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Neurosurgical training with simulators: a novel neuroendoscopy model

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Abstract

Purpose

The aim of this study is to present a novel neuroendoscopy simulation model in live animals, with the objective of enhancing patient safety with realistic surgical training.

Methods

A simulation model using live Wistar rats was designed after the approval of the Institutional Committee for the Care and Use of Laboratory Animals. Under anesthesia, a hydroperitoneum was created in order to simulate a cavity with mesenteric membranes and vessels, viscera, and a solid and bleeding tumor (the liver) floating in a liquid environment. For validation purposes, we evaluated trainees’ basal and final skills for each neuroendoscopic procedure, and we also acknowledged trainees’ and instructors’ opinion on the model’s realism.

Results

This model is simple and low cost effective for complete and real-life training in neuroendoscopy, with the possibility of performing all the basic and advanced endoscopic procedures, such as endoscopic exploration, membrane fenestration, vessel coagulation, hematoma evacuation, and endoscopic tumor biopsy and resection using a ventricular neuroendoscopy set. Although the model does not represent human ventricular anatomy, a reliable simulation is possible in real living tissue in a liquid environment. Trainees’ skills improvements were notorious.

Conclusion

Minimally invasive endoscopic techniques require specific training. Simulation training can improve and accelerate the learning curve. The presented training model allows simulating the different neuroendoscopic procedures. We believe that due to its practical possibilities, its simplicity, low cost, reproducibility, and reality, being live animal tissue, it can be considered a fundamental model within a complete training program on neuroendoscopy.

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Acknowledgments

The authors would like to acknowledge the nurses and staff of the Simulation Center and the Bioterium and Experimental Surgery Department at “Prof. Dr. Juan P. Garrahan” Pediatric Hospital. They also thank Adrian Gomez for the statistical analysis.

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Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Hospital de Pediatría S.A.M.I.C. “Prof. Dr. Juan P. Garrahan”, 1881 Combate de los Pozos St, Buenos Aires, Argentina

    Sebastián G. Jaimovich

  2. Department of Pediatric Neurosurgery, FLENI Neurological Research Institute Dr. Raúl Carrea, Buenos Aires, Argentina

    Sebastián G. Jaimovich & Roberto Jaimovich

  3. Head of Department of Surgery, Hospital de Pediatría S.A.M.I.C. “Prof. Dr. Juan P. Garrahan”, Buenos Aires, Argentina

    Marcela Bailez

  4. Bioterium and Experimental Surgery, Hospital de Pediatría S.A.M.I.C. “Prof. Dr. Juan P. Garrahan”, Buenos Aires, Argentina

    Marcelo Asprea

  5. Head of Department of Pediatric Neurosurgery, Hospital de Pediatría S.A.M.I.C. “Prof. Dr. Juan P. Garrahan”, Buenos Aires, Argentina

    Roberto Jaimovich

Authors
  1. Sebastián G. Jaimovich
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  2. Marcela Bailez
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  3. Marcelo Asprea
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  4. Roberto Jaimovich
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Corresponding author

Correspondence to Sebastián G. Jaimovich.

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Conflict of interests

The authors declare that they have no conflicts of interests.

Ethical approval

All applicable international, national, and institutional guidelines for the care and use of animals were followed.

All procedures performed on animals were in accordance with the ethical standards and with the approval of the Institutional Committee for the Care and Use of Laboratory Animals and following ethical guidelines for the use of experimental and biological research animals of the World Medical Association.

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Jaimovich, S.G., Bailez, M., Asprea, M. et al. Neurosurgical training with simulators: a novel neuroendoscopy model. Childs Nerv Syst 32, 345–349 (2016). https://doi.org/10.1007/s00381-015-2936-7

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  • DOI: https://doi.org/10.1007/s00381-015-2936-7

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