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Zaki MM, Joshi RS, Joseph JR, Saadeh YS, Kashlan ON, Godzik J, Uribe JS, Park P. Virtual Reality-Enabled Resident Education of Lateral-Access Spine Surgery. World Neurosurg 2024; 183:e401-e407. [PMID: 38143034 DOI: 10.1016/j.wneu.2023.12.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE Lateral-access spine surgery has many benefits, but adoption has been limited by a steep learning curve. Virtual reality (VR) is gaining popularity and lends itself as a useful tool in enhancing neurosurgical resident education. We thus sought to assess whether VR-based simulation could enhance the training of neurosurgery residents in lateral spine surgery. METHODS Neurosurgery residents completed a VR-based lateral spine module on lateral patient positioning and performing lateral lumbar interbody fusion using the PrecisionOS VR system on the Meta Quest 2 headset. Simulation occurred 1×/week every other week for a total of 3 simulations over 6 weeks. Pre- and postintervention surveys as well as intrasimulation performance metrics were assessed over time. RESULTS The majority of resident participants showed improvement in performance scores, including an automated PrecisionOS precision score, number of radiographs used within the simulation, and time to completion. All participants showed improvement in comfort with anatomic landmarks for lateral access surgery, confidence performing lateral surgery without direct supervision, and assessing fluoroscopy in spine surgery for hardware placement and image interpretation. Participant perception on the utility of VR as an educational tool also improved. CONCLUSIONS VR-based simulation enhanced neurosurgical residents' ability to understand lateral access surgery. Immersive surgical simulation resulted in improved resident confidence with surgical technique and workflow, perceived improvement in anatomical knowledge, and simulation performance scores. Trainee perceptions on virtual simulation and training as a curriculum supplement also improved following completion of VR training.
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Affiliation(s)
- Mark M Zaki
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Rushikesh S Joshi
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacob R Joseph
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Yamaan S Saadeh
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Osama N Kashlan
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jakub Godzik
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Juan S Uribe
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Paul Park
- Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, Tennessee, USA.
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Scullen T, Milburn J, Mathkour M, Larrota A, Aduloju O, Dumont A, Nerva J, Amenta P, Wang A. Training Cerebrovascular and Neuroendovascular Surgery Residents: A Systematic Literature Review and Recommendations. Ochsner J 2024; 24:36-46. [PMID: 38510222 PMCID: PMC10949058 DOI: 10.31486/toj.23.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Background: The rapid evolution of neuroendovascular intervention has resulted in the inclusion of endovascular techniques as a core competency in neurosurgical residency training. Methods: We conducted a literature review of studies involving the training of neurosurgical residents in cerebrovascular and endovascular neurosurgery. We reviewed the evolution of cerebrovascular neurosurgery and the effects of these changes on residency, and we propose interventions to supplement contemporary training. Results: A total of 48 studies were included for full review. Studies evaluated trainee education and competency (29.2%, 14/48), neuroendovascular training models (20.8%, 10/48), and open cerebrovascular training models (52.1%, 25/48), with some overlap. We used a qualitative analysis of reviewed reports to generate a series of suggested training supplements to optimize cerebrovascular education. Conclusion: Cerebrovascular neurosurgery is at a crossroads where trainees must develop disparate skill sets with inverse trends in volume. Continued longitudinal exposure to both endovascular and open cerebrovascular surgical fields should be mandated in general resident education, and blended learning tactics using adjunct simulation systems and models should be incorporated with didactics to both optimize learning and alleviate restraints placed by decreased volume and autonomy.
