Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Milan, Italy; Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Milan, Italy; Department of Life Sciences, University of Trieste, Trieste, Italy.
Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Milan, Italy; Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Milan, Italy.
World Neurosurg. 2021 Oct;154:e19-e28. doi: 10.1016/j.wneu.2021.06.058. Epub 2021 Jun 19.
Skull base meningiomas represent a challenge for neurosurgeons, and the procedures are typically performed by experienced neurosurgeons, thus limiting resident training. A new simulation and rehearsal device can be used as an aid for senior surgeons during these operations and serve as a training tool for junior surgeons.
Forty patients harboring an anterior/middle fossa meningioma were recruited. Surgical Theater, a rehearsal/simulation platform, was used for preoperative planning and intraoperative 3D navigation on 20 patients (CT-MADE group), while the remaining (control group) underwent a traditional navigation. Qualitative comparisons between the 2 groups were made with regard to surgical procedure and patient outcome. Satisfaction questionnaires were completed by expert neurosurgeons and residents to assess the overall usefulness of the platform. Furthermore, the surface of the simulated craniotomy performed during the planning was compared with the one actually performed during surgery in order to evaluate the reliability of the planning.
No differences between the 2 groups were found (surgery duration: P = 0.4; visual impairment: P = 0.56). Both residents and senior neurosurgeons enjoyed using the platform for intraoperative navigation and planning; simulated craniotomies were significantly smaller as compared with the real ones (P = 0.009), probably because it was not intuitive to depict the exact margins of the operculum with the platform.
Surgical Theater helped residents to improve their anatomic and procedural comprehension and was deemed as a useful aid to safely perform some demanding neurosurgical procedures, by both senior and junior surgeons.
颅底脑膜瘤对神经外科医生来说是一个挑战，这些手术通常由经验丰富的神经外科医生进行，因此限制了住院医师的培训。一种新的模拟和排练设备可以作为这些手术中资深外科医生的辅助工具，并作为初级外科医生的培训工具。
招募了 40 名患有前/中颅窝脑膜瘤的患者。20 名患者（CT-MADE 组）使用 Surgical Theater（排练/模拟平台）进行术前规划和术中 3D 导航，而其余患者（对照组）则采用传统导航。对两组患者的手术过程和患者预后进行定性比较。由经验丰富的神经外科医生和住院医师填写满意度调查问卷，以评估该平台的整体实用性。此外，还比较了在规划期间进行的模拟开颅术的表面与实际手术期间进行的开颅术的表面，以评估规划的可靠性。
两组之间没有发现差异（手术时间：P=0.4；视力障碍：P=0.56）。住院医师和资深神经外科医生都喜欢使用该平台进行术中导航和规划；模拟开颅术明显小于实际开颅术（P=0.009），可能是因为该平台不能直观地描绘出帽状腱膜的确切边界。
Surgical Theater 有助于住院医师提高解剖和手术程序的理解，并被认为是一种有用的辅助工具，可以帮助资深和初级外科医生安全地进行一些高要求的神经外科手术。
