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Arnau Benet, Jordina Rincon-Torroella, Michael T. Lawton, and J. J. González Sánchez

N eurosurgery is one of the most challenging surgical specialties because it deals with the most complex and fragile organ in the human body—the brain—and because it requires a combination of precise technical skills, experience in the surgical setting, and superb knowledge of anatomy. Surgical simulation using a cadaveric human head is one of the most valid strategies for neurosurgical research and training because it provides the closest approximation to a live surgical procedure with true human anatomy. Several models for neurosurgical training have

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Matthew A. Kirkman, Maria Ahmed, Angelique F. Albert, Mark H. Wilson, Dipankar Nandi, and Nick Sevdalis

the effect of resident duty-hour restrictions as stipulated by the Accreditation Council for Graduate Medical Education (ACGME) is an increase in adverse patient outcomes. 17 As such, working-hour restrictions necessitate the delivery of high-quality, time-effective training to surgeons to ensure optimal patient outcomes. Simulation has been postulated as a potential solution to the challenge of providing appropriate training in less time 21 , 50 and represents a useful proxy measure for expert surgical performance. Simulation as a concept is diverse and can

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Daniel R. Cleary, Dominic A. Siler, Nathaniel Whitney, and Nathan R. Selden

without experience or direct support. In 2009, postgraduate year 1 (PGY1) neurological surgery residents attended a Society of Neurological Surgeons (SNS) pilot “boot camp” course designed in part to enhance their familiarity with and safety performing neurosurgical procedures and basic operative skills prior to practicing them in the live clinical environment. 24 , 25 Simulation training early in residency is effective in improving residents’ confidence in and proficiency with basic technical skills, as well as knowledge retention. 3 , 9 , 23 Neurosurgery program

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Sean Sullivan, Pedro Aguilar-Salinas, Roberta Santos, Alexandra D. Beier, and Ricardo A. Hanel

F or many years simulation has been used in a variety of fields, from aviation to general surgery, as a training tool to gain technical skills through repetition while also rehearsing procedures in a safe environment. 12 , 17 The use of simulation in neurointervention to acquire and enhance skills before treating a patient is more recent, but the lack of good models and deficient haptics have limited its utilization. The advent of 3D printing technology and the development of new training models have modified this landscape. The use of simulation in

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Jesse L. Winer, Daniel R. Kramer, Richard A. Robison, Ifije Ohiorhenuan, Michael Minneti, Steven Giannotta, and Gabriel Zada

to operative cases throughout the training process may be a progressively limiting factor in education. For these reasons, surgical simulation in 3D virtual reality and live-tissue models for trainee education has garnered considerable popularity in recent years. 9 , 11 , 12 , 14 The ability to rehearse skills required to perform key steps in an operative procedure before performing live surgery, acquire basic familiarity with equipment and surgical approaches, and build the psychosomatic foundations required to perform a given operation may improve surgical

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Daniel A. Donoho, Dhiraj J. Pangal, Guillaume Kugener, Martin Rutkowski, Alexander Micko, Shane Shahrestani, Andrew Brunswick, Michael Minneti, Bozena B. Wrobel, and Gabriel Zada

experience. 4 , 5 When technical skill cannot be learned during standard surgical education, surgeons often turn to simulation. 6 Most technical skill simulations train for complex, high-fidelity rehearsals or routine scenarios where minimum performance can be improved using low-cost materials. 8 Simulation for surgeons to achieve mastery of rare, life-threatening complications does not fit the context of many routine simulation scenarios. During the creation of our departmental simulation curriculum, 9 we recognized the importance of specific training to manage ICAI

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Avital Perry, Christopher S. Graffeo, Lucas P. Carlstrom, William J. Anding, Michael J. Link, and Leonardo Rangel-Castilla

animals, perfused human or animal cadavers, placenta, virtual reality, augmented reality, haptic controllers, molded or cast synthetics, 3D printing, and many others. 1 , 3 , 4 , 6–9 , 14–16 , 18 , 21 , 22 , 24–27 , 29 The development of a sophisticated microsurgical skill set—the pillar of many neurosurgical niches—is simultaneously more susceptible to erosion in the current clinical context and also more challenging to meaningfully replicate in a simulation environment, given that few high-fidelity models have been developed or validated. Open cerebrovascular

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Makoto Oishi, Masafumi Fukuda, Tetsuya Hiraishi, Naoki Yajima, Yosuke Sato, and Yukihiko Fujii

surgical procedures. 13 , 15 , 20 , 21 , 26 There are recent reports demonstrating a 3D interactive computer simulation system applicable not only to surveying 3D data visually but also to manipulating data by employing haptic sensations through a specific device. 13 , 15 , 26 Neurovascular compression syndromes, such as trigeminal neuralgia and hemifacial spasm, are defined as hyperactive dysfunctions involving the cranial nerves and have been explained as being caused by anatomical factors including vascular compression of the cranial nerve. 6 The success of MVD

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Prem Venugopal, Daniel Valentino, Holger Schmitt, J. Pablo Villablanca, Fernando Viñuela, and Gary Duckwiler

D iseases of the cerebrovasculature, such as stroke, are a leading cause of death and disability in developed countries. Cerebral aneurysms are dilations of the vascular wall, the rupture of which can lead to the most severe form of stroke—hemorrhagic stroke. The anatomy, hemodynamics, and biomechanics of the vasculature are believed to be important in the growth and rupture of these vascular lesions, but little is known about the relative significance of these factors. Numerical simulations can facilitate the investigation of brain aneurysm hemodynamics

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Faizal A. Haji, Adam Dubrowski, James Drake, and Sandrine de Ribaupierre

, trainees' direct surgical experience has been further eroded by increasing subspecialization of surgeons, technological advances in the delivery of care, and increased emphasis on mitigating medical error. 29 , 35 Together these factors have created an environment in which operative exposure is far less than what Halsted originally envisioned. As a result, interest in SBME has increased dramatically. With the introduction of the FLS program developed by the American College of Surgeons and the Society of American Gastrointestinal Endoscopic Surgeons, simulation