Neurosurgical training model in bovine brain for resection of intraaxial tumors.

Abstract

Background: Practice in simulation models optimizes learning and manual skills necessary in neurosurgical training.

Objectives: To describe a neurosurgical simulation model for the resection of brain tumors using easily accessible materials and to evaluate the acceptance of the model through a questionnaire.

Methods: An artificial tumor based on gelatin and spongostan with infiltrative characteristics was elaborated. It was injected into a bovine brain and the latter into a dry skull. Its location was studied to later operate it using microsurgical instruments. Dural opening, corticotomy, biopsy and debulking with supramarginal resection were performed and the participants evaluated the model through a Likert-type questionnaire.

Results: In vivo simulation models, cadaveric preparations, 3D printing, virtual reality and injection of artificial lesions into animal brains ex vivo are described. In the latter, the creation of tumors based on different materials, including gelatin, is mentioned. It is important that the tumor is easy to inject and resistant to heat, so a mixture of gelatin - spongostan was created. This model describes qualities to emulate tumor surgery as well as pre-surgical planning, reconstruction of the subarachnoid space and continuous instillation of artificial blood to the surgical bed.

Conclusion: An intraaxial tumor simulation model was described as a useful tool to improve surgical techniques in oncological neurosurgery. It proved to have a good degree of acceptance in the participants.