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Neurosurgical Simulation

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https://www.readbyqxmd.com/read/27817764/supplementary-educational-models-in-canadian-neurosurgery-residency-programs
#1
Won Hyung A Ryu, Sonny Chan, Garnette R Sutherland
BACKGROUND: The proposed implementation of work hour restrictions has presented a significant challenge of maintaining the quality of resident education and ensuring adequate hands-on experience that is essential for novice surgeons. To maintain the level of resident surgical competency, revision of the apprentice model of surgical education to include supplementary educational methods, such as laboratory and virtual reality (VR) simulations, have become frequent topics of discussion...
November 7, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27689458/the-force-pyramid-a-spatial-analysis-of-force-application-during-virtual-reality-brain-tumor-resection
#2
Hamed Azarnoush, Samaneh Siar, Robin Sawaya, Gmaan Al Zhrani, Alexander Winkler-Schwartz, Fahad Eid Alotaibi, Abdulgadir Bugdadi, Khalid Bajunaid, Ibrahim Marwa, Abdulrahman Jafar Sabbagh, Rolando F Del Maestro
OBJECTIVE Virtual reality simulators allow development of novel methods to analyze neurosurgical performance. The concept of a force pyramid is introduced as a Tier 3 metric with the ability to provide visual and spatial analysis of 3D force application by any instrument used during simulated tumor resection. This study was designed to answer 3 questions: 1) Do study groups have distinct force pyramids? 2) Do handedness and ergonomics influence force pyramid structure? 3) Are force pyramids dependent on the visual and haptic characteristics of simulated tumors? METHODS Using a virtual reality simulator, NeuroVR (formerly NeuroTouch), ultrasonic aspirator force application was continually assessed during resection of simulated brain tumors by neurosurgeons, residents, and medical students...
September 30, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27683680/rural-neurosurgical-and-spinal-laboratory-setup
#3
Adam Smith, Filippo Gagliardi, Nicholas Robert Pelzer, Jacob Hampton, Anthony Minh Tien Chau, Fiona Stewart, Pietro Mortini, Cristian Gragnaniello
BACKGROUND: Increasing focus has been placed on the use of simulation in neurosurgical and spinal surgical training worldwide, with the establishment of many surgical laboratories dedicated to such purpose. So far, the opportunities for hands-on cadaveric training in the areas of neurosurgery and spine surgery remain limited in Australia, owing to various factors, including the abolition of dissection in many medical schools, high maintenance requirements and widespread geographical distribution of surgical trainees...
December 2015: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27613497/coconut-model-for-learning-first-steps-of-craniotomy-techniques-and-csf-leak-avoidance
#4
Bernardo Drummond Braga, Sebastião Berquó Peleja, Guaracy Macedo, Carlos Roberto S A Drummond, Pollyana H V Costa, Marco T Garcia-Zapata, Marcelo Magaldi Oliveira
INTRODUCTION: Neurosurgery simulation has gained attention recently due to changes in the medical system. First-year neurosurgical residents in low-income countries usually perform their first craniotomy on a real subject. Development of high-fidelity, cheap, and largely available simulators is a challenge in residency training. An original model for the first steps of craniotomy with cerebrospinal fluid (CSF) leak avoidance practice using a coconut is described. MATERIAL AND METHODS: The coconut is a drupe from Cocos nucifera L...
September 6, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27601027/simulation-in-neurosurgical-training-a-blueprint-and-national-approach-to-implementation-for-initial-years-trainees
#5
Lihan Zhang, Ian Kamaly, Pramod Luthra, Peter Whitfield
Simulation has played an increasing role in surgical training in recent years, this follows from various reports such as the Chief Medical Officer annual report and Sir John Temple's 'Time for Training' and also from other factors such as increasing focus on efficiency and transparency within the healthcare system. Evidence has shown that simulation can develop and improve technical, clinical, communication and management skills. With technological advances, the quality of simulation has also improved with more realistic models and environment...
