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现代神经外科中将神经解剖学与显微外科技能相结合的艺术。

The art of combining neuroanatomy and microsurgical skills in modern neurosurgery.

作者信息

Ahumada-Vizcaino Juan Carlos, Wuo-Silva Raphael, Hernández Manuel Moreno, Chaddad-Neto Feres

机构信息

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Department of Neurosurgery, Beneficência Portuguesa Hospital, São Paulo, SP, Brazil.

出版信息

Front Neurol. 2023 Jan 12;13:1076778. doi: 10.3389/fneur.2022.1076778. eCollection 2022.

Abstract

Neurosurgical training outside the operating room has become a priority for all neurosurgeons around the world. The exponential increase in the number of publications on training in neurosurgery reflects changes in the environment that future neurosurgeons are expected to work in. In modern practice, patients and medicolegal experts demand objective measures of competence and proficiency in the growing list of techniques available to treat complex neurosurgical conditions. It is important to ensure the myriad of training models available lead to tangible improvements in the operating room. While neuroanatomy textbooks and atlases are continually revised to teach the aspiring surgeon anatomy with a three-dimensional perspective, developing technical skills are integral to the pursuit of excellence in neurosurgery. Parapharsing William Osler, one of the fathers of neurosurgical training, without anatomical knowledge we are lost, but without the experience and skills from practice our journey is yet to begin. It is important to constantly aspire beyond competence to mastery, as we aim to deliver good outcomes for patients in an era of declining case volumes. In this article, we discuss, based on the literature, the most commonly used training models and how they are integrated into the treatment of some surgical brain conditions.

摘要

手术室之外的神经外科培训已成为全球所有神经外科医生的工作重点。神经外科培训相关出版物数量呈指数级增长,这反映了未来神经外科医生预期工作环境的变化。在现代医疗实践中,患者和法医学专家要求对治疗复杂神经外科疾病的一系列日益增多的技术的能力和熟练程度进行客观评估。确保现有的众多培训模式能切实提高手术室操作水平至关重要。虽然神经解剖学教科书和图谱不断修订,以便从三维视角教授有抱负的外科医生解剖学知识,但培养技术技能对于追求神经外科卓越水平不可或缺。套用神经外科培训之父之一威廉·奥斯勒的话来说,没有解剖学知识我们就会迷失,但没有实践经验和技能,我们的征程尚未开始。在病例数量不断减少的时代,我们旨在为患者带来良好治疗效果,因此不断追求从胜任到精通至关重要。在本文中,我们将基于文献讨论最常用的培训模式,以及它们如何融入某些脑部外科疾病的治疗中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/928a/9877616/3a9141ef7c9c/fneur-13-1076778-g0001.jpg

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