A Cost-Effective and Reproducible Cadaveric Training Model for Internal Carotid Artery Injury Management During Endoscopic Endonasal Surgery: The Submersible Peristaltic Pump.

Humans Carotid Artery, Internal / surgery Reproducibility of Results Cost-Benefit Analysis Endoscopy / methods Carotid Artery Injuries / etiology Cadaver
Cadaveric models ICA Internal carotid artery injury Perfusion-based models Training models

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Mar 2023
Historique:
received: 18 10 2022
revised: 04 12 2022
accepted: 05 12 2022
pubmed: 14 12 2022
medline: 8 3 2023
entrez: 13 12 2022
Statut: ppublish

Résumé

Internal carotid artery injury (ICAI) represents one of the most challenging complications in endoscopic endonasal neurosurgery and its rarity results in limited opportunities for trainees and surgeons to achieve proficiency in its management. Currently, available models for ICAI have employed costly systems that prevent their widespread use. The objective of this study is to validate an affordable submersible peristaltic pump (SPP)-based model as a reproducible and realistic paradigm for ICAI management training. A laceration of the left parasellar internal carotid artery was purposely carried out in 2 human cadaveric heads. A blood substitute was perfused to ensure a perfusion flow of 1 L/min using an affordable SPP. A cohort of 20 neurosurgery and otolaryngology residents, fellows, and attendings were enrolled to evaluate the realism and content validity of the model using a validated 5-grade questionnaire. The model proved to mimic a real intraoperative scenario of ICAI with an expected output flow of 1 L/min. Questionnaire responses reported a realistic experience and the impact of this model on improving trainee surgical coordination and capability to rehearse the most accepted repair technique. The use of a fixed noninjected head allowed the reproducibility of the training session without the additional cost of new fresh-frozen heads. The affordable SPP allowed an impactful reduction of ICAI model training expenses maintaining high realism. The SPP-based ICAI model with noninjected cadaveric specimens is an affordable and cost-effective system that allows reproducibility and realism. These qualities favor greater adoption in neurosurgery and otolaryngology training curricula.

Sections du résumé

BACKGROUND BACKGROUND
Internal carotid artery injury (ICAI) represents one of the most challenging complications in endoscopic endonasal neurosurgery and its rarity results in limited opportunities for trainees and surgeons to achieve proficiency in its management. Currently, available models for ICAI have employed costly systems that prevent their widespread use. The objective of this study is to validate an affordable submersible peristaltic pump (SPP)-based model as a reproducible and realistic paradigm for ICAI management training.
METHODS METHODS
A laceration of the left parasellar internal carotid artery was purposely carried out in 2 human cadaveric heads. A blood substitute was perfused to ensure a perfusion flow of 1 L/min using an affordable SPP. A cohort of 20 neurosurgery and otolaryngology residents, fellows, and attendings were enrolled to evaluate the realism and content validity of the model using a validated 5-grade questionnaire.
RESULTS RESULTS
The model proved to mimic a real intraoperative scenario of ICAI with an expected output flow of 1 L/min. Questionnaire responses reported a realistic experience and the impact of this model on improving trainee surgical coordination and capability to rehearse the most accepted repair technique. The use of a fixed noninjected head allowed the reproducibility of the training session without the additional cost of new fresh-frozen heads. The affordable SPP allowed an impactful reduction of ICAI model training expenses maintaining high realism.
CONCLUSIONS CONCLUSIONS
The SPP-based ICAI model with noninjected cadaveric specimens is an affordable and cost-effective system that allows reproducibility and realism. These qualities favor greater adoption in neurosurgery and otolaryngology training curricula.

Identifiants

DOI: 10.1016/j.wneu.2022.12.014 PMID: 36513301
pubmed: 36513301
pii: S1878-8750(22)01719-3
doi: 10.1016/j.wneu.2022.12.014
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e355-e362

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Edoardo Porto (E)

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.

J Manuel Revuelta Barbero (JM)

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.

Hanyao Sun (H)

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.

Justin Maldonado (J)

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.

Alejandra Rodas (A)

Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.

John M DelGaudio (JM)

Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.

Oswaldo A Henriquez (OA)

Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.

Emily Barrow (E)

Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.

Gabriel Zada (G)

Department of Neurosurgery, USC Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

C Arturo Solares (CA)

Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA.

Tomas Garzon-Muvdi (T)

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA.

Gustavo Pradilla (G)

Department of Neurosurgery, Emory University, Atlanta, Georgia, USA. Electronic address: gpradil@emory.edu.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A Cost-Effective and Reproducible Cadaveric...
questionsmedicales.fr › Système cardiovasculaire › Vaisseaux sanguins › Artères › Artères carotides › Artère carotide commune › Artère carotide interne › A Cost-Effective and Reproducible Cadaveric...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Reproductibilité des résultats › A Cost-Effective and Reproducible Cadaveric...
questionsmedicales.fr › Organisations et économie des soins de santé › Économie › Coûts et analyse des coûts › Analyse coût-bénéfice › A Cost-Effective and Reproducible Cadaveric...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Endoscopie › A Cost-Effective and Reproducible Cadaveric...
questionsmedicales.fr › Plaies et blessures › Traumatismes du système nerveux › Lésions traumatiques cérébrovasculaires › Lésions traumatiques de l'artère carotide › A Cost-Effective and Reproducible Cadaveric...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Mort › Cadavre › A Cost-Effective and Reproducible Cadaveric...