Training Models for Skull-Base and Vascular Micro-Neurosurgery

Abstract

This overview presents computer-based augmented reality (AR) and virtual reality (VR) tools, in-vitro and in-vivo models as useful teaching tools for neurosurgical training, especially in skull-base surgery. An easy set-up and practicable training model for ventricular drainage (VD) is demonstrated. The model allows to evaluate practices, pitfalls and traceability in a virtual but realistic set-up for simulating VD placement. Computer-assisted planning and simulation of skull-base approaches and integration within the daily neurosurgical routine with VR and AR models are discussed for neurosurgical education. A set-up for microvascular training on a plastic rat and a specific vascular anastomosis practice kit with different tube diameters of 1–3 mm of specific plastic vessels for the training of microvascular anastomoses is shown. End-to-end and end-to-side anastomoses were performed with different levels of difficulty, trying to simulate realistic conditions in bypass surgery. Additionally, the teaching strategy of experimental silicone aneurysm clipping in a 3D printed plastic skull and silicone brain model is demonstrated in video sequences. An experimental animal model with microsurgically created bifurcation aneurysms is discussed because this training model for clip occlusion of aneurysms on a living object, still has the greatest relevance to neurosurgical reality.