Filling the gap between the OR and virtual simulation: a European study on a basic neurosurgical procedure

Abstract

Background Currently available simulators are supposed to allow young neurosurgeons to hone their technical skills in a safe environment, without causing any unnecessary harm to their patients caused by their inexperience. For this training method to be largely accepted in neurosurgery, it is necessary to prove simulation efficacy by means of large-scale clinical validation studies. Methods We correlated and analysed the performance at a simulator and the actual operative skills of different neurosurgeons (construct validity). We conducted a study involving 92 residents and attending neurosurgeons from different European Centres; each participant had to perform a virtual task, namely the placement of an external ventricular drain (EVD) at a neurosurgical simulator (ImmersiveTouch). The number of attempts needed to reach the ventricles and the accuracy in positioning the catheter were assessed. Results Data suggests a positive correlation between subjects who placed more EVDs in the previous year and those who get better scores at the simulator (p = .008) (fewer attempts and better surgical accuracy). The number of attempts to reach the ventricle was also analysed; senior residents needed fewer attempts (mean = 2.26; SD = 1.11) than junior residents (mean = 3.12; SD = 1.05) (p = .007) and staff neurosurgeons (mean = 2.89, SD = 1.23). Scoring results were compared by using the Fisher's test, for the analysis of the variances, and the Student's T test. Surprisingly, having a wider surgical experience overall does not correlate with the best performance at the simulator. Conclusion The performance of an EVD placement on a simulator correlates with the density of the neurosurgical experience for that specific task performed in the OR, suggesting that simulators are able to differentiate neurosurgeons according to their surgical ability. Namely this suggests that the simulation performance reflects the surgeons' consistency in placing EVDs in the last year.

Augmented reality head-mounted display–based incision planning in cranial neurosurgery: a prospective pilot study

“…Advances in augmented reality (AR) have enabled the investigation of digital superimposition of radiographic images onto the surgical field using wireless glasses that do not require a physical footprint in the OR. [3][4][5][6][7] This allows for FIN during neurosurgical cases in a potentially less cumbersome fashion than with MWBNS (Video 1). VIDEO 1.…”

The evolution of an SBNS-accredited NANSIG simulated skills workshop for aspiring neurosurgical trainees: an analysis of qualitative and quantitative data

“…This course employed a low tutor to delegate ratio and received excellent feedback on the small group learning with immediate feedback model similar to that of our workshop [28]. Conversely, another VR simulator study confirmed that simulator performance reflects surgeons' ability to place an EVD correctly [30]. Examples of physical simulator models other than ROWENA include MARTYN [23], babyMARTYN [8], Sinus Model Oto-Rhino Neuro Trainer (SIMONT) [11] and the OMeR model (for simulation of deep microvascular anastomosis procedures) [17].…”

A Systematic Review of Simulation-Based Training in Neurosurgery, Part 1: Cranial Neurosurgery

“…The ImmersiveTouch, a VR simulator, was validated for EVD placement in a multicentre study involving 92 participants 26 . The simulator achieved a rating of 2 for both content and relations to other variables, however only achieved a LoE of 1.…”