Training Models for Vascular Microneurosurgery

Spetzger, Uwe; Schilling, Andrej von; Brombach, Till; Winkler, Gerd

doi:10.1007/978-3-7091-0661-7_21

Cited by 35 publications

(38 citation statements)

References 17 publications

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“…These instruments can be repetitively tried on this appropriate model in the practical and technical understanding of the capabilities of the attachments and specific ball and ball-diamond tools. In addition, it is required for one to develop his/ her own abilities [1,[5][6][7][8][9]. The results of this study verified that using walnut shell microdrilling model has advantages in gaining practical microdrilling techniques and technical understanding of the capabilities of the attachments and specific ball and ball-diamond tools of the high-speed drill.…”

Section: Resultssupporting

confidence: 59%

“…safe and delicate neurovascular dissection, and careful and proper microdrilling of the cranial base bones are some steps that should be repetitively trained on the appropriate experimental models in the training laboratory until the gaining of safe surgical technique [1,[6][7][8][9]. Spending of time in experimental microsurgical laboratory to practice on some kind of microsurgical models such as dissection and suturing of the rat external carotid artery, dissection and evaluation of the abdominal vena cava of rats, suturing of the plastic glove materials by using microforceps under the operating microscope, and drilling and dissection of some cadaveric bone materials are essential in improving and gaining advanced microneurosurgical practical techniques [1,[5][6][7][8][9].…”

mentioning

confidence: 99%

“…Spending of time in experimental microsurgical laboratory to practice on some kind of microsurgical models such as dissection and suturing of the rat external carotid artery, dissection and evaluation of the abdominal vena cava of rats, suturing of the plastic glove materials by using microforceps under the operating microscope, and drilling and dissection of some cadaveric bone materials are essential in improving and gaining advanced microneurosurgical practical techniques [1,[5][6][7][8][9].…”

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confidence: 99%

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Using walnut shell in the microdrilling training model

Çokluk¹

2018

Arch Clin Exp Surg

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IntroductionMicrosurgical drilling of thin and delicate bones is a specific part of microneurosurgery. The neuroanatomical location of cranial base structures including basal cerebral arteries, hypophysis, cranial nerves, and brain stem makes the surgical approach to the cranial base unique in microneurosurgery [1][2][3][4][5]. Specific microneurosurgical techniques should be repetitively trained in laboratory on the appropriate models. Proper using of the operative microscope, holding, and grasping of the microneurosurgical instruments, proper microsurgical technique of the opening of the arachnoid membranes, The modeling of the surgical steps with creating a suitable laboratory models is critically important issue in the successful gaining of microneurosurgical practice. In this experimental study, a laboratory-training model was created for microneurosurgical drilling of delicate and thin cranial base bones using walnut shell in the repetitive repeating of experimental microsurgical training technique. Materials and Methods: All steps of this study were performed under the operating microscope. Twenty-five walnut shells were used for this experimental feasibility study. The difficulty and suitability of the model were evaluated in terms of the usability in the training of microneurosurgical microdrilling. Difficulty of the procedure was divided into three degrees (very easy, easy, and difficult). The objective criterion for the evaluation of the difficulty of the procedure was the protection of the interior organic material during the procedure. The suitability of the procedure was also evaluated within three groups, bad, good, and perfect. Results: In three (12%) walnut shells, the microdrilling was evaluated as difficult. The microdrilling procedures of the twelve (48%) walnut shells were evaluated as easy procedure. Microdrilling procedure of the remaining ten (40%) of the walnut shells was evaluated as very easy. The suitability of the model was evaluated as bad in two (8%) of the walnut shells. The suitability was found as good in 17 (68%) of the walnut shells. In microdrilling of the remaining six (24%) of the walnut shells, the suitability of the model was evaluated as perfect. Conclusion: Microsurgical drilling of the walnut shells without any interior organic injury is accepted as the indication of the successful surgical microdrilling process. Consolidation of the surgical practice in a laboratory setting, grasping, and using of microsurgical instruments can be repeated several times in this model. We believe that this model will contribute to the practical training of microneurosurgery.

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Section: Resultssupporting

confidence: 59%

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confidence: 99%

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confidence: 99%

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Using walnut shell in the microdrilling training model

Çokluk¹

2018

Arch Clin Exp Surg

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“…Knowing the anatomy of subarachnoid cisternae is also important. Specific micro-neurosurgical techniques such as proper use of the operative microscope, holding and grasping of the microneurosurgical instruments, a proper microsurgical technique of the opening of the arachnoid membranes, safe and delicate neurovascular dissection, and careful and proper micro-drilling of the cranial base bones should be learned before operating on a patient [1][2][3][4][5][6][7]. Theoretical knowledge, practical techniques, and microsurgical operative disciplines for the extreme protection of the delicate brain and related structures located within the cranium are mainly provided during the residency years of neurosurgical education [4,5,7].…”

Section: Introductionmentioning

confidence: 99%

“…Specific micro-neurosurgical techniques such as proper use of the operative microscope, holding and grasping of the microneurosurgical instruments, a proper microsurgical technique of the opening of the arachnoid membranes, safe and delicate neurovascular dissection, and careful and proper micro-drilling of the cranial base bones should be learned before operating on a patient [1][2][3][4][5][6][7]. Theoretical knowledge, practical techniques, and microsurgical operative disciplines for the extreme protection of the delicate brain and related structures located within the cranium are mainly provided during the residency years of neurosurgical education [4,5,7]. Many neurosurgeons interested in microneurosurgery try to gain some additional and advanced progress in the improving their micro-neurosurgical ability including brain protection and delicate micro-neurosurgical techniques in laboratory training setting [2,4,5,7].…”

Section: Introductionmentioning

confidence: 99%

The use of fresh cadaveric cow brain as an experimental model for Sylvian fissure microdissection

Gökyar¹

2018

Ann Clin Anal Med

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Aim: The aim of this study was to evaluate the feasibility of using fresh cow brain as a training model for microsurgical dissection of Sylvian fissure. Microneurosurgical intervention to the brain includes many surgical activities performed by using metallic instruments to the vascular and/or parenchymal structure of the nervous system. For this purpose, an experimental micro-neurosurgical brain model using fresh cadaveric uncovered cow brain was used in the evaluation of the feasibility as a training model. Material and Method: Experimental micro-neurosurgical activities in this study were performed under the operating microscope. Bilateral Sylvian cisterns of the fresh cadaveric cow brain were used as an interested area for this experiment. The dissection and separation was continued reaching down to the floor of the cistern, and total dissection of the middle cerebral artery inside the cisternal space was performed. The suitability of a cow brain as a training model for Sylvian fissure microdissection was evaluated as three groups; bad, good, and perfect. Results: Ten uncovered fresh cadaveric cow brain were used in this experimental feasibility study. The suitability of the experiment for training model was evaluated as bad in (2) 20% of the fresh cadaveric cow brains. The suitability was found as good in (6) 60% of the procedures. In the remaining (2) 20% of the brain dissection, the suitability of the experiment was evaluated as perfect. Discussion: To sum up, safe surgical interventions require protecting of the brain tissue and neurovascular structures. Thus, it's extremely necessary to perform dissection and separation on neurovascular on training models before real practices on humans. Cow's Sylvian cistern training model is feasible as shown in this experimental study. We believe that this training model will contribute to the practical micro-neurosurgery in various terms primarily, it helps to protect of neurovascular tissue. Additionally, it provides adequate performance for the microsurgical intervention around the Sylvian cistern.

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