Coelho Giselle, Warf Benjamin, Lyra Marcos, Zanon Nelci
Pediatric Neurosurgery Center/CENEPE, Beneficência Portuguesa Hospital, Rua Capitão Mor Roque Barreto, no. 47 - Térreo Bela Vista, São Paulo, SP, 01323-030, Brazil,
Childs Nerv Syst. 2014 Dec;30(12):2009-14. doi: 10.1007/s00381-014-2537-x. Epub 2014 Sep 3.
INTRODUCTION: Several surgical training simulators have been created to improve the learning curve of residents in neurosurgery and plastic surgery. Laboratory training is fundamental for acquiring familiarity with the techniques of surgery and the skill in handling instruments. The aim of this study is to present a novel simulator for training in the technique of craniosynostectomy, specifically for the scaphocephaly type. DESCRIPTION OF THE SIMULATOR: This realistic simulator was built with a synthetic thermo-retractile and thermo-sensible rubber which, when combined with different polymers, produces more than 30 different formulas. These formulas present textures, consistencies, and mechanical resistance similar to many human tissues. Fiberglass molds in the shape of the skull constitute the basic structure of the craniosynostectomy training module. It has been possible to perform computerized tomography images due to the radiopacity of this simulator and to compare the pre- and postoperative images. RESULTS: The authors present a training model to practice the biparietal remodeling used in scaphocephaly correction. All aspects of the procedure are simulated: the skin incision, the subcutaneous and subperiosteal dissection, the osteotomies, and finally, the skull remodeling with absorbable microplates. The presence of superior sagittal sinus can simulate emergency situations with bleeding. CONCLUSION: The authors conclude that this training model can represent a fairly useful method to accustom trainees to the required surgical techniques and simulates well the steps of standard surgery for scaphocephaly. This training provides an alternative to the use of human cadavers and animal models. Furthermore, it can represent the anatomical alteration precisely as well as intraoperative emergency situations.
引言:已经创建了几种手术训练模拟器,以改善神经外科和整形外科住院医师的学习曲线。实验室训练对于熟悉手术技术和掌握器械操作技能至关重要。本研究的目的是介绍一种用于颅骨缝早闭手术技术训练的新型模拟器,特别是针对舟状头畸形类型。 模拟器描述:这个逼真的模拟器由一种合成的热缩性和热敏性橡胶制成,与不同的聚合物结合时,可产生30多种不同的配方。这些配方呈现出与许多人体组织相似的质地、稠度和机械阻力。颅骨形状的玻璃纤维模具构成了颅骨缝早闭训练模块的基本结构。由于该模拟器的不透射线性,已经能够进行计算机断层扫描图像,并比较术前和术后图像。 结果:作者提出了一个训练模型,用于练习舟状头畸形矫正中使用的双侧顶骨重塑。该手术的所有方面都进行了模拟:皮肤切口、皮下和骨膜下剥离、截骨术,最后是使用可吸收微型钢板进行颅骨重塑。上矢状窦的存在可以模拟出血的紧急情况。 结论:作者得出结论,这个训练模型可以成为一种相当有用的方法,使受训者熟悉所需的手术技术,并很好地模拟舟状头畸形标准手术的步骤。这种训练为使用人体尸体和动物模型提供了一种替代方案。此外,它可以精确地呈现解剖学改变以及术中紧急情况。
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