Novel embalming solution for neurosurgical simulation in cadavers

Benet, Arnau; Rincón-Torroella, Jordina; Lawton, Michael T.; Sánchez, José Juan González

doi:10.3171/2014.1.jns131857

Cited by 88 publications

(68 citation statements)

References 17 publications

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“…In the field of neurosurgery, various simulators for training in bypass surgery and endoscopic surgery have been reported. [8][9][10][11] To make simulation training in neuroendovascular treatment more practical, it is necessary to make the training environment closer to clinical settings. Trainees are required not only to learn the procedure of catheter treatment and the usage of instruments, but also to experience comprehensive simulation including rinsing inside of the catheter, imaging, catheter and wire manipulation, and handling of various other devices.…”

Section: Resultsmentioning

confidence: 99%

Development of Simulator System Using Endovascular Evaluator for Catheter Intervention Training

Koyama

Hanaoka

Kiuchi

et al. 2018

JNET

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Objective: We formulated a simulator system for catheter intervention training by developing a sliding table and an electrically controlled camera-holding C-arm and combining them with the silicone vessel model EndoVascular Evaluator (EVE). We performed simulation of mechanical thrombectomy using this system and evaluated its usability for simulation training.Methods: After three experts in neuroendovascular treatment were given instructions for the use of this system, they performed mechanical thrombectomy by a procedure as close as possible to that in clinical situations using an artificial thrombus model simulating left middle cerebral artery occlusion, and the procedural times and maneuvers were studied.The time required for guiding catheter placement in the cervical internal carotid artery (guiding time), time required for stent placement (stent placement time), and time required for retrieval of thrombus together with the stent (stent retrieval time) were measured, and the number of movements of the sliding table and C-arm during the procedure were counted. Results:The intended procedure could be executed faithfully by all physicians. The mean guiding, stent placement, and stent retrieval times were 185 ± 18, 387 ± 33, and 616 ± 27 seconds, respectively. The mean numbers of table and C-arm movements during the procedure were 14 ± 1.7 and 8.3 ± 0.5, respectively. Conclusion:This system allows operators to faithfully reproduce the mechanical thrombectomy procedure and is considered to have functions necessary for simulation training of catheter intervention and performance assessment.

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Section: Resultsmentioning

confidence: 99%

Development of Simulator System Using Endovascular Evaluator for Catheter Intervention Training

Koyama

Hanaoka

Kiuchi

et al. 2018

JNET

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“…This area was obtained by touching the insular cortex with the navigation probe to obtain the stereotactic coordinates as previously described. 1 The surgical window is a polygonal area formed by the structures that, in more superficial planes, limit the corridor to the insula exposure. Typical structures limiting the surgical window were arteries, veins and cerebral cortex.…”

Section: Dependent Variablesmentioning

confidence: 99%

“…The navigation probe touched the tip of the dissector handle in each major change in trajectory and recorded a set of stereotactic coordinates. 1 Additionally, we measured the extent of cortical resection after a transcortical approach to each insular zone. Three stereotactic points were obtained in each zone by touching the lips of the sylvian fissure with the navigation probe.…”

Section: Dependent Variablesmentioning

confidence: 99%

“…In our recent publication, 1 we described our customized surgical simulation method for neurosurgical research. One of the most interesting findings of the study was that there were no differences on the retraction profile between the specimens prepared with our customized embalming formula and that of unembalmed (i.e., fresh) cadavers.…”

Section: Study Limitationsmentioning

confidence: 99%

“…One of the most interesting findings of the study was that there were no differences on the retraction profile between the specimens prepared with our customized embalming formula and that of unembalmed (i.e., fresh) cadavers. 1 This new method overcomes the major limitations for surgical simulation when using classical cadaver processing techniques (brain stiffness and inability to retract), allowing a very realistic surgical simulation with life-like manipulation of the brain. Therefore, the present study uses the most advanced cadaveric neurosurgical research methods to provide information on the surgical profile of the transsylvian and transcortical approaches to the insula.…”

Section: Study Limitationsmentioning

confidence: 99%

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Surgical assessment of the insula. Part 1: surgical anatomy and morphometric analysis of the transsylvian and transcortical approaches to the insula

