ABSTRACT
Introduction: Pediatric hydrocephalus is highly prevalent and therefore a major neurosurgical problem in Africa. In addition to ventriculoperitoneal shunts, which have high cost and potential complications, endoscopic third ventriculostomy is becoming an increasingly popular technique especially in this part of the world. However, performing this procedure requires trained neurosurgeons with an optimal learning curve. For this reason, we have developed a 3D printed training model of hydrocephalus so that neurosurgeons without previous experience with endoscopic techniques can acquire these skills, especially in low-income countries, where specific techniques training as this, are relatively absent. Research Question: Our research question was about the possibility to develop and produce a low-cost endoscopic training model and to evaluate the usefulness and the skills acquired after training with it. Material and Methods: A neuroendoscopy simulation model was developed. A sample of last year medical students and junior neurosurgery residents without prior experience in neuroendoscopy were involved in the study. The model was evaluated by measuring several parameters, as procedure time, number of fenestration attempts, diameter of the fenestration, and number of contacts with critical structures. Results: An improvement of the average score on the ETV-Training-Scale was noticed between the first and last attempt (11.6, compared to 27.5 points; p<0.0001). A statistically significant improvement in all parameters, was observed. Discussion and Conclusion: This 3D printed simulator facilitates acquiring surgical skills with the neuroendoscope to treat hydrocephalus by performing an endoscopic third ventriculostomy. Furthermore, it has been shown to be useful to understand the intraventricular anatomical relationships.
ABSTRACT
BACKGROUND: Stereoscopy has been demonstrated to be a useful method of education in the field of anatomy because it allows users to see, in a simulation, the anatomical structures in their actual volume and depth. METHODS: Cadaveric specimens preserved under formaldehyde using the Thiel and Klinger techniques have been dissected and photographed in the medical school anatomy laboratory (University Miguel Hernández) for the past 10 years. The photographic material and technique required to capture and project stereoscopic photographs have been described in different fields of surgical neuroanatomy. We used the results from a survey completed by the participants of different training courses to evaluate the utility of the 3-dimensional (3D) method. RESULTS: A large database of photographs taken of different anatomical regions and approaches of neurosurgical interest was obtained. We have presented some examples in the form of pairs of photographs in 2-dimensional (2D) format, with explanatory labels, paired with the corresponding 3D photograph in anaglyph format. The survey showed that the lectures that had included 3D photographs were significantly better accepted than the lectures with conventional 2D photographs. CONCLUSIONS: The teaching of basic, academic, and clinical neuroanatomy through the projection of stereoscopic photographs can be useful. The methods of image capture and stereoscopic projection in neuroanatomy, once combined with the necessary theoretical and practical knowledge, can be reproduced at other centers of neuroanatomy teaching.