October 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27572392/population-pharmacokinetics-and-dosing-regimen-optimization-of-meropenem-in-cerebrospinal-fluid-and-plasma-in-patients-with-meningitis-after-neurosurgery
#6
Cheng Lu, Yuyi Zhang, Mingyu Chen, Ping Zhong, Yuancheng Chen, Jicheng Yu, Xiaojie Wu, Jufang Wu, Jing Zhang
Meropenem is used to manage post-neurosurgical meningitis, but its population pharmacokinetics (PPK) in plasma and cerebrospinal fluid (CSF) in this patient group is not well known. Our aims were: (i) characterizing meropenem PPK in plasma and CSF; (ii) recommending favorable dosing regimens in post-neurosurgical meningitis patients. 82 patients were enrolled to receive 2g q8h, 1g q8h or 1g q6h meropenem infusion for at least 3 days. Serial blood and CSF samples were collected, with concentrations determined and analyzed via population modeling...
August 29, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27399533/335%C3%A2-a-modular-multimodality-integrative-pipeline-for-neurosurgery-simulation-and-visualization
#7
Anthony Beardsworth Costa, Joshua B Bederson
INTRODUCTION: The practice of pre- and intraoperative interactive visualization and modeling continues to grow as its value to clinical practice is augmented by new technologies, such as virtual and augmented reality, or 3D printing. Current tools that extract the necessary structural information from medical imaging modalities and allow virtual or other interrogation of the data are either difficult to use in a practical clinical setting, or sufficiently simple as to limit the knowledge available to the operator...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27395397/bimanual-psychomotor-performance-in-neurosurgical-resident-applicants-assessed-using-neurotouch-a-virtual-reality-simulator
#8
Alexander Winkler-Schwartz, Khalid Bajunaid, Muhammad A S Mullah, Ibrahim Marwa, Fahad E Alotaibi, Jawad Fares, Marta Baggiani, Hamed Azarnoush, Gmaan Al Zharni, Sommer Christie, Abdulrahman J Sabbagh, Penny Werthner, Rolando F Del Maestro
OBJECTIVE: Current selection methods for neurosurgical residents fail to include objective measurements of bimanual psychomotor performance. Advancements in computer-based simulation provide opportunities to assess cognitive and psychomotor skills in surgically naive populations during complex simulated neurosurgical tasks in risk-free environments. This pilot study was designed to answer 3 questions: (1) What are the differences in bimanual psychomotor performance among neurosurgical residency applicants using NeuroTouch? (2) Are there exceptionally skilled medical students in the applicant cohort? and (3) Is there an influence of previous surgical exposure on surgical performance? DESIGN: Participants were instructed to remove 3 simulated brain tumors with identical visual appearance, stiffness, and random bleeding points...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27331235/-new-simulation-technologies-in-neurosurgery
#9
REVIEW
V A Byvaltsev, E G Belykh, N A Konovalov
The article presents a literature review on the current state of simulation technologies in neurosurgery, a brief description of the basic technology and the classification of simulation models, and examples of simulation models and skills simulators used in neurosurgery. Basic models for the development of physical skills, the spectrum of available computer virtual simulators, and their main characteristics are described. It would be instructive to include microneurosurgical training and a cadaver course of neurosurgical approaches in neurosurgery training programs and to extend the use of three-dimensional imaging...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27295648/estimation-of-penetrated-bone-layers-during-craniotomy-via-bioimpedance-measurement
#10
Daniel Teichmann, Lucas Rohe, Annegret Niesche, Meiko Mueller, Klaus Radermacher, Steffen Leonhardt
: Craniotomy is the removal of a bone flap from the skull and is a first step in many neurosurgical interventions. During craniotomy, an efficient cut of the bone without injuring adjoining soft tissues is very critical. The aim of this work is to investigate the feasibility of estimating the currently penetrated cranial bone layer by means of bioimpedance measurement. METHODS: A finite element model was developed and a simulation study conducted. Simulations were performed at different positions along an elliptical cutting path and at three different operation areas...
