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Neurosurgical Simulation

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https://www.readbyqxmd.com/read/29782617/patient-specific-neurosurgical-phantom-assessment-of-visual-quality-accuracy-and-scaling-effects
#1
Felipe Wilker Grillo, Victor Hugo Souza, Renan Hiroshi Matsuda, Carlo Rondinoni, Theo Zeferino Pavan, Oswaldo Baffa, Helio Rubens Machado, Antonio Adilton Oliveira Carneiro
Background: Training in medical education depends on the availability of standardized materials that can reliably mimic the human anatomy and physiology. One alternative to using cadavers or animal bodies is to employ phantoms or mimicking devices. Styrene-ethylene/butylene-styrene (SEBS) gels are biologically inert and present tunable properties, including mechanical properties that resemble the soft tissue. Therefore, SEBS is an alternative to develop a patient-specific phantom, that provides real visual and morphological experience during simulation-based neurosurgical training...
2018: 3D printing in medicine
https://www.readbyqxmd.com/read/29768273/subcaudate-tractotomy-white-matter-anatomy-and-variability-a-diffusion-tensor-imaging-study
#2
Kartik D Bhatia, Luke A Henderson, Eugene Hsu, Mark Yim
BACKGROUND: Subcaudate tractotomy is a functional ablative procedure performed for treatment-resistant psychiatric disease, targeting the white matter tracts ventral to the head of the caudate nucleus. The white matter anatomy of this region has extensive interindividual variability, and this is thought to impact upon the treatment response to ablative and deep brain stimulation procedures. OBJECTIVE: We aim to assess in detail the white matter tract anatomy and topographic variability underlying subcaudate tractotomy...
May 16, 2018: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29749910/a-novel-low-cost-reusable-high-fidelity-neurosurgical-training-simulator-for-cerebrovascular-bypass-surgery
#3
Ulas Cikla, Balkan Sahin, Sahin Hanalioglu, Azam S Ahmed, David Niemann, Mustafa K Baskaya
OBJECTIVE Cerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techniques. Most available training tools, however, either lack the realism of the actual bypass surgery (e.g., artificial vessel, chicken wing models) or require special facilities and regulations (e...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29749882/low-cost-endoscopic-third-ventriculostomy-simulator-with-mimetic-endoscope
#4
Richard Justin Garling, Xin Jin, Jianzhong Yang, Ahmad H Khasawneh, Carolyn Anne Harris
OBJECTIVE Hydrocephalus affects approximately 1 in 500 people in the US, yet ventricular shunting, the gold standard of treatment, has a nearly 85% failure rate. Endoscopic third ventriculostomy (ETV) is an alternative surgical approach for a specific subset of hydrocephalic patients, but can be limited by the inability of neurosurgical residents to practice prior to patient contact. The goal of this study was to create an affordable ETV model and endoscope for resident training. METHODS Open-source software was used to isolate the skull and brain from the CT and MR images of a 2-year-old boy with hydrocephalus...
May 11, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29519179/the-evolution-of-british-neurosurgical-selection-and-training-over-the-past-decade
#5
Alexander Alamri, Aswin Chari, Gráinne McKenna, Ian Kamaly-Asl, Peter C Whitfield
Selection of junior doctors into the British neurosurgical training program and subsequent speciality training have undergone several key changes over the past decade. Shift patterns in the era of the European Working Time Directive (EWTD) have had a major impact on surgical training. We discuss the national selection process, formalization of surgical simulation training and the need to encompass generic professional capabilities within the neurosurgical curriculum in order to create the "well-rounded surgeon"...
March 8, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29486312/feasibility-of-clinician-facilitated-three-dimensional-printing-of-synthetic-cranioplasty-flaps
#6
Sandip S Panesar, Joao Tiago A Belo, Rhett N D'Souza
BACKGROUND: Integration of three-dimensional (3D) printing and stereolithography into clinical practice is in its nascence, and concepts may be esoteric to the practicing neurosurgeon. Currently, creation of 3D printed implants involves recruitment of offsite third parties. We explored a range of 3D scanning and stereolithographic techniques to create patient-specific synthetic implants using an onsite, clinician-facilitated approach. METHODS: We simulated bilateral craniectomies in a single cadaveric specimen...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29439905/three-dimensional-intracranial-middle-cerebral-artery-aneurysm-models-for-aneurysm-surgery-and-training
#7
Liang Wang, Xun Ye, Qiang Hao, Li Ma, Xiaolin Chen, Hao Wang, Yuanli Zhao
To develop a realistic model of middle cerebral artery (MCA) aneurysms using three-dimensional (3D) printing for surgical planning, research, and training of neurosurgical residents. This study included eight MCA aneurysm cases. The aneurysm together with the adjacent arteries and skull base were printed based on raw computed tomography angiography (CTA) data using a 3D printer with acrylonitrile-butadiene-styrene as the model material. The aneurysm models were used for surgical planning, and craniotomy and clipping practice by neurosurgical residents...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29417076/forecasting-the-shortage-of-neurosurgeons-in-iran-using-a-system-dynamics-model-approach
#8
Sima Rafiei, Arman Daneshvaran, Sina Abdollahzade
CONTEXT: Shortage of physicians particularly in specialty levels is considered as an important issue in Iran health system. Thus, in an uncertain environment, long-term planning is required for health professionals as a basic priority on a national scale. AIMS: This study aimed to estimate the number of required neurosurgeons using system dynamic modeling. SETTING AND DESIGN: System dynamic modeling was applied to predict the gap between stock and number of required neurosurgeons in Iran up to 2020...
