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New surgical tools, such as the exoscope, are being developed, and even skilled neurosurgeons need to learn the differences between an exoscope and a microscope. A middle cerebral artery aneurysm was clipped using an exoscope. Before clinical use, we simulated clipping by exoscope using model aneurysms. The characteristics of the position, quantity of light, and movement of the camera were recorded. Such simulation may be useful for new operative techniques.

With the development of stereotactic radiotherapy, opportunities to perform craniotomies for brain tumors under a microscope are decreasing, making it difficult to learn surgical techniques in clinical practice. For safety and ethical reasons, it is useful to create a brain tumor training model for hands-on practice. We created a sphenoidal ridge meningioma model with the following parameters: (1) the location of the tumor should be distinguishable using neuronavigation, (2) the feeding artery should allow for confirmation and hemostasis, (3) the tumor and brain should be properly adherent and dissectable, and (4) the tumor can be decompressed and removed using an ultrasonic surgical device. We created the model out of polyvinyl alcohol and produced a mold using a 3-dimensional printer. Thirteen young neurosurgeons used these models, and a questionnaire survey was conducted. It was possible to train neurosurgeons for tumor removal using this model. The results of the questionnaire showed that the model, usefulness of the clinical application, and willingness to participate again were highly rated. This model was created to practice procedures with realty and designed to be visualized by navigation systems, to be removed with ultrasonic surgical instruments, and to be dissected using microinstruments. This model is useful to learn surgical techniques and strategies and to test and develop new surgical equipment. Training using a brain tumor model should be good off-the-job training for young neurosurgeons.

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