June 7, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27241118/simulator-and-2-tools-validation-of-performance-measures-from-a-novel-neurosurgery-simulation-model-using-the-current-standards-framework
#11
Deborah M Rooney, Bruce L Tai, Oren Sagher, Albert J Shih, David Andrew Wilkinson, Luis E Savastano
BACKGROUND: Ventriculostomy is a common neurosurgical procedure with a relatively steep learning curve. A low-cost, high-fidelity simulator paired with procedure-specific performance measures would provide a safe environment to teach ventriculostomy procedural skills. The same validated simulation model could also allow for assessment of trainees' proficiencies with measures that align with Accreditation Council for Graduate Medical Education milestones. This study extends previous work to evaluate validity evidence from the simulator, its newly developed performance assessment, the Ventricolostomy Procedural Assessment Tool, and the Objective Structured Assessment for Technical Skills...
September 2016: Surgery
https://www.readbyqxmd.com/read/27233494/simulation-based-training-for-burr-hole-surgery-instrument-recognition
#12
David B Clarke, Nelofar Kureshi, Murray Hong, Maryam Sadeghi, Ryan C N D'Arcy
BACKGROUND: The use of simulation training in postgraduate medical education is an area of rapidly growing popularity and research. This study was designed to assess the impact of simulation training for instrument knowledge and recognition among neurosurgery residents. METHODS: This was a randomized control trial of first year residents from neurosurgery residency training programs across Canada. Eighteen neurosurgery trainees were recruited to test two simulation-based applications: PeriopSim™ Instrument Trainer and PeriopSim™ for Burr Hole Surgery...
2016: BMC Medical Education
https://www.readbyqxmd.com/read/27147144/simulation-in-neurosurgery-past-present-and-future
#13
Ashish Suri, Devi Prasad Patra, Rajesh Kumar Meena
Neurosurgery is one of the most technically demanding medical professions that warrants a high level of expertise. In the present context of competitive medical practice, high societal expectations regarding quality of patient care and medicolegal and financial constraints, there are fewer opportunities for a trainee to achieve competency in standard neurosurgical, microsurgical, and operative techniques. Practice on simulation models like cadavers has been a trend since antiquity; however, recent development of newer models with their strategic modifications has given simulation education a new dimension...
May 2016: Neurology India
https://www.readbyqxmd.com/read/27081908/the-relative-efficacy-of-3-different-freehand-frontal-ventriculostomy-trajectories-a-prospective-neuronavigation-assisted-simulation-study
#14
Matthew A Kirkman, William Muirhead, Nick Sevdalis
OBJECTIVE Ventriculostomy is a relatively common neurosurgical procedure, often performed in the setting of acute hydrocephalus. Accurate positioning of the catheter is vital to minimize morbidity and mortality, and several anatomical landmarks are currently used. The aim of this study was to prospectively evaluate the relative performance of 3 recognized trajectories for frontal ventriculostomy using imaging-derived metrics: perpendicular to skull (PTS), contralateral medial canthus/external auditory meatus (CMC/EAM), and ipsilateral medial canthus/external auditory meatus (IMC/EAM)...
April 15, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27062917/a-novel-method-for-3-dimensional-printing-a-brain-that-feels-and-looks-like-one-the-next-step-in-the-search-of-the-perfect-neurosurgical-simulator
#15
Juan Del Castillo-Calcáneo, Jacob Alexander Donoghue
No abstract text is available yet for this article.
July 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27052513/a-neurosurgical-simulation-of-skull-base-tumors-using-a-3d-printed-rapid-prototyping-model-containing-mesh-structures
#16
Kosuke Kondo, Naoyuki Harada, Hiroyuki Masuda, Nobuo Sugo, Sayaka Terazono, Shinichi Okonogi, Yuki Sakaeyama, Yutaka Fuchinoue, Syunpei Ando, Daisuke Fukushima, Jun Nomoto, Masaaki Nemoto
BACKGROUND: Deep regions are not visible in three-dimensional (3D) printed rapid prototyping (RP) models prepared from opaque materials, which is not the case with translucent images. The objectives of this study were to develop an RP model in which a skull base tumor was simulated using mesh, and to investigate its usefulness for surgical simulations by evaluating the visibility of its deep regions. METHODS: A 3D printer that employs binder jetting and is mainly used to prepare plaster models was used...
