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Francisco Vaz Guimarães Filho, Giselle Coelho, Sergio Cavalheiro, Marcos Lyra, and Samuel T. Zymberg

N eurosurgical skill formation is a long, consuming process. During the first years of resident training, initial support is provided by anatomical lectures and direct or indirect (video sessions) observation of surgeries. However, improvement in surgical techniques and manual skills must still be accomplished through laboratory training followed by supervised surgeries. Several models are used in surgical training: cadaveric or animal models as well as surgical simulators. 2 , 4 , 5 , 7 , 8 , 10–12 , 14–16 , 22–24 Unfortunately, financial, technical, and

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Jia-Ping Zheng, Chu-Zhong Li, and Guo-Qiang Chen

P ituitary adenomas are common tumors that occur in the pituitary gland. The mainstay of treatment for pituitary adenomas is resection. Furthermore, endoscopic endonasal transsphenoidal surgery (EETSS) has been widely used as a safe approach. EETSS provides a clearer surgical panoramic view, and allows for a more complete tumor removal. 5 , 6 , 8 , 12 However, transnasal endoscopic surgery has a steep learning curve, and young neurosurgeons face great challenges. 4 , 21 The lack of a convenient and practical model for anatomical learning and surgical training

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Rimal Hanif Dossani, John Shaughnessy, Piyush Kalakoti, and Anil Nanda

for the United States or the United Kingdom to gain surgical training. Gallie’s influence was not limited to a single surgical discipline. His other novel contributions to surgery include his work on tendon fixation for repair of pediatric foot deformities and use of fascia lata autograft for closure of large ventral abdominal hernias. 7 , 9 Gallie was a prolific leader and educator. He served as the longest acting President of the American College of Surgeons from 1941 to 1947. 12 This historical article describes Gallie’s life and details his contributions to

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Giselle Coelho, Eduardo Vieira, Jose Hinojosa, and Hans Delye

: Coelho. Supervision: Coelho. Defining video content/format together with corresponding author: Delye. References 1 Coelho G , Warf B , Lyra M , Zanon N . Anatomical pediatric model for craniosynostosis surgical training . Childs Nerv Syst . 2014 ; 30 ( 12 ): 2009 – 2014 . 2 Coelho G , Figueiredo EG , Rabelo NN , . Development and evaluation of a new pediatric mixed-reality model for neurosurgical training . J Neurosurg Pediatr . 2019 ; 24 ( 4 ): 423 – 432 . 3 Hinojosa J , Esparza J , Muñoz MJ . Endoscopic

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Tufan Hicdonmez, Turgay Parsak, and Sebahattin Cobanoglu

procedures must be followed, and the neurosurgical tools and microplates used should be instruments dedicated solely to laboratory training. In terms of its advantages for craniofacial surgical training, this model offers opportunities to practice performing subperiosteal and subperiorbital dissection in and around the orbits, cutting bone with an osteotome, mobilizing the supraorbital bar, and handling rigid fixation devices such as microplates and screws. However, training on sheep cadavers should not be substituted for other modes of training, especially training on

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Emad Aboud, Ossama Al-Mefty, and M. Gazi Yaşargil

surgical approaches, including skull base, neurovascular, endoscopic, and even endovascular procedures. The presence of clear fluid in the subarachnoid spaces, the pulsation, and the vascular filling give greater realism to these training procedures. This model provides the trainee with a unique opportunity to practice hemostasis, management of bleeding, and the paramount tasks of surgical training under crisis conditions, such as the presence of a ruptured aneurysm, which are not available using any alternative model. Similar opportunities for training can be offered to

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

acquisition of neuroendoscopic skills. 8 Despite the obvious advantages of a cadaveric model as pertains to real human tissue and normal anatomical variations, thus far it has been virtually impossible to simulate neuroendoscopic intraventricular approaches. Cadavers lack the circulating CSF system required for performing intraventricular neuroendoscopy, and to our knowledge no prior method of reconstituting ventricular CSF flow has been successfully developed and used for surgical training purposes. Tubbs et al. injected saline directly into the ventricles of cadavers

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Emad Aboud, Ghaith Aboud, Ossama Al-Mefty, Talal Aboud, Stylianos Rammos, Mohammad Abolfotoh, Sanford P. C. Hsu, Sebastian Koga, Adam Arthur, and Ali Krisht

toward minimal or even noninvasive treatment of surgical pathologies have resulted in residents’ decreased exposure to major surgeries. This decreased exposure becomes particularly crucial in vascular surgery when surgeons encounter vascular injuries and intraoperative rupture of cerebral aneurysms; thus, the call for significant training in a laboratory setting. 4 , 7 Although the training models and simulators currently available provide a wide range of opportunities to practice skills and play a unique role in surgical training, they do not successfully replicate

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Mihir Gupta, Allison Reichl, Luis Daniel Diaz-Aguilar, Pate J. Duddleston, Jamie S. Ullman, Karin M. Muraszko, Shelly D. Timmons, Isabelle M. Germano, Aviva Abosch, Jennifer A. Sweet, Susan C. Pannullo, Deborah L. Benzil, and Sharona Ben-Haim

neurosurgery: inequality redux . J Neurosurg . 2018 ; 129 ( 2 ): 277 – 281 . 5 Agarwal N , White MD , Pannullo SC , Chambless LB . Analysis of national trends in neurosurgical resident attrition . J Neurosurg . 2019 ; 131 ( 5 ): 1668 – 1673 . 6 Rangel EL , Smink DS , Castillo-Angeles M , Pregnancy and motherhood during surgical training . JAMA Surg . 2018 ; 153

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Irving J. Sherman, Ryan M. Kretzer, and Rafael J. Tamargo

time, the surgical subspecialties were not sufficiently developed to stand apart from general surgery or train their own residents. Although Halsted established separate clinics for the various surgical subspecialties, including a division for diseases of the nervous system, his residents trained in all fields of surgery. 4 Halsted’s revolutionary surgical residency program set the precedent for surgical training in the United States. Initially, a prospective resident completed an internship of undefined length, until Halsted felt that the individual was skilled