Human cadaver brain infusion model for neurosurgical training

Jon Olabe MD , Javier Olabe MD, PhD , Vidal Sancho MD
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引用次数: 53

Abstract

Background

Microneurosurgical technique and anatomical knowledge require extensive laboratory training before mastering these skills. There are diverse training models based on synthetic materials, anesthetized animals, cadaver animals, or human cadaver. Human cadaver models are especially beneficial because they are the closest to live surgery with the greatest disadvantage of lacking hemodynamic factors. We developed the “brain infusion model” to provide a simple but realistic training method minimizing animal use or needs for special facilities.

Methods

Four human cadaveric brains donated for educational purposes were explanted at autopsy. Carotids and vertebral arteries were cannulated with plastic tubes and fixed with suture. Water was flushed through the tubings until the whole arterial vasculature was observed as clean. The cannulated specimens were fixed with formaldehyde. Tap water infusion at a flow rate of 10 L/h was infused through the arterial tubings controlled with a drip regulator filling the arterial tree and leaking into the interstitial and cisternal space.

Results

Multiple microneurosurgical procedures were performed by 4 trainees. Cisternal and vascular dissection was executed in a very realistic fashion. Bypass anastomosis was created as well as aneurysm simulation with venous pouches. Vessel and aneurysm clipping and rupture situations were emulated and solution techniques were trained.

Conclusion

Standard microsurgical laboratories regularly have scarce opportunities for working with decapitated human cadaver heads but could have human brains readily available. The human brain infusion model presents a realistic microneurosurgical training method. It is inexpensive and easy to set up. Such simplicity provides the adequate environment for developing microsurgical techniques.

用于神经外科训练的人尸体脑灌注模型
在掌握这些技能之前,微神经外科技术和解剖学知识需要广泛的实验室培训。基于合成材料、麻醉动物、尸体动物或人类尸体的训练模式多种多样。人体尸体模型是特别有益的,因为它们是最接近现场手术的,最大的缺点是缺乏血液动力学因素。我们开发了“脑灌注模型”,以提供一种简单而现实的训练方法,最大限度地减少动物使用或对特殊设施的需求。方法对4例捐赠的教育用人脑进行解剖移植。颈动脉和椎动脉用塑料管插管,缝合固定。用水冲洗管道,直到观察到整个动脉血管系统是干净的。管状标本用甲醛固定。自来水以10 L/h的流速通过动脉导管输注,由点滴调节器控制,填充动脉树,渗漏至组织间质和池腔。结果4名受训者完成了多次显微神经外科手术。池和血管的解剖以非常逼真的方式进行。建立旁路吻合及静脉囊模拟动脉瘤。模拟血管和动脉瘤夹断和破裂的情况,并训练解决技术。结论标准显微外科实验室通常很少有机会处理斩首人头,但可以随时获得人脑。人脑输注模型提供了一种现实的微神经外科训练方法。它既便宜又容易安装。这种简单性为显微外科技术的发展提供了充分的环境。
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来源期刊
Surgical Neurology
Surgical Neurology 医学-临床神经学
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