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Training in endoscopic endonasal transsphenoidal surgery using a skull model and eggs

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Abstract

Background

Recently, endoscopic pituitary surgery is increasingly being used in pituitary surgery. Compared to conventional microscopic pituitary surgery, outcomes have been non-inferior, so endoscopic pituitary surgery has become an established surgical technique. However, this is a highly specialized surgery and sophisticated surgical techniques are required. We report our development of a training model for endoscopic endonasal transsphenoidal surgery.

Methods

Our training model is constructed using a skull model and eggs. The sella turcica of the skull model is hollowed out and an egg is placed. The bottom of the egg simulates the sella turcica floor and the egg contents simulate a tumor. Training is conducted using this model in an actual operating room with actual surgical instruments.

Results

This model is highly realistic and is within acceptable limits as a surgical simulation. Since practice can be repeated, this model is effective for familiarization with endoscopic imaging and to increase technical skills such as drilling and curetting. In addition, variations in eggs, ranging from raw eggs to boiled eggs, can be used to simulate various tumors for training.

Conclusions

This training model using a skull model and eggs is useful to improve surgical techniques in endoscopic endonasal transsphenoidal surgery.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Takeshi Okuda & Amami Kato

  2. Department of Neurosurgery, Nara Hospital, Kinki University School of Medicine, Nara, Japan

    Kazuo Kataoka

Authors
  1. Takeshi Okuda
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  2. Kazuo Kataoka
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  3. Amami Kato
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Corresponding author

Correspondence to Takeshi Okuda.

Additional information

Comment

This report describes a very simple but effective training tool for transnasal endoscopic pituitary surgery. An egg, raw or boiled, is placed into the sella turcica of a skull model. Using conventional endoscopic pituitary instruments, the egg shell can be drilled, where the egg shell membrane simulates the dura mater and the egg yolk and white (with different boiling time) simulate the adenoma tissue. The illustrations are straightforward, and they can serve as an image-guided manual for preparing this training model in a few minutes. For the young endoscopist, it is important to train practically. Cadaver courses are very important to memorize the surgical anatomy. The manual skills can be trained using the presented egg model. This cannot substitute living models with bleeding wounds. But the egg model definitely persuades of simplicity.

Jens Lehmberg

Munich, Germany

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Okuda, T., Kataoka, K. & Kato, A. Training in endoscopic endonasal transsphenoidal surgery using a skull model and eggs. Acta Neurochir 152, 1801–1804 (2010). https://doi.org/10.1007/s00701-010-0728-0

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  • DOI: https://doi.org/10.1007/s00701-010-0728-0

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