The Use of a Novel Perfusion-Based Human Cadaveric Model for Simulation of Dural Venous Sinus Injury and Repair

Abstract

BACKGROUND Dural sinus injuries are potentially serious complications associated with acute blood loss. It is imperative that neurosurgery trainees are able to recognize and manage this challenging scenario. OBJECTIVE To assess the feasibility of a novel perfusion-based cadaveric simulation model to provide the fundamentals of dural sinus repair to neurosurgical trainees. METHODS A total of 10 perfusion-based human cadaveric models underwent superior sagittal sinus (SSS) laceration. Neurosurgery residents were instructed to achieve hemostasis by any method in the first trial and then repeated the trial after watching the instructional dural flap technique video. Trials were timed until hemostasis and control of the region of injury was achieved. Pre- and post-trial questionnaires were administered to assess trainee confidence levels. RESULTS The high-flow extravasation of the perfusion-based cadaveric model mimicked similar conditions and challenges encountered during acute SSS injury. Mean ± standard deviation time to hemostasis was 341.3 ± 65 s in the first trial and 196.9 ± 41.8 s in the second trial (P < .0001). Mean trainee improvement time was 144.4 s (42.3%). Of the least-experienced trainees with longest repair times in the initial trial, a mean improvement time of 188.3 s (44.8%) was recorded. All participants reported increased confidence on post-trial questionnaires following the simulation (median pretrial confidence of 2 vs post-trial confidence of 4, P = .002). CONCLUSION A perfusion-based human cadaveric model accurately simulates acute dural venous sinus injury, affording neurosurgical trainees the opportunity to hone management skills in a simulated and realistic environment.

SimLife model: introducing a new teaching device in endocrine surgery simulation

“…However, are potentially subject to restrictive measures that vary from one country to another [10,19]. Human cadaverbased models, the oldest models available, are considered the best models for surgical training [10,[19][20][21][22][23][24][25][26][27][28][29][30][31]. Nevertheless, their major drawback is that they are static and do not provide real-time dynamic in-theater clinical scenarios [10,[19][20][21][22][23][24][25][26].…”

“…Nevertheless, their major drawback is that they are static and do not provide real-time dynamic in-theater clinical scenarios [10,[19][20][21][22][23][24][25][26]. To overcome this issue, a perfused cadaveric model that offers a hyper-realistic working environment have been introduced [27][28][29][30][31]. SimLife is an organic dynamic simulator that provides the pedagogical items of surgical simulation with the highest possible degree of resemblance to reality, but, away from the patient.…”

Bariatric Surgical Simulation: Evaluation in a Pilot Study of SimLife, a New Dynamic Simulated Body Model

“…A wide number of surgical simulators are available for the benefit of trainees [6,7,9,10,30,[32][33][34][35][36][37][38][39][40][41]. They can be divided into synthetic and organic simulators [7,9].…”

“…To overcome this problem few teams introduced model of perfused cadaveric material, mainly in neurosurgery, reporting higher satisfaction of trainees and increased fidelity, similar to a living patient [6,[40][41][42]. These late reports particularly highlight the increased degree of reality represented by a perfused cadaveric model, which allowed training in hyper-realistic environment [39][40][41].…”

“…Surgical apprenticeship on SimLife is performed safely and achieved a high satisfaction score among trainees, as shown previously. This last point is truly important as apprentice appreciation of simulators is the key to provide successful training as it allows gaining of confidence, increasing of experience, and mastering of surgical techniques, which may be lately translated into proficient medical practice [29,41].…”