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Affiliation(s)
- Tyler Scullen
- Department of Neurological Surgery, Tulane Medical Center, New Orleans, LA
| | - James Milburn
- Department of Radiology, Ochsner Clinic Foundation, New Orleans, LA
- The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA
| | - Mansour Mathkour
- Department of Neurological Surgery, Tulane Medical Center, New Orleans, LA
| | - Angela Larrota
- International School of Louisiana, West Bank Campus, New Orleans, LA
| | | | - Aaron Dumont
- Department of Neurological Surgery, Tulane Medical Center, New Orleans, LA
| | - John Nerva
- Department of Neurological Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Peter Amenta
- Department of Neurological Surgery, University of Massachusetts, Worchester, MA
| | - Arthur Wang
- Department of Neurological Surgery, Tulane Medical Center, New Orleans, LA
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Colombo E, Lutters B, Kos T, van Doormaal T. Application of virtual and mixed reality for 3D visualization in intracranial aneurysm surgery planning: a systematic review. Front Surg 2023; 10:1227510. [PMID: 37829601 PMCID: PMC10564996 DOI: 10.3389/fsurg.2023.1227510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Background Precise preoperative anatomical visualization and understanding of an intracranial aneurysm (IA) are fundamental for surgical planning and increased intraoperative confidence. Application of virtual reality (VR) and mixed reality (MR), thus three-dimensional (3D) visualization of IAs could be significant in surgical planning. Authors provide an up-to-date overview of VR and MR applied to IA surgery, with specific focus on tailoring of the surgical treatment. Methods A systematic analysis of the literature was performed in accordance with the PRISMA guidelines. Pubmed, and Embase were searched to identify studies reporting use of MR and VR 3D visualization in IA surgery during the last 25 years. Type and number of IAs, category of input scan, visualization techniques (screen, glasses or head set), inclusion of haptic feedback, tested population (residents, fellows, attending neurosurgeons), and aim of the study (surgical planning/rehearsal, neurosurgical training, methodological validation) were noted. Results Twenty-eight studies were included. Eighteen studies (64.3%) applied VR, and 10 (35.7%) used MR. A positive impact on surgical planning was documented by 19 studies (67.9%): 17 studies (60.7%) chose the tailoring of the surgical approach as primary outcome of the analysis. A more precise anatomical visualization and understanding with VR and MR was endorsed by all included studies (100%). Conclusion Application of VR and MR to perioperative 3D visualization of IAs allowed an improved understanding of the patient-specific anatomy and surgical preparation. This review describes a tendency to utilize mostly VR-platforms, with the primary goals of a more accurate anatomical understanding, surgical planning and rehearsal.
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Affiliation(s)
- Elisa Colombo
- Department of Neurosurgery and Klinisches Neurozentrum Zurich ZH, Universität Zürich; Universitätsspital Zürich, Zurich, Switzerland
| | - Bart Lutters
- Julius Center for Health Sciences and Primary Care, Medical Humanities, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tessa Kos
- Image Science Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tristan van Doormaal
- Department of Neurosurgery and Klinisches Neurozentrum Zurich ZH, Universität Zürich; Universitätsspital Zürich, Zurich, Switzerland
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4
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Adnan S, Xiao J. A scoping review on the trends of digital anatomy education. Clin Anat 2023; 36:471-491. [PMID: 36583721 DOI: 10.1002/ca.23995] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
Digital technologies are changing the landscape of anatomy education. To reveal the trend of digital anatomy education across medical science disciplines, searches were performed using PubMed, EMBASE, and MEDLINE bibliographic databases for research articles published from January 2010 to June 2021 (inclusive). The search was restricted to publications written in English language and to articles describing teaching tools in undergraduate and postgraduate anatomy and pre-vocational clinical anatomy training courses. Among 156 included studies across six health disciplines, 35% used three-dimensional (3D) digital printing tools, 24.2% augmented reality (AR), 22.3% virtual reality (VR), 11.5% web-based programs, and 4.5% tablet-based apps. There was a clear discipline-dependent preference in the choice and employment of digital anatomy education. AR and VR were the more commonly adopted digital tools for medical and surgical anatomy education, while 3D printing is more broadly used for nursing, allied health and dental health education compared to other digital resources. Digital modalities were predominantly adopted for applied interactive anatomy education and primarily in advanced anatomy curricula such as regional anatomy and neuroanatomy. Moreover, there was a steep increase in VR anatomy combining digital simulation for surgical anatomy training. There is a consistent increase in the adoption of digital modalities in anatomy education across all included health disciplines. AR and VR anatomy incorporating digital simulation will play a more prominent role in medical education of the future. Combining multimodal digital resources that supports blended and interactive learning will further modernize anatomy education, moving medical education further away from its didactic history.
