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提高神经外科技能:颅内-颅外脑旁路培训模型的比较研究。

Advancing Neurosurgical Skills: A Comparative Study of Training Models for Intra-Extracranial Cerebral Bypass.

机构信息

Department of Neurosurgery, Hospital Regional "1° de Octubre", Institute of Social Security and Services for State Workers (ISSSTE), Mexico City, Mexico.

Neural Dynamics and Modulation Lab, Cleveland Clinic, Cleveland, Ohio USA.

出版信息

World Neurosurg. 2024 Sep;189:e921-e931. doi: 10.1016/j.wneu.2024.07.039. Epub 2024 Jul 8.

Abstract

BACKGROUND

Training in anastomosis is fundamental in neurosurgery due to the precision and dexterity required. Biological models, although realistic, present limitations such as availability, ethical concerns, and the risk of biological contamination. Synthetic models, on the other hand, offer durability and standardized conditions, although they sometimes lack anatomical realism. This study aims to evaluate and compare the efficiency of anastomosis training models in the intra-extracranial cerebral bypass procedure, identifying those characteristics that enhance optimal microsurgical skill development and participant experience.

METHODS

A neurosurgery workshop was held from March 2024 to June 2024 with 5 vascular techniques and the participation of 22 surgeons. The models tested were the human placenta, the Wistar rat, the chicken wing artery, the nasogastric feeding tube, and the UpSurgeOn Mycro simulator. The scales used to measure these models were the Main Characteristics Score and the Evaluation Score. These scores allowed us to measure, qualitatively and quantitatively, durability, anatomical similarity, variety of simulation scenarios, risk of biological contamination, ethical considerations and disadvantages with specific infrastructure.

RESULTS

The human placenta model, Wistar rat model, and UpSurgeOn model were identified as the most effective for training. The human placenta and Wistar rat models were highly regarded for anatomical realism, while the UpSurgeOn model excelled in durability and advanced simulation scenarios. Ethical and cost implications were also considered.

CONCLUSIONS

The study identifies the human placenta and UpSurgeOn models as optimal for training in intra-extracranial bypass procedures, emphasizing the need for diverse and effective training models in neurosurgery.

摘要

背景

神经外科需要高度的精确性和灵活性,因此吻合训练至关重要。生物模型虽然具有现实性,但存在可用性、伦理问题和生物污染风险等限制。合成模型则提供了耐用性和标准化条件,但有时缺乏解剖学的真实性。本研究旨在评估和比较颅内-颅外脑旁路手术吻合训练模型的效率,确定那些能增强最佳显微手术技能发展和参与者体验的特征。

方法

2024 年 3 月至 2024 年 6 月,举办了一个神经外科研讨会,共有 5 种血管技术和 22 名外科医生参与。测试的模型有人胎盘、Wistar 大鼠、鸡翅动脉、鼻饲管和 UpSurgeOn Mycro 模拟器。用于测量这些模型的量表是主要特征评分和评估评分。这些评分使我们能够定性和定量地测量耐用性、解剖相似性、模拟场景的多样性、生物污染风险、伦理问题以及与特定基础设施相关的缺点。

结果

胎盘模型、Wistar 大鼠模型和 UpSurgeOn 模型被认为是最有效的训练模型。胎盘和 Wistar 大鼠模型在解剖学真实性方面得到高度评价,而 UpSurgeOn 模型则在耐用性和先进的模拟场景方面表现出色。伦理和成本问题也被考虑在内。

结论

本研究确定胎盘和 UpSurgeOn 模型是颅内-颅外旁路手术训练的最佳选择,强调神经外科需要多样化和有效的训练模型。

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