Topographical systematization of human placenta model for training in microneurosurgery.

Human placenta microsurgery training neurovascular surgery vascular by-pass

Journal

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

Informations de publication

Date de publication:
28 Nov 2023
Historique:
received: 15 09 2023
revised: 23 11 2023
accepted: 24 11 2023
medline: 1 12 2023
pubmed: 1 12 2023
entrez: 30 11 2023
Statut: aheadofprint

Résumé

Neurosurgical training continuously seeks innovative methods to enhance the acquisition of essential technical skills for neurosurgeons worldwide. While various training models have been employed, few truly replicate real-life conditions optimally. Human placenta is a good model for neurosurgical microsurgery training due to its anatomical similarities to neurovascular structures. Placental vessels exhibit a branching pattern and caliber comparable to intracranial vessels, making them suitable for practicing microsurgical techniques. The study aims to delineate the anatomical zones of the placenta and propose a segmented training model, resulting in a reproducible, cost-effective, and realistic neurosurgical microsurgery training environment. Twenty human placentas were meticulously prepared, injected with dyes, and categorized into zones based on anatomical features. Measurements of placental vessels were recorded and compared to cerebral vessels. The placenta was divided into four quadrants to facilitate specific training techniques. Our results revealed varying vessel diameters across placental zones, closely resembling cerebral vessels. Different microsurgical techniques were applied to specific placental zones, thereby optimizing training scenarios. The applicability section described exercises such as membrane dissection, vessel skeletonization, aneurysm creation, vascular bypass, and tumor dissection within the placental model, providing detailed guidance on the zones suitable for each exercise. Human placenta serves as an effective microsurgical training model for neurosurgery, enhancing neurosurgeons' skills through anatomical segmentation. Integrating this model into training programs can significantly contribute to skill acquisition and improved surgical outcomes. Further research is warranted to refine and expand its utilization, complemented by clinical experiences and other simulation tools.

Sections du résumé

BACKGROUND BACKGROUND
Neurosurgical training continuously seeks innovative methods to enhance the acquisition of essential technical skills for neurosurgeons worldwide. While various training models have been employed, few truly replicate real-life conditions optimally. Human placenta is a good model for neurosurgical microsurgery training due to its anatomical similarities to neurovascular structures. Placental vessels exhibit a branching pattern and caliber comparable to intracranial vessels, making them suitable for practicing microsurgical techniques.
OBJECTIVE OBJECTIVE
The study aims to delineate the anatomical zones of the placenta and propose a segmented training model, resulting in a reproducible, cost-effective, and realistic neurosurgical microsurgery training environment.
METHODS METHODS
Twenty human placentas were meticulously prepared, injected with dyes, and categorized into zones based on anatomical features. Measurements of placental vessels were recorded and compared to cerebral vessels. The placenta was divided into four quadrants to facilitate specific training techniques.
RESULTS RESULTS
Our results revealed varying vessel diameters across placental zones, closely resembling cerebral vessels. Different microsurgical techniques were applied to specific placental zones, thereby optimizing training scenarios. The applicability section described exercises such as membrane dissection, vessel skeletonization, aneurysm creation, vascular bypass, and tumor dissection within the placental model, providing detailed guidance on the zones suitable for each exercise.
CONCLUSION CONCLUSIONS
Human placenta serves as an effective microsurgical training model for neurosurgery, enhancing neurosurgeons' skills through anatomical segmentation. Integrating this model into training programs can significantly contribute to skill acquisition and improved surgical outcomes. Further research is warranted to refine and expand its utilization, complemented by clinical experiences and other simulation tools.

Identifiants

pubmed: 38036172
pii: S1878-8750(23)01687-X
doi: 10.1016/j.wneu.2023.11.123
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023. Published by Elsevier Inc.

Auteurs

Rene Alejandro Apaza-Tintaya (RA)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

Luis Ángel Jiménez Canache (LÁ)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

Felipe Pereira Salvagni (FP)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

Luis Gustavo Biondi Soares (LG)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

Edgar David Tenelema Aguaisa (ED)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

Alexander Feliciano Vilcahuamán Paitán (AF)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

Raphael Wuo-Silva (R)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil.

Feres Chaddad-Neto (F)

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo-SP, Brazil; Department of Neurosurgery Hospital Beneficência Portuguesa de São Paulo, São Paulo-SP, Brazil. Electronic address: feres.chaddad@unifesp.com.

Classifications MeSH