The art of combining neuroanatomy and microsurgical skills in modern neurosurgery

Abstract

Neurosurgical training outside the operating room has become a priority for all neurosurgeons around the world. The exponential increase in the number of publications on training in neurosurgery reflects changes in the environment that future neurosurgeons are expected to work in. In modern practice, patients and medicolegal experts demand objective measures of competence and proficiency in the growing list of techniques available to treat complex neurosurgical conditions. It is important to ensure the myriad of training models available lead to tangible improvements in the operating room. While neuroanatomy textbooks and atlases are continually revised to teach the aspiring surgeon anatomy with a three-dimensional perspective, developing technical skills are integral to the pursuit of excellence in neurosurgery. Parapharsing William Osler, one of the fathers of neurosurgical training, without anatomical knowledge we are lost, but without the experience and skills from practice our journey is yet to begin. It is important to constantly aspire beyond competence to mastery, as we aim to deliver good outcomes for patients in an era of declining case volumes. In this article, we discuss, based on the literature, the most commonly used training models and how they are integrated into the treatment of some surgical brain conditions.

Students’ perspectives regarding needs for and opportunities with mixed-reality education in neurosurgery at German medical schools

“…However, neurosurgery is a surgical field with several dedicated tools, such as microscopic surgery, neuronavigation, and fiber tracking, necessitating a sufficient understanding of neuroanatomy to preserve the functionality of patients. 23 In the present survey, the voted median optimum timepoint for incorporating neurosurgical mixed-reality classes was during the 2nd year. Interestingly, in particular young students in their 1st or 2nd year advocated for this early integration within the preclinical program of medical school.…”

Mixed reality compared to the traditional ex cathedra format for neuroanatomy learning: the value of a three-dimensional virtual environment to better understand the real world

“…[1][2][3][4] The 3D spatial representation is, however, fundamental for students or residents aiming to understand the surgical neuroanatomy. [5][6][7] Traditional instruction through ex cathedra lectures and/or cadaveric laboratory sessions presents limitations in terms of visual representation, comprehension, and immersion for students acquiring knowledge in neuroanatomy. 8 Moreover, because of the constantly increasing number of medical students, the evolution of a global curriculum, 9 and the decreased time allocated to neuroanatomy, 10-12 it appears obvious that new strategies to teach and learn neuroanatomy must be developed and implemented.To reduce "neurophobia," or the fear of neurology, neu-…”

Technical Nuances of Using the Peritrigeminal and Infrafacial Entry Zones in Brainstem Cavernoma Surgery: 2-Dimensional Operative Video

“…6 A good understanding of the anatomy of the far-lateral approach and brainstem entry zones is critical to their successful use in brainstem cavernoma surgery. [7][8][9][10][11] The patient was a female in her 20s, with no family history of CCM, prior radiation, or other comorbid conditions. She presented after a 3-week history of progressive headaches associated with left-sided hemisensory disturbance.…”

“…A good understanding of the anatomy of the far-lateral approach and brainstem entry zones is critical to their successful use in brainstem cavernoma surgery. 7-11…”