Abstract
Background
The development of high levels of technical competence and excellent decision-making skills are key goals of all neurosurgical residency training programs. This acquisition of technical skills is becoming increasingly difficult due to many factors including less exposure to operative cases, demand for more time and cost-effective practices, and resident work hour restrictions. We describe a step-by-step method for how to build a low-cost and feasible model that allows residents to improve their neuroendoscopic skills.
Methods
The bell pepper-based model was developed as an endoscopic training model. Using continuous irrigation, several hands-on procedures were proposed under direct endoscopic visualization. Endoscope setup, endoscopic third ventriculostomy, septostomy, and tumor biopsy procedures were simulated and video recorded for further edition and analysis.
Results
The model can be setup in less than 15 min with minimal cost and infrastructure requirements. A single model allows simulation of all the exercises described above. The model allows exposure to the camera skills, instrument handling, and hand-eye coordination inherent to most neuroendoscopic procedures.
Conclusion
Minimal infrastructure requirements, simplicity, and easily setup models provide a proper environment for regular training. The bell pepper-based model is inexpensive, widely available, and a feasible model for routine training. Neurosurgery residents may benefit from the use of this model to accelerate their learning curve and familiarize themselves with the neuroendoscopic core principles in a risk-free environment without time or resource constraints.
Similar content being viewed by others
Availability of data and material
Not applicable.
Code availability
Not applicable.
References
Breimer GE, Bodani V, Looi T, Drake JM (2015) Design and evaluation of a new synthetic brain simulator for endoscopic third ventriculostomy. J Neurosurg Pediatr 15:82–88
Ahmed N, Devitt KS, Keshet I et al (2014) A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes. Ann Surg 259:1041–1053
Feng H, Huang G, Liao X et al (2004) Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis. J Neurosurg 100:626–633
McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB (2011) Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 86:706–711
Olabe J, Olabe J (2009) Microsurgical training on an in vitro chicken wing infusion model. Surg Neurol 72:695–699
Di Somma A, Narros Gimenez JL, Almarcha Bethencourt JM, Cavallo LM, Márquez-Rivas J (2019) Neuroendoscopic intraoperative ultrasound-guided technique for biopsy of paraventricular tumors. World Neurosurg 122:441–450
Cinalli G, Salazar C, Mallucci C, Yada JZ, Zerah M, Sainte-Rose C (1998) The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery 43:1323–1327 discussion 1327-1329
Durkin ET, McDonald R, Munoz A, Mahvi D (2008) The impact of work hour restrictions on surgical resident education. J Surg Educ 65:54–60
Tubbs RS, Loukas M, Shoja MM, Wellons JC, Cohen-Gadol AA (2009) Feasibility of ventricular expansion postmortem: a novel laboratory model for neurosurgical training that simulates intraventricular endoscopic surgery. J Neurosurg 111:1165–1167
Zymberg S, Vaz-Guimarães Filho F, Lyra M (2010) Neuroendoscopic training: presentation of a new real simulator. Minim Invasive Neurosurg 53:44–46
Cohen AR, Lohani S, Manjila S, Natsupakpong S, Brown N, Cavusoglu MC (2013) Virtual reality simulation: basic concepts and use in endoscopic neurosurgery training. Childs Nerv Syst 29:1235–1244
Zhu J, Yang J, Tang C, Cong Z, Cai X, Ma C (2020) Design and validation of a 3D-printed simulator for endoscopic third ventriculostomy. Childs Nerv Syst 36:743–748
Romero AD, Zicarelli CA, Pinto FC, Pasqualucci CA, Aguiar PH (2009) Simulation of endoscopic third ventriculostomy in fresh cadaveric specimens. Minim Invasive Neurosurg 52:103–106
Hayashi N, Kurimoto M, Hamada H, Kurosaki K, Endo S, Cohen AR (2008) Preparation of a simple and efficient laboratory model for training in neuroendoscopic procedures. Childs Nerv Syst 24:749–751
Wen G, Cong Z, Liu K et al (2016) A practical 3D printed simulator for endoscopic endonasal transsphenoidal surgery to improve basic operational skills. Childs Nerv Syst 32:1109–1116
Choudhury N, Gelinas-Phaneuf N, Delorme S, Del Maestro R (2013) Fundamentals of neurosurgery: virtual reality tasks for training and evaluation of technical skills. World Neurosurg 80:e9
Weinstock P, Rehder R, Prabhu SP, Forbes PW, Roussin CJ, Cohen AR (2017) Creation of a novel simulator for minimally invasive neurosurgery: fusion of 3D printing and special effects. J Neurosurg Pediatr 20:1–9
Deopujari CE, Karmarkar VS, Shaikh ST, Gadgil US (2019) Developing a dynamic simulator for endoscopic intraventricular surgeries. Childs Nerv Syst 35:621–627
Yaşargil MG (2005) From the microsurgical laboratory to the operating theatre. Acta Neurochir 147:465–468
Acknowledgements
We would like to thank the sterilization staff of the Hospital Universitario Torrecárdenas, Almería, Spain, for their valuable help and assistance in the development of this laboratory study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics approval
This manuscript involves research not conducted on human subjects, animals, or patients. All procedures performed were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standard.
Consent to participate
Not applicable.
Consent for publication
Not applicable.
Conflict of interest
The authors declare that they have no conflict of interest to declare that are relevant to the content of this article. Authors declare that they have no personal or institutional financial interest in drugs, materials, or devices described in their submissions.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Gomar-Alba, M., Parrón-Carreño, T., Narro-Donate, J.M. et al. Neuroendoscopic training in neurosurgery: a simple and feasible model for neurosurgical education. Childs Nerv Syst 37, 2619–2624 (2021). https://doi.org/10.1007/s00381-021-05190-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-021-05190-z