Menna Grazia, Riva Dora, Marino Salvatore, Garber Jocelyn, Gerritsen Jasper Kees Wim, Mattogno Pier Paolo, Young Jacob Stewart, Olivi Alessandro, Doglietto Francesco, Berger Mitchel Stuart, Della Pepa Giuseppe Maria
Neurosurgery Unit, Department of Neurosciences, Catholic University School of Medicine, Rome, Italy.
Neurosurgery Unit, Department of Neurosciences, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
J Neurooncol. 2025 May;173(1):21-35. doi: 10.1007/s11060-025-04972-8. Epub 2025 Mar 19.
Neuro-oncological surgery has lagged other neurosurgical subspecialties in integrating simulation technologies for training and surgical planning. This study provides a comprehensive scoping review of the current landscape of simulation tools in neuro-oncological surgery, mapping existing research, identifying technological advancements, and highlighting gaps in surgical training and perioperative planning.
We formulated the research question: "What is the effect of perioperative simulation and neuro-oncological training on surgical skill acquisition, patient outcomes, and safety among neurosurgeons, compared to traditional or no training methods?" A comprehensive search was conducted on PubMed, Scopus and ClinicalTrials.gov, with the final search completed in May 2024. The quality of training studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI), and the Cochrane ROBINS-I tool was used to evaluate bias in simulation studies.
The search yielded 5,518 records, with 51 studies meeting the inclusion criteria. These were categorized into six groups: (1) 3D Models in Presurgical Planning and Intraoperative Navigation: 5 articles; (2) Augmented Reality (AR) in Presurgical Planning and Intraoperative Navigation: 25 articles; (3) Mixed Reality (MR) in Presurgical Planning and Intraoperative Navigation: 6 articles; (4) Virtual Reality (VR) in Presurgical Planning and Intraoperative Navigation: 4 articles; (5) AR in Surgical Training: 5 articles; (6) VR in Surgical Training: 6 articles.
While the number of studies on simulation in neuro-oncological surgery is increasing, their analytical depth remains limited. Simulation holds promise for advancing the field, but a significant journey lies ahead before achieving universal academic validation.
神经肿瘤外科在将模拟技术整合用于培训和手术规划方面落后于其他神经外科亚专业。本研究对神经肿瘤外科模拟工具的当前状况进行了全面的范围综述，梳理现有研究，确定技术进步，并突出手术培训和围手术期规划中的差距。
我们提出研究问题：“与传统或无培训方法相比，围手术期模拟和神经肿瘤培训对神经外科医生的手术技能获取、患者结局和安全性有何影响？”在PubMed、Scopus和ClinicalTrials.gov上进行了全面检索，最终检索于2024年5月完成。使用医学教育研究质量工具（MERSQI）评估培训研究的质量，并使用Cochrane ROBINS - I工具评估模拟研究中的偏倚。
检索共获得5518条记录，其中51项研究符合纳入标准。这些研究分为六组：（1）术前规划和术中导航中的三维模型：5篇文章；（2）术前规划和术中导航中的增强现实（AR）：25篇文章；（3）术前规划和术中导航中的混合现实（MR）：6篇文章；（4）术前规划和术中导航中的虚拟现实（VR）：4篇文章；（5）手术培训中的AR：5篇文章；（6）手术培训中的VR：6篇文章。
虽然神经肿瘤外科模拟研究的数量在增加，但其分析深度仍然有限。模拟有望推动该领域发展，但在获得普遍的学术验证之前，仍有很长的路要走。
