TITLE:
Complications of Learning Curve in Supratentorial Intraventricular Region. The Concept of Fast Daily Fresh Cadaver Practice. (Technical Note for Training Method)
AUTHORS:
Csókay András, Péter Forró, Josvai Attila, Gergely Csókay, Jäckel Márta
KEYWORDS:
Cadaver Practice, Fresh Cadaver Practice, Neurosurgical Training, Endovascular Training
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.12 No.4,
October
28,
2022
ABSTRACT: Background: The difficulty of learning curve in
different microsurgical regions is one of the most challenging factors that
affect neurosurgeon’s life. Two of the delicate areas are the suprasellar intraventricular and pontocerebellar region. High level
of microsurgery or endoscopic surgery requires virtuosity, which can not be
learnt only by assisting. Even among the well skilled neurosurgeons who work in
big centers we can often hear “in
spite of centralization there are not enough operations available to keep the high
level of our skills”. The situation of surgeons working at mid centers is more difficult
especially on duties. Methods: Huge number of scientific articles demonstrate
the importance of different types of
cadaver practice, but always did not pay enough attention to the daily fast
fresh cadaver exercises. Focusing on lifelong every
day practice we examined the difficulties of learning curve in intraventricular
and pontocerebellar region and try to give some useful advice for practicing on
fresh cadavers on a daily basis. We offer a simple endovascular fresh cadaver
model for practicing. Results: We have performed more than 800 quick (60 - 90
minutes long) routine practice sessions in these two regions during last 18
years. We found that implantation a modelized pathology and removing it by
microscopical or endoscopic way without causing injuries to sensitive
structures seems to be the most practical way of fast everyday training. Nerves
and vascular bypass sutures are also
excellent practical method. Conclusions: We have focused on daily fast fresh
cadaver practice as a novel training method like used in professional sport and
art. After 18 years experience we can state that, for mastering the microsurgery of pontocerebellar and intraventricular region, which is one of
the most challenging regions minimum 100 fresh cadaver practice sessions
need before performing the operation. We
believe this region should be part of fast fresh cadaver microsurgical practice
routine programme on daily bases, minimum one time/week/person.