Face, content, and construct validity of human placenta as a haptic training tool in neurointerventional surgery

Abstract

N euroiNterveNtioNal procedures have become a significant asset in the treatment of cerebrovascular disorders. Training in these techniques requires several years of dedicated study to develop an understanding of and the haptic feel for catheter navigation and interventional treatments. However, medicolegal concerns and work hour restrictions may limit the experience trainees receive. Simulators allow trainees to improve their technical expertise and also allow physicians and industry to collaborate in the development of innovative devices. 3The ideal training model should be inexpensive, readily available, and have haptic characteristics similar to those encountered in the endovascular treatment of human disorders. Animal and computer-based models have been developed for this purpose. 3,5,7 While each model has certain advantages and disadvantages, it is difficult to reproduce all the haptic qualities necessary for these procedures using virtual simulators or animal models.4,6-8 Thus, it is necessary to continue to develop and research new techniques for neurointerventional training. In this article, we abbreviatioNs GDC = Guglielmi detachable coil; HP = human placenta. obJective The development of neurointerventional treatments of central nervous system disorders has resulted in the need for adequate training environments for novice interventionalists. Virtual simulators offer anatomical definition but lack adequate tactile feedback. Animal models, which provide more lifelike training, require an appropriate infrastructure base. The authors describe a training model for neurointerventional procedures using the human placenta (HP), which affords haptic training with significantly fewer resource requirements, and discuss its validation. methods Twelve HPs were prepared for simulated endovascular procedures. Training exercises performed by interventional neuroradiologists and novice fellows were placental angiography, stent placement, aneurysm coiling, and intravascular liquid embolic agent injection. results The endovascular training exercises proposed can be easily reproduced in the HP. Face, content, and construct validity were assessed by 6 neurointerventional radiologists and 6 novice fellows in interventional radiology. coNclusioNs The use of HP provides an inexpensive training model for the training of neurointerventionalists. Preliminary validation results show that this simulation model has face and content validity and has demonstrated construct validity for the interventions assessed in this study.

Development of Simulator System Using Endovascular Evaluator for Catheter Intervention Training

“…In the field of neurosurgery, various simulators for training in bypass surgery and endoscopic surgery have been reported. [8][9][10][11] To make simulation training in neuroendovascular treatment more practical, it is necessary to make the training environment closer to clinical settings. Trainees are required not only to learn the procedure of catheter treatment and the usage of instruments, but also to experience comprehensive simulation including rinsing inside of the catheter, imaging, catheter and wire manipulation, and handling of various other devices.…”

Endovascular technique simulator for Neuroradiology learning

“…Virtual simulators, such as the ANGIO Mentor (Simbionix, Cleveland, OH, USA), the Vascular Intervention System Trainer (VIST) (Mentice AB, Gothenburg, Sweden), and the SimSuite (Medical Simulation Corporation, Denver, CO, USA), are the most common. In addition to being durable, they enable replication of patient-specific situations, come in several models and carry low risk, but with low median fidelity, little haptic response, with high acquisition and maintenance costs 22 .…”

“…The simulations in live animals enable high fidelity, but high costs and ethical problems as well. Simulations using placenta have the advantages of low cost, high accuracy, and low risk, but are single-use and do not reproduce human cervical vessels 22 .…”

Three-dimensional printing and neuroendovascular simulation for the treatment of a pediatric intracranial aneurysm: case report

“…16 Another option is to use ex-vivo models such as a human placenta, in which aneurysms can be developed, multiple surgical scenarios simulated, and complication management practiced. 15,18 The benefits of using human placenta include low cost, ready accessibility, and most importantly, realistic haptic feedback. 3 Nonetheless, ex-vivo models are not able to simulate specific patient vasculature.…”