning, simulation, and training. In this review, the development of 3D-printed neurosurgical disease models and their application are summarized and discussed.
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Affiliation(s)
- Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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