Do overlapping neurosurgical procedures affect patient outcomes? A systematic review and meta-analysis

Kumarapuram, Siddhant; Elmogazy, Omar; Mokhtari, Pooneh; Goldstein, Ira M.; Meybodi, Ali Tayebi

doi:10.1007/s10143-023-01993-7

Cited by 1 publication

(2 citation statements)

References 27 publications

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“…Initially, it is clear that only residents in their final year (fifth year) had successive and autonomous contact with the dural closure procedure, while the others, even with a neurosurgeon preceptor in the field, had restricted contact. These results show that, although medicine and health technologies are advancing rapidly [ 11 - 14 ], new policies defending patients' privacy and autonomy are increasingly limiting the practical activities of resident doctors [ 11 - 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding, there is concern that, within the current scenario, residents do not receive the necessary preparation, mainly due to recent advents of reduced working hours, limitation of residents' peri-operative work, especially in an adequate laboratory, in addition to the difficulty of anatomical pieces due to bureaucracy specific to each region [ 11 - 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Dural Closure Training With Prototyped Model

El Husseini,

Chenisz da Silva,

Giacomelli Leal

et al. 2024

Cureus

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Introduction: The hermetic closure of the dura mater is a critical step in neurosurgical training, often undervalued but crucial to preventing serious complications such as cerebrospinal fluid (CSF) leaks leading to meningitis and death. Inadequate closure, often due to insufficient training, can result in challenging complications, including prolonged hospitalization and reoperation. Objective: To address the deficiencies in dural closure training, this study aims to describe a 3D prototype for simulating post-craniotomy dura mater suturing. The objective is to reduce the incidence of CSF leaks and improve the training of neurosurgery residents. Design: The study involves the creation of a 3D prototype based on magnetic resonance imaging and computed tomography scans. The additive manufacturing of structures is performed using ABS filament, and a silicone rubber membrane is used to simulate the meningeal dura mater. Neurosurgery residents undergo training using this model, and the effectiveness is evaluated. Setting: The study is conducted at the Institute of Neurology of Curitiba (Hospital INC), focusing on neurosurgery residents from the first to fifth year of residency. Participants: Seven residents participate in the study, with varying levels of experience in dural closure procedures. The training involves a simulated surgical environment using the 3D prototype. Results: After training, residents show improvements in confidence and theoretical knowledge related to dural closure. Binary questions indicate a strong desire for more practical training on dural closure, with 85.7% believing in the essential role of 3D molds in their neurosurgery training. Conclusion: The study highlights the importance of adequate training for dural closure to prevent serious complications in neurosurgery. The use of 3D simulation models, despite some limitations, proves to be an effective educational strategy. The emerging technology of bioprinting holds promise for further enhancing simulation materials, bringing medical education closer to realistic tissue replication.

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