2018: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/29395225/mechanical-properties-of-porcine-brain-tissue-in-vivo-and-ex-vivo-estimated-by-mr-elastography
#9
Charlotte A Guertler, Ruth J Okamoto, John L Schmidt, Andrew A Badachhape, Curtis L Johnson, Philip V Bayly
The mechanical properties of brain tissue in vivo determine the response of the brain to rapid skull acceleration. These properties are thus of great interest to the developers of mathematical models of traumatic brain injury (TBI) or neurosurgical simulations. Animal models provide valuable insight that can improve TBI modeling. In this study we compare estimates of mechanical properties of the Yucatan mini-pig brain in vivo and ex vivo using magnetic resonance elastography (MRE) at multiple frequencies. MRE allows estimations of properties in soft tissue, either in vivo or ex vivo, by imaging harmonic shear wave propagation...
March 1, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29366347/correlation-of-hospital-magnet-status-with-the-quality-of-physicians-performing-neurosurgical-procedures-in-new-york-state
#10
Kimon Bekelis, Symeon Missios, Todd A MacKenzie
PURPOSE: The quality of physicians practicing in hospitals recognized for nursing excellence by the American Nurses Credentialing Center has not been studied before. We investigated whether Magnet hospital recognition is associated with higher quality of physicians performing neurosurgical procedures. MATERIALS AND METHODS: We performed a cohort study of patients undergoing neurosurgical procedures from 2009-2013, who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database...
January 24, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29354486/quantitative-comparison-of-cranial-approaches-in-the-anatomy-laboratory-a-neuronavigation-based-research-method
#11
Francesco Doglietto, Jimmy Qiu, Mayoorendra Ravichandiran, Ivan Radovanovic, Francesco Belotti, Anne Agur, Gelareh Zadeh, Marco Maria Fontanella, Walter Kucharczyk, Fred Gentili
AIM: To describe the development and validation of a novel neuronavigation-based method, which allows the quantification of the anatomical features that define an approach, as well as real-time visualization of the surgical pyramid. METHODS: The method was initially developed with commercially-available hardware for coordinate collection (a digitizer and a frameless navigation system) and software for volume rendering; dedicated neuronavigation software (ApproachViewer, part of GTx-UHN) was then developed...
December 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/29337170/virtual-cerebral-aneurysm-clipping-with-real-time-haptic-force-feedback-in-neurosurgical-education
#12
Matthias Gmeiner, Johannes Dirnberger, Wolfgang Fenz, Maria Gollwitzer, Gabriele Wurm, Johannes Trenkler, Andreas Gruber
OBJECTIVE: Realistic, safe, and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education, and they should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force feedback and real-time deformation of the aneurysm and vessels. METHODS: A prototype simulator was developed from 2012 to 2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software, and the prototype was evaluated by 18 neurosurgeons...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325962/systematic-review-of-factors-influencing-surgical-performance-practical-recommendations-for-microsurgical-procedures-in-neurosurgery
#13
Evgenii Belykh, Naomi R Onaka, Irakliy T Abramov, Kaan Yağmurlu, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaj, Mark C Preul
BACKGROUND: Microneurosurgical techniques involve complex manual skills and hand-eye coordination that require substantial training. Many factors affect microneurosurgical skills. The goal of this study was to use a systematic evidence-based approach to analyze the quality of evidence for intrinsic and extrinsic factors that influence microneurosurgical performance and to make weighted practical recommendations. METHODS: A literature search of factors that may affect microsurgical performance was conducted using PubMed and Embase...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29249540/a-morphometric-and-analytical-cadaver-dissection-study-of-a-tumor-simulation-balloon-model
#14
Baran Bozkurt, Evgenii Belykh, Kaan Yağmurlu, Abhishek Agrawal, Steve W Chang, Michael S Staren, Robert F Spetzler, Joseph M Zabramski, Mark C Preul
We quantified the effects on anatomical cadaver dissection of a balloon-inflation tumor model positioned in the parasellar region and approached through an orbitozygomatic (OZ) craniotomy. A modified supraorbital OZ was performed bilaterally on 5 silicon-injected cadaver heads. Ten predetermined anatomical points assigned using a frameless stereotactic device were used to measure the working area of exposure, degree of surgical freedom, and horizontal and vertical angles of attack to specific target points before and after inflation of a balloon catheter mimicking a parasellar tumor...
