New laboratory model for neurosurgical training that simulates live surgery

Aboud, Emad; Al‐Mefty, Ossama; Yaşargil, M. Gazi

doi:10.3171/jns.2002.97.6.1367

Cited by 191 publications

(120 citation statements)

References 8 publications

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“…scribed by Aboud et al 1 was also tested in 1 customized specimen. Brain movements encompassing arterial beating were observed at a normal arterial pressure resembling live surgery.…”

Section: Imaging and Postprocessing Techniquesmentioning

confidence: 99%

“…Despite important advances in surgical simulation, 1,2,14,16,17 an embalming formula customized to allow brain retraction while preserving living brain properties is necessary to recreate neurosurgical scenarios in cadavers. In 2002, Aboud et al introduced a revolutionary laboratory model for neurosurgical training that enabled blood hemorrhage simulations in cadaveric specimens.…”

Section: Surgical Simulation Profilesmentioning

confidence: 99%

“…There have been several major breakthroughs in this field. 1,4,16 However, none of these cited studies provides advances in cadaveric embalming methods to maintain the physical properties of a living brain while preserving the brain specimen from decay.…”

mentioning

confidence: 99%

“…1,4,14,16,17 The main goal of anatomical cadaveric processing is to achieve the most realistic model possible. There have been several major breakthroughs in this field.…”

mentioning

confidence: 99%

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Novel embalming solution for neurosurgical simulation in cadavers

Benet

Rincón-Torroella

Lawton

et al. 2014

JNS

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Object Surgical simulation using postmortem human heads is one of the most valid strategies for neurosurgical research and training. The authors customized an embalming formula that provides an optimal retraction profile and lifelike physical properties while preventing microorganism growth and brain decay for neurosurgical simulations in cadavers. They studied the properties of the customized formula and compared its use with the standard postmortem processing techniques: cryopreservation and formaldehyde-based embalming. Methods Eighteen specimens were prepared for neurosurgical simulation: 6 formaldehyde embalmed, 6 cryopreserved, and 6 custom embalmed. The customized formula is a mixture of ethanol 62.4%, glycerol 17%, phenol 10.2%, formaldehyde 2.3%, and water 8.1%. After a standard pterional craniotomy, retraction profiles and brain stiffness were studied using an intracranial pressure transducer and monitor. Preservation time—that is, time that tissue remained in optimal condition—between specimen groups was also compared through periodical reports during a 48-hour simulation. Results The mean (± standard deviation) retraction pressures were highest in the formaldehyde group and lowest in the cryopreserved group. The customized formula provided a mean retraction pressure almost 3 times lower than formaldehyde (36 ± 3 vs 103 ± 14 mm Hg, p < 0.01) and very similar to cryopreservation (24 ± 6 mm Hg, p < 0.01). For research purposes, preservation time in the cryopreserved group was limited to 4 hours and was unlimited for the customized and formaldehyde groups for the duration of the experiment. Conclusions The customized embalming solution described herein is optimal for allowing retraction and surgical maneuverability while preventing decay. The authors were able to significantly lower the formaldehyde content as compared with that in standard formulas. The custom embalming solution has the benefits from both cryopreservation (for example, biological brain tissue properties) and formaldehyde embalming (for example, preservation time and microorganism growth prevention) and minimizes their drawbacks, that is, rapid decay in the former and stiffness in the latter. The presented embalming formula provides an important advance for neurosurgical simulations in research and teaching.

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“…scribed by Aboud et al 1 was also tested in 1 customized specimen. Brain movements encompassing arterial beating were observed at a normal arterial pressure resembling live surgery.…”

Section: Imaging and Postprocessing Techniquesmentioning

confidence: 99%

Section: Surgical Simulation Profilesmentioning

confidence: 99%

mentioning

confidence: 99%

“…1,4,14,16,17 The main goal of anatomical cadaveric processing is to achieve the most realistic model possible. There have been several major breakthroughs in this field.…”

mentioning

confidence: 99%

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Novel embalming solution for neurosurgical simulation in cadavers

Benet

Rincón-Torroella

Lawton

et al. 2014

JNS

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“…Although this form of simulation uses dead tissue and thus cannot faithfully emulate all physiological conditions, some cadaveric surgical courses have utilized pressurized systems to perfuse cadaveric tissues with blood. Perfusing cadaveric tissue creates high-fidelity models for vascular, microvascular and trauma surgery (25)(26)(27)(28). Additionally, cadavers have been used for training flap coverage techniques as well as various endoscopic and laparoscopic operations (29,30).…”

Section: Cadaversmentioning

confidence: 99%

Innovations in surgery simulation: a review of past, current and future techniques

Badash¹,

Burtt²,

Solorzano³

et al. 2016

Ann. Transl. Med.

260

165

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As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future.Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.

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Performing Procedures on the Newly Deceased for Teaching Purposes

Morag

DeSouza²,

Steen³

et al. 2005

Arch Intern Med

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Asking for permission to perform procedures on the recently deceased for physician training purposes may often anger the bereaved. The emotional response to the consent request may be culturally determined. Increased willingness of individuals to permit the use of their bodies in the immediate postmortem period suggests that a preauthorization program similar to organ donor cards might be acceptable, successful, and ethical.

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New laboratory model for neurosurgical training that simulates live surgery

Cited by 191 publications

References 8 publications

Novel embalming solution for neurosurgical simulation in cadavers

Novel embalming solution for neurosurgical simulation in cadavers

Innovations in surgery simulation: a review of past, current and future techniques

Performing Procedures on the Newly Deceased for Teaching Purposes

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