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Affiliation(s)
- Sharmeen Adnan
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Junhua Xiao
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,School of Allied Health, La Trobe University, Bundoora, Australia
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Wickramasinghe N, Thompson BR, Xiao J. The Opportunities and Challenges of Digital Anatomy for Medical Sciences: Narrative Review. JMIR MEDICAL EDUCATION 2022; 8:e34687. [PMID: 35594064 PMCID: PMC9166657 DOI: 10.2196/34687] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/23/2022] [Accepted: 03/25/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Anatomy has been the cornerstone of medical education for centuries. However, given the advances in the Internet of Things, this landscape has been augmented in the past decade, shifting toward a greater focus on adopting digital technologies. Digital anatomy is emerging as a new discipline that represents an opportunity to embrace advances in digital health technologies and apply them to the domain of modern medical sciences. Notably, the use of augmented or mixed and virtual reality as well as mobile and platforms and 3D printing in modern anatomy has dramatically increased in the last 5 years. OBJECTIVE This review aims to outline the emerging area of digital anatomy and summarize opportunities and challenges for incorporating digital anatomy in medical science education and practices. METHODS Literature searches were performed using the PubMed, Embase, and MEDLINE bibliographic databases for research articles published between January 2005 and June 2021 (inclusive). Out of the 4650 articles, 651 (14%) were advanced to full-text screening and 77 (1.7%) were eligible for inclusion in the narrative review. We performed a Strength, Weakness, Opportunity, and Threat (SWOT) analysis to evaluate the role that digital anatomy plays in both the learning and teaching of medicine and health sciences as well as its practice. RESULTS Digital anatomy has not only revolutionized undergraduate anatomy education via 3D reconstruction of the human body but is shifting the paradigm of pre- and vocational training for medical professionals via digital simulation, advancing health care. Importantly, it was noted that digital anatomy not only benefits in situ real time clinical practice but also has many advantages for learning and teaching clinicians at multiple levels. Using the SWOT analysis, we described strengths and opportunities that together serve to underscore the benefits of embracing digital anatomy, in particular the areas for collaboration and medical advances. The SWOT analysis also identified a few weaknesses associated with digital anatomy, which are primarily related to the fact that the current reach and range of applications for digital anatomy are very limited owing to its nascent nature. Furthermore, threats are limited to technical aspects such as hardware and software issues. CONCLUSIONS This review highlights the advances in digital health and Health 4.0 in key areas of digital anatomy analytics. The continuous evolution of digital technologies will increase their ability to reinforce anatomy knowledge and advance clinical practice. However, digital anatomy education should not be viewed as a simple technical conversion and needs an explicit pedagogical framework. This review will be a valuable asset for educators and researchers to incorporate digital anatomy into the learning and teaching of medical sciences and their practice.
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Affiliation(s)
- Nilmini Wickramasinghe
- School of Health Sciences, Swinburne University of Technology, Victoria, Australia
- Epworth Healthcare, Melbourne, Australia
| | - Bruce R Thompson
- School of Health Sciences, Swinburne University of Technology, Victoria, Australia
- Alfred Health, Melbourne, Australia
- School of Health Sciences, University of Melbourne, Parkville, Australia
| | - Junhua Xiao
- School of Health Sciences, Swinburne University of Technology, Victoria, Australia
- School of Allied Health, La Trobe University, Bundoora, Australia
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Scott H, Griffin C, Coggins W, Elberson B, Abdeldayem M, Virmani T, Larson-Prior LJ, Petersen E. Virtual Reality in the Neurosciences: Current Practice and Future Directions. Front Surg 2022; 8:807195. [PMID: 35252318 PMCID: PMC8894248 DOI: 10.3389/fsurg.2021.807195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/30/2021] [Indexed: 01/05/2023] Open
Abstract
Virtual reality has made numerous advancements in recent years and is used with increasing frequency for education, diversion, and distraction. Beginning several years ago as a device that produced an image with only a few pixels, virtual reality is now able to generate detailed, three-dimensional, and interactive images. Furthermore, these images can be used to provide quantitative data when acting as a simulator or a rehabilitation device. In this article, we aim to draw attention to these areas, as well as highlight the current settings in which virtual reality (VR) is being actively studied and implemented within the field of neurosurgery and the neurosciences. Additionally, we discuss the current limitations of the applications of virtual reality within various settings. This article includes areas in which virtual reality has been used in applications both inside and outside of the operating room, such as pain control, patient education and counseling, and rehabilitation. Virtual reality's utility in neurosurgery and the neurosciences is widely growing, and its use is quickly becoming an integral part of patient care, surgical training, operative planning, navigation, and rehabilitation.