March 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29241171/virtual-reality-surgical-simulation-implications-for-resection-of-intracranial-gliomas
#15
Ayoub Dakson, Murray Hong, David B Clarke
Surgical simulation has the potential to play important roles in surgical training and preoperative planning. The advent of virtual reality (VR) with tactile haptic feedback has revolutionized surgical simulation, creating a novel environment for residents to learn manual skills without compromising patient safety. This concept is particularly relevant in neurosurgical training where the acquired skill set demands performance of technically challenging tasks under pressure and where the consequences of error are significant...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29238645/the-effectiveness-of-bioskills-training-for-simulated-open-lumbar-laminectomy
#16
Barrett S Boody, Brett D Rosenthal, Tyler J Jenkins, Alpesh A Patel, Jason W Savage, Wellington K Hsu
Study Design: Randomized, prospective study within an orthopedic surgery resident program at a large urban academic medical center. Objectives: To develop an inexpensive, user-friendly, and reproducible lumbar laminectomy bioskills training module and evaluation protocol that can be readily implemented into residency training programs to augment the clinical education of orthopedic and neurosurgical physicians-in-training. Methods: Twenty participants comprising senior medical students and orthopedic surgical residents...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29198889/virtual-reality-based-simulators-for-cranial-tumor-surgery-a-systematic-review
#17
REVIEW
Travis Mazur, Tarek R Mansour, Luke Mugge, Azedine Medhkour
BACKGROUND: Virtual reality (VR) simulators have become useful tools in various fields of medicine. Prominent uses of VR technologies include assessment of physician skills and presurgical planning. VR has shown effectiveness in multiple surgical specialties, yet its use in neurosurgery remains limited. OBJECTIVE: To examine all current literature on VR-based simulation for presurgical planning and training in cranial tumor surgeries and to assess the quality of these studies...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29184655/editorial-challenges-for-the-usability-of-ar-and-vr-for-clinical-neurosurgical-procedures
#18
EDITORIAL
Sandrine de Ribaupierre, Roy Eagleson
There are a number of challenges that must be faced when trying to develop AR and VR-based Neurosurgical simulators, Surgical Navigation Platforms, and "Smart OR" systems. Trying to simulate an operating room environment and surgical tasks in Augmented and Virtual Reality is a challenge many are attempting to solve, in order to train surgeons or help them operate. What are some of the needs of the surgeon, and what are the challenges encountered (human computer interface, perception, workflow, etc)...
October 2017: Healthcare Technology Letters
https://www.readbyqxmd.com/read/29174238/association-of-hospital-teaching-status-with-neurosurgical-outcomes-an-instrumental-variable-analysis
#19
Kimon Bekelis, Symeon Missios, Shannon Coy, Todd A MacKenzie
BACKGROUND: The interpretation of the results of prior studies on the association of hospital teaching status with surgical outcomes is limited by selection bias. We investigated whether undergoing surgical operations in teaching hospitals is associated with improved outcomes. METHODS: We performed a cohort study of all patients undergoing spine and cranial operations who were registered in the New York Statewide Planning and Research Cooperative System database from 2009 to 2013...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29170740/tip-design-for-safety-of-steerable-needles-for-robot-controlled-brain-insertion
#20
Craig A Lehocky, Wendy Fellows-Mayle, Johnathan A Engh, Cameron N Riviere
Background: Current practice in neurosurgical needle insertion is limited by the straight trajectories inherent with rigid probes. One technique allowing curvilinear trajectories involves flexible bevel-tipped needles, which bend during insertion due to their asymmetry. In the brain, safety will require avoidance of the sharp tips often used in laboratory studies, in favor of a more rounded profile. Steering performance, on the other hand, requires maximal asymmetry. Design of safe bevel-tipped brain needles thus involves management of this tradeoff by adjusting needle gauge, bevel angle, and fillet (or tip) radius to arrive at a design that is suitably asymmetrical while producing strain, strain rate, and stress below the levels that would damage brain tissue...
2017: Robotic Surgery: Research and Reviews
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