Morosanu Cezar Octavian, Nicolae Liviu, Moldovan Remus, Farcasanu Alexandru Stefan, Filip Gabriela Adriana, Florian Ioan Stefan
Department of Neurosurgery, Southmead Hospital, North Bristol Trust, Bristol, .
Department of Neurosurgery, Southmead Hospital, North Bristol Trust, Bristol.
Neurol Neurochir Pol. 2019;53(1):8-17. doi: 10.5603/PJNNS.a2019.0001. Epub 2019 Jan 7.
Due to its high complexity, neurosurgery consists of a demanding learning curve that requires intense training and a deep knowledge of neuroanatomy. Microsurgical skill development can be achieved through various models of simulation, but as human cadaveric models are not always accessible, cadaveric animal models can provide a reliable environment in which to enhance the acquisition of surgical dexterity. The aim of this review was to analyse the current role of animal brains in laboratory training and to assess their correspondence to the procedures performed in humans.
A Pubmed literature search was performed to identify all the articles concerning training cranial and spinal techniques on large animal heads. The search terms were 'training model', and 'neurosurgery' in association with 'animal', 'sheep', 'cow', and 'swine'. The exclusion criteria were articles that were on human brains, experimental fundamental research, or on virtual simulators.
The search retrieved 119 articles, of which 25 were relevant to the purpose of this review. Owing to their similar neuroanatomy, bovine, porcine and ovine models prove to be reliable structures in simulating neurosurgical procedures. On bovine skulls, an interhemispheric transcalosal and retrosigmoid approach along with different approaches to the Circle of Willis can be recreated. Ovine model procedures have varied from lumbar discectomies on sheep spines to craniosynostosis surgery, whereas in ex vivo swine models, cadaveric dissections of lateral sulcus, median and posterior fossa have been achieved.
Laboratory training models enhance surgical advancements by familiarising trainee surgeons with certain neuroanatomical structures and promoting greater surgical dexterity. The accessibility of animal brains allows trainee surgeons to exercise techniques outside the operating theatre, thus optimising outcomes in human surgical procedures.
由于其高度复杂性，神经外科手术的学习曲线要求很高，需要强化训练以及对神经解剖学有深入了解。显微外科技能的发展可以通过各种模拟模型来实现，但由于人体尸体模型并非总能获取，尸体动物模型可以提供一个可靠的环境，以增强手术灵活性的习得。本综述的目的是分析动物脑在实验室训练中的当前作用，并评估它们与人类所进行手术操作的对应性。
进行了一项PubMed文献检索，以识别所有关于在大型动物头部训练颅脑和脊柱技术的文章。检索词为“训练模型”以及与“动物”“绵羊”“牛”和“猪”相关联的“神经外科手术”。排除标准为关于人脑、实验基础研究或虚拟模拟器的文章。
检索到119篇文章，其中25篇与本综述的目的相关。由于其相似的神经解剖结构，牛、猪和羊模型被证明是模拟神经外科手术的可靠结构。在牛颅骨上，可以重现经胼胝体间的半球间入路和乙状窦后入路以及对 Willis 环的不同入路。绵羊模型的手术操作从绵羊脊柱的腰椎间盘切除术到颅缝早闭手术不等，而在离体猪模型中，已实现了外侧沟、中颅窝和后颅窝的尸体解剖。
实验室训练模型通过使实习外科医生熟悉某些神经解剖结构并提高手术灵活性来促进手术进展。动物脑的可获取性使实习外科医生能够在手术室之外练习技术，从而优化人类手术操作的结果。
