Simulator Training for Endovascular Neurosurgery

摘要

Simulation of complex, high-risk procedures is critical to the education of medical trainees. A protocol for simulator-based endovascular neurosurgery training in a controlled academic environment is described. The protocol includes stepwise guidelines for trainees of varying levels, with a discussion of the advantages and limitations of this model.

摘要

Simulation-based training has become common practice across medical specialties, especially for learning complex skills performed in high-risk environments. In the field of endovascular neurosurgery, the demand for consequence- and risk-free learning environments led to the development of simulation devices valuable for medical trainees. The goal of this protocol is to provide instructive guidelines for the use of an endovascular neurosurgery simulator in an academic setting. The simulator provides trainees with the opportunity to receive realistic feedback on their knowledge of anatomy, as well as haptic feedback indicative of their success in handling the catheter-based systems without negative consequences. The utility of this specific protocol in relation to other neuroendovascular training modalities is also discussed.

引言

Simulation-based training is an established educational tool for medical trainees and is particularly beneficial in high-risk fields such as endovascular neurosurgery. Multiple virtual reality training devices utilizing catheter-based systems exist, such as the ANGIO Mentor simulator (Simbionix Ltd., Airport City, Israel) and VIST-C and VIST G5 simulators (Mentice AB, Gothenburg, Sweden), with a significant body of data demonstrating the utility of training on procedural aptitude¹. In spite of the usefulness of the simulators, step-by-step procedural instructions for their use are lacking.

Presented is a detailed pro....

方案

1. Simulator setup

1. Prior to all procedures, assemble the simulator as shown in Figure 1 and turn on. Refer to Table 1 for the full list of simulator equipment needed to complete each simulation.
2. Select the patient scenario using the software interface on the attached laptop (Figure 1C).
3. Select the appropriate arterial sheath or guide catheter from the drop-down menu. This does not need to be physically inserted as part of the simulation, but will act as the femoral access site and allow subsequent entry of wires and catheters into the system (

结果

The ANGIO Mentor simulator was previously shown to improve the skills of surgical trainees with varying neuroendovascular experience when performing simulated diagnostic angiograms, thrombectomies, and ruptured aneurysm coil embolizations in an academic setting². In this study, performance metrics for the aforementioned procedures were established over the course of 30 days in one medical student, one neurosurgery resident, two diagnostic neuroradiology fellows, and one endovascular neurosurgery f.......

讨论

Endovascular surgery is an expanding field that offers a minimally invasive treatment approach to a variety of pathologies. The significant risks associated with vascular injuries nonetheless provides unique educational challenges. With advances in simulation-based training, the education of trainees now allows practice in a risk-free environment that mimics real-life cases. Accordingly, endovascular simulation-based training has been shown to consistently improve performance metrics such as procedure time, fluoroscopy t.......

材料

本文使用的材料清单

姓名	公司	目录编号	评论
ANGIO Mentor 模拟器	Simbionix Ltd.，以色列机场城	N/a	ANGIO Mentor 模拟器的设置包括模拟器外壳，如图 1 所示： （A），用于图像投影的外部监视器（X 射线、血管造影;B），用于与 Simbionix 软件接口的笔记本电脑 （C），模拟股动脉鞘（显示外部导尿管、内部诊断微导管和导丝;D）、造影剂注射器 （E）、球囊充气器（F）、支架输送装置（G;不用于这些患者场景）、用于透视、路线图引导和血管造影运行的脚踏板 （H），以及模拟器外壳上的作员控制面板，作员可以在其中控制患者和图像增强器定位 （I）。