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Affiliation(s)
- Hayden Scott
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- *Correspondence: Hayden Scott
| | - Connor Griffin
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - William Coggins
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Brooke Elberson
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Mohamed Abdeldayem
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Tuhin Virmani
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Linda J. Larson-Prior
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Erika Petersen
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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7
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Rubio RR, Bonaventura RD, Kournoutas I, Barakat D, Vigo V, El-Sayed I, Abla AA. Stereoscopy in Surgical Neuroanatomy: Past, Present, and Future. Oper Neurosurg (Hagerstown) 2021; 18:105-117. [PMID: 31214715 DOI: 10.1093/ons/opz123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/13/2018] [Indexed: 11/13/2022] Open
Abstract
Since the dawn of antiquity, scientists, philosophers, and artists have pondered the nature of optical stereopsis-the perception of depth that arises from binocular vision. The early 19th century saw the advent of stereoscopes, devices that could replicate stereopsis by producing a 3D illusion from the super-imposition of 2D photographs. This phenomenon opened up a plethora of possibilities through its usefulness as an educational tool-particularly in medicine. Before long, photographers, anatomists, and physicians were collaborating to create some of the first stereoscopic atlases available for the teaching of medical students and residents. In fields like neurosurgery-where a comprehensive visuospatial understanding of neuro-anatomical correlates is crucial-research into stereoscopic modalities are of fundamental importance. Already, medical institutions all over the world are capitalizing on new and immersive technologies-such as 3D intraoperative recording, and 3D endoscopes-to refine their pedagogical efforts as well as improve their clinical capacities. The present paper surveys the history of stereoscopy from antiquity to the modern era-with a focus on its role in neurosurgery and medical education. Through the tracking of this evolution, we can discuss potential benefits, future directions, and highlight areas in which further research is needed. By anticipating these factors, we may strive to take full advantage of an emergent field of technology, for our ultimate goal of improving patient care.
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Affiliation(s)
- Roberto Rodriguez Rubio
- Department of Neurological Surgery, University of California, San Francisco, California.,Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California.,Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California
| | - Rina Di Bonaventura
- Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California
| | - Ioannis Kournoutas
- Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California
| | - Dania Barakat
- Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California
| | - Vera Vigo
- Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California
| | - Ivan El-Sayed
- Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California.,Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California
| | - Adib A Abla
- Department of Neurological Surgery, University of California, San Francisco, California.,Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, California
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8
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Benet A, Tabani H, Griswold D, Zhang X, Kola O, Meybodi AT, Lawton MT. Three-Dimensional Imaging in Neurosurgical Research and Education. World Neurosurg 2016; 91:317-25. [PMID: 27102636 DOI: 10.1016/j.wneu.2016.04.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/05/2016] [Accepted: 04/06/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We describe the setup and use of different 3-dimensional (3-D) recording modalities (macroscopic, endoscopic, and microsurgical) in our laboratory and operating room and discuss their implications in neurosurgical research and didactics. We also highlight the utility of 3-D images in providing depth perception and discernment of structures compared with 2-dimensional (2-D) images. METHODS The technical details for equipment and laboratory setup for obtaining 3-D images were described. The stereoscopic pair of images was obtained using a modified "shoot-shift-shoot" method and later converged to a 3-D image. For microsurgical procedures, 3-D images were obtained using an integrated 3-D video camera coupled to the surgical microscope in both the laboratory and the operating room. Illustrative cases were used to compare 2-D and 3-D images. RESULTS Side-by-side comparisons of 2-D and 3-D images obtained using all modalities revealed that 3-D imaging was superior to 2-D imaging in providing depth perception and structure identification. CONCLUSIONS This is the first report in the literature of the methodology for obtaining 3-D endoscopic endonasal images using the 2-D endoscope. The use of 3-D imaging is invaluable in neurosurgical research and education, as it provides immediate depth perception (third dimension), allowing efficient understanding of key spatial relationships. Integration of 3-D imaging in neurosurgical residency programs may increase learning efficiency and shorten learning curves. However, use of 3-D imaging should not replace direct hands-on practice.
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Affiliation(s)
- Arnau Benet
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA; Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.
