Training System for Young Neurosurgeons on Aneurysm Clipping(&lt;SPECIAL ISSUE&gt;Treatment of Cerebral Aneurysms)

To teach microsurgical techniques despite the limited clinical case volume, we prepared an easily accessible and practical training program. The program consists of a micro-scissors exercise with gauze (gauze cutting method), which simulates dissection of the sylvian fissure or the interhemispheric fissure, an anastomosis exercise with gauze, prosthetic tubes, chicken wing artery, or cadaver artery, and an operative stand with a small hole, which simulates a variety of surgical fields.We believe that this protocol is useful for young neurosurgeons to learn and establish steady and skillful microsurgical techniques.

Microsurgical Training Program for Young Neurosurgeons in Our Institute

Saito¹,

Satô²,

Morikawa³

et al. 2008

Microsurgery Training with Opposite Side Stereoscopic Microscopes

桃崎¹,

田中²,

本田³

et al. 2009

Summary:The efficiency of training systems for microsurgery has steadily become more important due to both the increasing need for medical oversight because of medico-legal considerations and the reduction in total number of surgeries being performed. Both Gamma-knife radiosurgery and intravascular intervention techniques have led to a reduction in indication for surgery. We have found that the use of opposite-side stereoscopic microscopes by the surgical assistant is a very useful training method. Younger trainee operators can gain surgical experience under the oversight of an experienced operator with very small risk for the patient.Opposite-side microscopes appear to provide an opportunity for the younger operator to gain experience in as efficiently as possible.

Outcome of Neck Clipping for Ruptured Cerebral Aneurysms by Young Neurosurgeon

Aoki¹,

Morimoto²,

Tokutomi³

et al. 2010

Summary:The favorable surgical result of neck clipping (NC) for ruptured cerebral aneurysms is required even for young neurosurgeons. The results of NC performed by a young neurosurgeon under the supervision of senior neurosurgeons were studied over the last 6 years. The subjects were 32 patients with 34 small aneurysms of anterior circulation (10 males and 22 females) ranging from 27 to 79 years (mean age of 57 years). The location of the aneurysms were 17 of MCA, 13 of ACA and 4 of ICA. Hunt & Hess grade were Grade I to IV without Fisher group 4, and all aneurysms were clipped within 72 hrs of SAH. Outcomes were evaluated by GOS at discharge. Twenty-seven patients (84%) showed favorable outcome (GR MD) and 3 patients (9.3%) died. Two patients had premature rupture during operation. There was no evidence of radiological cerebral contusion or venous infarction. Six patients (18.7%) developed symptomatic vasospasm and 4 patients (12.5%) had hydrocephalus that required VP shunt. Surgical results of NC for ruptured small aneurysm of anterior circulation by a young neurosurgeon are satisfactory under the supervision of senior neurosurgeon.