June 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27046549/an-examination-of-metrics-for-a-simulated-ventriculostomy-part-task
#17
Ryan Armstrong, Dayna Noltie, Roy Eagleson, Sandrine De Ribaupierre
As one of the most commonly performed neurosurgical procedures, ventriculostomy training simulators are becoming increasingly familiar features in research institutes and teaching facilities. Despite their widespread implementations and adoption, simulators to date have not fully explored the landscape of performance metrics that reflect surgical proficiency. They opt instead for measures that are qualitative or simple to compute and conceptualize. In this paper, we examine and compare the use of various metrics to characterize the performance of users on simulated part-task ventriculostomy scenarios derived from patient data...
2016: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/26967787/impact-of-acute-stress-on-psychomotor-bimanual-performance-during-a-simulated-tumor-resection-task
#18
Khalid Bajunaid, Muhammad Abu Shadeque Mullah, Alexander Winkler-Schwartz, Fahad E Alotaibi, Jawad Fares, Marta Baggiani, Hamed Azarnoush, Sommer Christie, Gmaan Al-Zhrani, Ibrahim Marwa, Abdulrahman Jafar Sabbagh, Penny Werthner, Rolando F Del Maestro
OBJECTIVE Severe bleeding during neurosurgical operations can result in acute stress affecting the bimanual psychomotor performance of the operator, leading to surgical error and an adverse patient outcome. Objective methods to assess the influence of acute stress on neurosurgical bimanual psychomotor performance have not been developed. Virtual reality simulators, such as NeuroTouch, allow the testing of acute stress on psychomotor performance in risk-free environments. Thus, the purpose of this study was to explore the impact of a simulated stressful virtual reality tumor resection scenario by utilizing NeuroTouch to answer 2 questions: 1) What is the impact of acute stress on bimanual psychomotor performance during the resection of simulated tumors? 2) Does acute stress influence bimanual psychomotor performance immediately following the stressful episode? METHODS Study participants included 6 neurosurgeons, 6 senior and 6 junior neurosurgical residents, and 6 medical students...
March 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/26926067/improving-the-accuracy-of-brain-tumor-surgery-via-raman-based-technology
#19
Todd Hollon, Spencer Lewis, Christian W Freudiger, X Sunney Xie, Daniel A Orringer
Despite advances in the surgical management of brain tumors, achieving optimal surgical results and identification of tumor remains a challenge. Raman spectroscopy, a laser-based technique that can be used to nondestructively differentiate molecules based on the inelastic scattering of light, is being applied toward improving the accuracy of brain tumor surgery. Here, the authors systematically review the application of Raman spectroscopy for guidance during brain tumor surgery. Raman spectroscopy can differentiate normal brain from necrotic and vital glioma tissue in human specimens based on chemical differences, and has recently been shown to differentiate tumor-infiltrated tissues from noninfiltrated tissues during surgery...
March 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/26816293/preliminary-experience-with-a-new-multidirectional-videoendoscope-for-neuroendoscopic-surgical-procedures
#20
Luigi Maria Cavallo, Alberto Di Somma, Domenico Solari, Oreste de Divitiis, Umberto Marcello Bracale, Paolo Cappabianca
PURPOSE: We assessed the applicability of a new multidirectional videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) in various neuroendoscopic procedures. METHODS: A 4-mm-diameter rigid videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) with 1 sensor and an internal LED light source was tested. The device offers a resolution of 1920 x 1080 pixels and weighs ≈ 215 g. The prototype was tested on three cadaveric heads using three different approaches: a) endoscopic endonasal transsphenoidal; b) frontal transcortical intraventricular; c) supraorbital...
2016: PloS One
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