| | - Halima Tabani
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA
| | - Dylan Griswold
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA
| | - Xin Zhang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA
| | - Olivia Kola
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA
| | - Ali Tayebi Meybodi
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA
| | - Michael T Lawton
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Skull Base and Cerebrovascular Laboratory, University of California, San Francisco, San Francisco, California, USA
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Implantation of 3D-Printed Patient-Specific Aneurysm Models into Cadaveric Specimens: A New Training Paradigm to Allow for Improvements in Cerebrovascular Surgery and Research. BIOMED RESEARCH INTERNATIONAL 2015; 2015:939387. [PMID: 26539542 PMCID: PMC4619899 DOI: 10.1155/2015/939387] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/21/2015] [Indexed: 11/17/2022]
Abstract
Aim. To evaluate the feasibility of implanting 3D-printed brain aneurysm model in human cadavers and to assess their utility in neurosurgical research, complex case management/planning, and operative training. Methods. Two 3D-printed aneurysm models, basilar apex and middle cerebral artery, were generated and implanted in four cadaveric specimens. The aneurysms were implanted at the same anatomical region as the modeled patient. Pterional and orbitozygomatic approaches were done on each specimen. The aneurysm implant, manipulation capabilities, and surgical clipping were evaluated. Results. The 3D aneurysm models were successfully implanted to the cadaveric specimens' arterial circulation in all cases. The features of the neck in terms of flexibility and its relationship with other arterial branches allowed for the practice of surgical maneuvering characteristic to aneurysm clipping. Furthermore, the relationship of the aneurysm dome with the surrounding structures allowed for better understanding of the aneurysmal local mass effect. Noticeably, all of these observations were done in a realistic environment provided by our customized embalming model for neurosurgical simulation. Conclusion. 3D aneurysms models implanted in cadaveric specimens may represent an untapped training method for replicating clip technique; for practicing certain approaches to aneurysms specific to a particular patient; and for improving neurosurgical research.
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10
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Phitayakorn R, Lachman N. Getting back together after a break-up: Relationship advice for anatomists and surgeons. Clin Anat 2015; 28:931-4. [PMID: 26174432 DOI: 10.1002/ca.22596] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/07/2015] [Accepted: 07/07/2015] [Indexed: 11/11/2022]
Abstract
The "surgeon-anatomist" was originally a single individual who self-pursued knowledge and understanding of anatomy as the foundation for successful surgical outcomes. However, recent advances in medical education have ironically led to the separation of anatomy and surgery. This physical and emotional "divorce" of anatomists and surgeons into separate individuals has created several critical educational issues for medical and surgical educators including a general lack of anatomical knowledge in medical students and misalignment of graduate medical education procedural specialty training with the Accreditation Council of Graduate Medical Education Core Competencies and now the Next Accreditation System. There are numerous opportunities for anatomists and surgeons to work together to improve educational instruction of established difficult anatomical regions, procedural training, or even develop new techniques and procedures. Similarly, anatomists with specialized training in medical education would be invaluable partners to ensure that procedural assessments align with instructional technologies for truly longitudinal curricula that starts at the medical student level, but stops at the patient outcomes of attending surgeons. This mutually beneficial relationship would be similar to multidisciplinary care teams and current surgeon and PhD/EdD partnerships. The restoration of the relationship between anatomists and surgeons would be invaluable to surgical education and remains an exciting research opportunity.
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Affiliation(s)
- Roy Phitayakorn
- Department of Surgery, The Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nirusha Lachman
- Department of Anatomy, College of Medicine, Mayo Clinic, Rochester, Minnesota
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11
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Wang SS, Li JF, Zhang SM, Jing JJ, Xue L. A virtual reality model of the clivus and surgical simulation via transoral or transnasal route. Int J Clin Exp Med 2014; 7:3270-3279. [PMID: 25419358 PMCID: PMC4238541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 09/20/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Neurosurgery in areas with restricted space and complicated anatomy can be greatly aided by the virtual reality (VR) technique. The clivus represents one of such challenging surgical areas, but its VR has not been established. The present study aimed to document a VR model of clival anatomy that may be useful in clival surgery. METHODS High resolution CT angiography and MRI were used. The study included a total of 20 patients who did not have any obvious abnormalities detected in the oral, nasal, and clival areas. The images were fused with a Dextroscope. RESULTS In the VR model, the key structures such as the clival bone, basilar artery, brainstem, pituitary gland, and paranasal sinuses were clearly observed. The morphology of the clivus and its spatial relationships with the neighboring structures were also illustrated. Visualization of the clival model can be made flexible from various planes, angles, or orientations. In addition, surgical access to the clivus via the transoral route or transnasal route was simulated in detail. CONCLUSION The simulation of the VR model offers a straightforward, three-dimensional, interactive understanding of the size and shape of the clivus, and its relationships with the surrounding blood vessels and bones. It also demonstrates simulated operational procedures such as opening the surgical window, measuring the exposure distance and angles, and determining the critical boundaries in relation to key structures such as the brainstem and arteries. Digitalized VR modeling appears to be helpful for understanding the anatomy of the clivus and its surgical approaches.
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12
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La simulation en anesthésie-réanimation: outil pédagogique et d’amélioration de la prise en charge des patients. MEDECINE INTENSIVE REANIMATION 2013. [DOI: 10.1007/s13546-012-0631-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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