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A microcontroller-based simulation of dural venous sinus injury for neurosurgical training.
J Neurosurg 2018; 128(5):1553-1559JN

Abstract

OBJECTIVE

Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year.

METHODS

The simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus.

RESULTS

Twelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course ("boot camp") provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey.

CONCLUSIONS

All trainee participants experienced tachycardia during the simulation, although the point in the simulation at which they experienced tachycardia varied. Survey results indicated that participants agreed the simulation was realistic, created stress, and was a useful tool in training neurosurgical residents. This simulator represents a novel, low-cost approach for hands-on training that effectively teaches and tests residents without risk of patient injury.

Authors+Show Affiliations

1Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and. 2Department of Neurological Surgery, University of California, San Diego, California.1Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and.1Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and.1Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Studies

Language

eng

PubMed ID

28574314

Citation

Cleary, Daniel R., et al. "A Microcontroller-based Simulation of Dural Venous Sinus Injury for Neurosurgical Training." Journal of Neurosurgery, vol. 128, no. 5, 2018, pp. 1553-1559.
Cleary DR, Siler DA, Whitney N, et al. A microcontroller-based simulation of dural venous sinus injury for neurosurgical training. J Neurosurg. 2018;128(5):1553-1559.
Cleary, D. R., Siler, D. A., Whitney, N., & Selden, N. R. (2018). A microcontroller-based simulation of dural venous sinus injury for neurosurgical training. Journal of Neurosurgery, 128(5), pp. 1553-1559. doi:10.3171/2016.12.JNS162165.
Cleary DR, et al. A Microcontroller-based Simulation of Dural Venous Sinus Injury for Neurosurgical Training. J Neurosurg. 2018;128(5):1553-1559. PubMed PMID: 28574314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A microcontroller-based simulation of dural venous sinus injury for neurosurgical training. AU - Cleary,Daniel R, AU - Siler,Dominic A, AU - Whitney,Nathaniel, AU - Selden,Nathan R, Y1 - 2017/06/02/ PY - 2017/6/3/pubmed PY - 2019/9/13/medline PY - 2017/6/3/entrez KW - HR = heart rate KW - OHSU = Oregon Health & Science University KW - PGY1 = postgraduate year 1 KW - SNS = Society of Neurological Surgeons KW - bpm = beats per minute KW - hemorrhage KW - neurological surgery KW - residency training KW - sagittal sinus KW - simulation SP - 1553 EP - 1559 JF - Journal of neurosurgery JO - J. Neurosurg. VL - 128 IS - 5 N2 - OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year. METHODS The simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus. RESULTS Twelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course ("boot camp") provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey. CONCLUSIONS All trainee participants experienced tachycardia during the simulation, although the point in the simulation at which they experienced tachycardia varied. Survey results indicated that participants agreed the simulation was realistic, created stress, and was a useful tool in training neurosurgical residents. This simulator represents a novel, low-cost approach for hands-on training that effectively teaches and tests residents without risk of patient injury. SN - 1933-0693 UR - https://www.unboundmedicine.com/medline/citation/28574314/A_microcontroller_based_simulation_of_dural_venous_sinus_injury_for_neurosurgical_training_ L2 - https://thejns.org/doi/10.3171/2016.12.JNS162165 DB - PRIME DP - Unbound Medicine ER -