Benet

Hervey-Jumper

Sánchez

et al. 2016

JNS

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obJective Transcortical and transsylvian corridors have been previously described as the main surgical approaches to the insula, but there is insufficient evidence to support one approach versus the other. The authors performed a cadaveric comparative study regarding insular exposure, surgical window and freedom, between the transcortical and transsylvian approaches (with and without cutting superficial sylvian bridging veins). Surgical anatomy and skull surface reference points to the different insular regions are also described. methods Sixteen cadaveric specimens were embalmed with a customized formula to enhance neurosurgical simulation. Two different blocks were defined in the study: first, transsylvian without (TS) and with the superficial sylvian bridging veins cut (TSVC) and transcortical (TC) approaches to the insula were simulated in all (16) specimens. Insular surface exposure, surgical window and surgical freedom were calculated for each procedure and related to the BergerSanai insular glioma classification (Zones I-IV) in 10 specimens. Second, the venous drainage pattern and anatomical landmarks considered critical for surgical planning were studied in all specimens. results In the insular Zone I (anterior-superior), the TC approach provided the best insular exposure compared with both TS and TSVC. The surgical window obtained with the TC approach was also larger than that obtained with the TS. The TC approach provided 137% more surgical freedom than the TS approach. Only the TC corridor provided complete insular exposure. In Zone II (posterior-superior), results depended on the degree of opercular resection. Without resection of the precentral gyrus in the operculum, insula exposure, surgical windows and surgical freedom were equivalent. If the opercular cortex was resected, the insula exposure and surgical freedom obtained through the TC approach was greater to that of the other groups. In Zone III (posterior-inferior), the TC approach provided better surgical exposure than the TS, yet similar to the TSVC. The TC approach provided the best insular exposure, surgical window, and surgical freedom if components of Heschl's gyrus were resected. In Zone IV (anterior-inferior), the TC corridor provided better exposure than both the TS and the TSVC. The surgical window was equivalent. Surgical freedom provided by the TC was greater than the TS approach. This zone was completely exposed only with the TC approach. A dominant anterior venous drainage was found in 87% of the specimens. In this group, 50% of the specimens had good alternative venous drainage. The sylvian fissure corresponded to the superior segment of the squamosal suture in 14 of 16 specimens. The foramen of Monro was 1.9 cm anterior and 4.42 cm superior to the external acoustic meatus. The M 2 branch over the central sulcus of the insula became the precentral M 4 (rolandic) artery in all specimens. coNclusioNs Overall, the TC approach to the insula provided better insula exposure and surgical freedom compared with the TS and the TSVC. Corti...

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The Usefulness of Saturated Salt Solution Embalming Method for Oral Surgical Skills Training: A New Cadaveric Training Model for Bone Harvesting

Watanabe

Yoneyama

Hamada

et al. 2019

Anatomical Sciences Ed

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The purpose of this study was to assess the usefulness of saturated salt solution‐embalmed cadavers for oral surgical skills training related to bone graft harvesting. Two half‐day surgical skills training workshops were held at the Tokyo Medical University utilizing eight cadavers embalmed with the saturated salt solution. A total of 22 participants including oral surgeons, residents, and dentists attended the workshop. Surgical training consisted of six procedures related to intraoral and extraoral bone harvesting. The participants were surveyed to assess self‐confidence levels for each surgical procedure before and after completion of each workshop. The Wilcoxon signed‐rank test was used to compare the differences between each median score before and after the workshop. There were statistically significant increases in the self‐assessed confidence scores in bone harvesting procedures for the zygomatic bone (P = 0.003), maxillary tuberosity (P = 0.002), and other sites (P < 0.001). The anatomical features of saturated salt solution‐embalmed cadavers were also examined. The textures of the oral mucosa and skin were similar to those of living individuals. The structure of bone tissues was well‐preserved and the hardness was realistic. Consequently, all procedures were performed with sufficient realism. The saturated salt solution method has a relatively low cost of preparation and storage, and almost no odor. The authors suggest that saturated salt solution‐embalmed cadavers could provide a new model for oral surgical skills training in bone harvesting.

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Novel embalming solution for neurosurgical simulation in cadavers

Cited by 88 publications

References 17 publications

Development of Simulator System Using Endovascular Evaluator for Catheter Intervention Training

Development of Simulator System Using Endovascular Evaluator for Catheter Intervention Training

Surgical assessment of the insula. Part 1: surgical anatomy and morphometric analysis of the transsylvian and transcortical approaches to the insula

The Usefulness of Saturated Salt Solution Embalming Method for Oral Surgical Skills Training: A New Cadaveric Training Model for Bone Harvesting

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