, the survey has been designed with specific reference to both the technical steps of the procedure and intraoperative errors committed by trainees while learning the technique. The data generated will inform the design of future VR simulation training platforms, curricula, and assessment metrics for ETV, potentially reducing adverse events for patients undergoing this procedure. Methods Study Design This cross-sectional study used mixed-methods survey methodology. A self-administered, structured online questionnaire consisting of 10 questions requested
Faizal A. Haji, Adam Dubrowski, James Drake, and Sandrine de Ribaupierre
Andrew M. Gardeck, Xuan Pu, Qiuyu Yang, David W. Polly, and Kristen E. Jones
Educational procedural simulation has been utilized in several areas of neurosurgery to provide a safe, reproducible learning experience prior to patient contact to maximize competency while working within the constraints of work-hour regulations. 9 , 10 Simulation training with either virtual simulators or physical spine models is portable, widely available, and reproducible. Simulation has therefore been used for spinal instrumentation placement training and results in increased learning retention and improved accuracy with repetition. 11–16 To our knowledge, there is
Eisha A. Christian, Joshua Bakhsheshian, Ben A. Strickland, Vance L. Fredrickson, Ian A. Buchanan, Martin H. Pham, Andrew Cervantes, Michael Minneti, Bozena B. Wrobel, Steven Giannotta, and Gabriel Zada
suprasellar arachnoid ( Fig. 2 ). Trainees then practiced repairing the CSF leak using a combination of fat, fascia lata, and pedicled nasoseptal flaps ( Fig. 3 ). Standard CSF repair techniques included a 2-layer fascial apposition method, as described by Couldwell et al., in which the sella turcica was packed with a fat graft and covered using a pedicled nasoseptal flap ( Video 1 ). 5 VIDEO 1. Video demonstrating the use of a perfusion-based human cadaveric specimen as a simulation training model in repairing CSF leaks during endoscopic endonasal skull base surgery. The
Debayan Dasgupta, Linda D’Antona, Daniel Aimone Cat, Ahmed K. Toma, Carmel Curtis, Laurence D. Watkins, and Lewis Thorne
improve placement of EVDs and reduce the rate of ERIs. We used two major interventions: the implementation of a standardized perioperative care bundle, supported by a series of advanced simulation training workshops to train the surgeons who undertake the procedure in the consensus-approved optimal method of insertion. Methods This quality-improvement project was registered with the Clinical Governance and Audit Department of the National Hospital for Neurology and Neurosurgery in London. The implementation of the standardized care bundle for EVD placement
Grace M. Thiong’o, Thomas Looi, James T. Rutka, Abhaya V. Kulkarni, and James M. Drake
’ knowledge, there is no record of a cerebral hemispheric surgery simulator prior to the invention described in this paper, due partly to a redundancy of materials available to simulate the nuances of hemispheric disconnection. 24 , 25 In an attempt to fill the gap in epilepsy surgery simulation training, our paper describes the design workflow of a novel, hands-on cerebral hemispheric surgical simulator and its validation as a useful tool for neurosurgical education through face, content, and construct validity studies. Methods The research and methodologies
Vivek P. Bodani, Gerben E. Breimer, Faizal A. Haji, Thomas Looi, and James M. Drake
resident work-hour restrictions have also played a significant role. 8 , 14 , 19 , 21 These challenges have led surgical educators to consider alternative methods of training and assessment, including the incorporation of surgical simulation into the training curriculum. Surgical simulators may allow trainees to engage in deliberate practice of surgical skills in a stress-free environment without any risk to patients. 6 , 13 , 22 Neuroendoscopic procedures are ideal for simulation training as they are technically challenging (constrained workspace, restricted field of
Marc Zanello, Thomas Baugnon, Alexandre Roux, and Federico Di Rocco
peer teaching in paediatric simulation training is a feasible low-cost alternative for education . Acta Paediatr 106 : 995 – 1000 , 2017 10.1111/apa.13792 28244140
Catherine Y. Lau, S. Ryan Greysen, Rita I. Mistry, Seunggu J. Han, Praveen V. Mummaneni, and Mitchel S. Berger
handoffs as well as lack of standardization in clinical protocols. 1 , 5 , 6 , 8 , 9 , 16 Despite these factors, promising work has been done in the surgical field to increase patient safety through the use of checklists, simulation training, and teamwork training to increase the quality of teamwork in the operating room. 3 , 8 , 13 , 15 , 17 , 18 Perhaps one of the strongest endorsements for the use of surgical checklists was demonstrated by the WHO Safe Surgery Saves Lives campaign. The implementation of this standardized, easy-to-use checklist not only has improved
Evgenii Belykh, Ting Lei, Sam Safavi-Abbasi, Kaan Yagmurlu, Rami O. Almefty, Hai Sun, Kaith K. Almefty, Olga Belykh, Vadim A. Byvaltsev, Robert F. Spetzler, Peter Nakaji, and Mark C. Preul
Microvascular anastomosis is a basic neurosurgical technique that should be mastered in the laboratory. Human and bovine placentas have been proposed as convenient surgical practice models; however, the histologic characteristics of these tissues have not been compared with human cerebral vessels, and the models have not been validated as simulation training models. In this study, the authors assessed the construct, face, and content validities of microvascular bypass simulation models that used human and bovine placental vessels.
The characteristics of vessel segments from 30 human and 10 bovine placentas were assessed anatomically and histologically. Microvascular bypasses were performed on the placenta models according to a delineated training module by “trained” participants (10 practicing neurosurgeons and 7 residents with microsurgical experience) and “untrained” participants (10 medical students and 3 residents without experience). Anastomosis performance and impressions of the model were assessed using the Northwestern Objective Microanastomosis Assessment Tool (NOMAT) scale and a posttraining survey.
Human placental arteries were found to approximate the M2–M4 cerebral and superficial temporal arteries, and bovine placental veins were found to approximate the internal carotid and radial arteries. The mean NOMAT performance score was 37.2 ± 7.0 in the untrained group versus 62.7 ± 6.1 in the trained group (p < 0.01; construct validity). A 50% probability of allocation to either group corresponded to 50 NOMAT points. In the posttraining survey, 16 of 17 of the trained participants (94%) scored the model's replication of real bypass surgery as high, and 16 of 17 (94%) scored the difficulty as “the same” (face validity). All participants, 30 of 30 (100%), answered positively to questions regarding the ability of the model to improve microsurgical technique (content validity).
Human placental arteries and bovine placental veins are convenient, anatomically relevant, and beneficial models for microneurosurgical training. Microanastomosis simulation using these models has high face, content, and construct validities. A NOMAT score of more than 50 indicated successful performance of the microanastomosis tasks.
and the VE reconstruction for SACs diagnosis and surgical planning and assessment. 3D Slicer VE modeling is rapid, low-cost and patient-specific which is applicable in SACs diagnosing and endoscopic training. J Neurosurg Journal of Neurosurgery JNS 0022-3085 1933-0693 American Association of Neurological Surgeons 2015.8.JNS.AANS2015ABSTRACTS Abstract 519. Simulation Training and Improved Performance: Neuroendoscopy Training Using the NeuroTouch Haptic Feedback Platform Jayesh Thawani , MD , Jayesh Thawani