Discipline of Neurosurgery, Escola Paulista de Medicina da Universidade Federal de São Paulo, Brasil.
Neurosurg Focus. 2011 Apr;30(4):E17. doi: 10.3171/2011.2.FOCUS10321.
Ideal surgical training models should be entirely reliable, atoxic, easy to handle, and, if possible, low cost. All available models have their advantages and disadvantages. The choice of one or another will depend on the type of surgery to be performed. The authors created an anatomical model called the S.I.M.O.N.T. (Sinus Model Oto-Rhino Neuro Trainer) Neurosurgical Endotrainer, which can provide reliable neuroendoscopic training. The aim in the present study was to assess both the quality of the model and the development of surgical skills by trainees.
The S.I.M.O.N.T. is built of a synthetic thermoretractable, thermosensible rubber called Neoderma, which, combined with different polymers, produces more than 30 different formulas. Quality assessment of the model was based on qualitative and quantitative data obtained from training sessions with 9 experienced and 13 inexperienced neurosurgeons. The techniques used for evaluation were face validation, retest and interrater reliability, and construct validation.
The experts considered the S.I.M.O.N.T. capable of reproducing surgical situations as if they were real and presenting great similarity with the human brain. Surgical results of serial training showed that the model could be considered precise. Finally, development and improvement in surgical skills by the trainees were observed and considered relevant to further training. It was also observed that the probability of any single error was dramatically decreased after each training session, with a mean reduction of 41.65% (range 38.7%-45.6%).
Neuroendoscopic training has some specific requirements. A unique set of instruments is required, as is a model that can resemble real-life situations. The S.I.M.O.N.T. is a new alternative model specially designed for this purpose. Validation techniques followed by precision assessments attested to the model's feasibility.
理想的手术培训模型应该完全可靠、无毒、易于操作，并且如果可能的话，成本低廉。所有现有的模型都有其优缺点。选择一种或另一种将取决于要进行的手术类型。作者创建了一种名为 S.I.M.O.N.T.（鼻窦模型耳鼻喉神经训练器）的解剖模型，它可以提供可靠的神经内窥镜培训。本研究的目的是评估模型的质量和受训者手术技能的发展。
S.I.M.O.N.T. 由一种称为 Neoderma 的合成热收缩、热敏橡胶制成，与不同的聚合物结合，可产生 30 多种不同的配方。模型质量评估基于 9 名经验丰富和 13 名缺乏经验的神经外科医生培训课程中获得的定性和定量数据。评估使用的技术包括面部验证、重测和评分者间可靠性以及结构验证。
专家认为 S.I.M.O.N.T. 能够复制手术情况，就像它们是真实的一样，并与人类大脑具有很大的相似性。连续训练的手术结果表明，该模型可以被认为是精确的。最后，观察到受训者的手术技能得到了发展和提高，这被认为与进一步培训有关。还观察到，每次培训后，任何单一错误的概率都会显著降低，平均降低 41.65%（范围 38.7%-45.6%）。
神经内窥镜培训有一些特定的要求。需要一套独特的仪器，以及一个可以模拟真实情况的模型。S.I.M.O.N.T. 是专为此目的设计的一种新型替代模型。经过验证技术和精度评估，证明了该模型的可行性。
