Cokluk Cengiz
Department of Neurosurgery, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Asian J Neurosurg. 2018 Oct-Dec;13(4):990-994. doi: 10.4103/ajns.AJNS_372_16.
Repetitive practicing of microneurosurgical techniques in experimental laboratory using real surgical instruments on training models is extremely important before starting the real surgical interventions. The modeling of the surgical steps with creating of suitable laboratory models is also another important issue in the successfully gaining of microneurosurgical practice.
In this experimental study, it was created a laboratory training model for microneurosurgical drilling of cranial bones including the close location with the neural and vascular structures. All steps of this study were performed under the operating microscope. Twenty-five fresh chicken wings obtained from supermarket were used for this study. The difficulty and suitability of the model was evaluated in terms of the usability in the training of microneruosurgical microdrilling. Difficulty of the procedure was divided as three degree (very easy, easy, and difficult). The objective criterion for the evaluation of the difficulty of the procedure was the protection of the neurovascular and muscular structures during the procedure.
The suitability of the procedure was also evaluated within three groups as bad, good, and perfect. In four (16%) chicken wing's bone, the difficulty of the microdirilling was evaluated as difficult. Fifteen (60%) of the chicken wing's bones were microsurgically drilled with easy procedure. The remaining six (24%) of the wing's bone microdrilling was evaluated as very easy procedure. The suitability of the model was evaluated as bad in three (12%) of the chicken wing's bone. The suitability was found as good in 16 (64%) of the bones. In the remaining three (24%) of the chicken wing's bone microdrilling, the suitability of the model was evaluated as perfect.
Microsurgical drilling of the chicken wing's bone without any vascular and muscular injury is accepted as the indication of the successfully surgical microdrilling process. Consolidation of the surgical practice in a laboratory setting, grasping and using of microsurgical instruments, can be repeated in several times in this model. We believe that this model will contribute to the practical training of microneurosurgery.
在开始实际手术干预之前,在实验室内使用真实手术器械在训练模型上反复练习显微神经外科技术极为重要。创建合适的实验室模型来模拟手术步骤也是成功获得显微神经外科实践经验的另一个重要问题。
在本实验研究中,创建了一个用于颅骨显微神经外科钻孔的实验室训练模型,该模型包括与神经和血管结构的紧邻位置。本研究的所有步骤均在手术显微镜下进行。从超市获取的25个新鲜鸡翅用于本研究。根据其在显微神经外科微钻孔训练中的可用性评估该模型的难度和适用性。手术难度分为三个等级(非常容易、容易和困难)。评估手术难度的客观标准是在手术过程中对神经血管和肌肉结构的保护。
该手术的适用性也分为三组进行评估,即差、好和完美。在4个(16%)鸡翅骨中,微钻孔难度被评估为困难。15个(60%)鸡翅骨通过简单的手术进行了显微钻孔。其余6个(24%)鸡翅骨的微钻孔被评估为非常简单的手术。在3个(12%)鸡翅骨中,该模型的适用性被评估为差。在16个(64%)骨头中,适用性被发现为好。在其余3个(24%)鸡翅骨的微钻孔中,该模型的适用性被评估为完美。
在不造成任何血管和肌肉损伤的情况下对鸡翅骨进行显微外科钻孔被视为成功的手术微钻孔过程的标志。在实验室环境中巩固手术实践、掌握和使用显微外科器械,在这个模型中可以重复进行多次。我们相信这个模型将有助于显微神经外科的实践培训。