A Next-Generation Cadaveric Microneurosurgery Skull Base Laboratory: A New Model for Technologically Integrated Surgical Training and Innovation

Abstract

Quality of neurosurgical care and patient outcomes is inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances—including 3D microscopy and endoscopy, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging—have continued to mold the surgeon-computer relationship. For developing neurosurgeons, such tools can reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills. Until recently, there have been few means for surgeons to obtain integrated surgical and technological training in an operating room setting. We report on a new model, currently in use at our institution, for technologically integrated surgical training and innovation using a next-generation microneurosurgery skull base laboratory, designed in such a way as to recreate the same surgical setting as a working operating room. Each workstation is equipped with a 3D surgical microscope, 3D endoscope, surgical drills, operating table with a Mayfield head holder, and a complete set of microsurgical tools. The laboratory also houses a neuronavigational system, a surgical robotic system, a surgical planning system, 3D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills. We attempt to provide a framework for establishing a next-generation neurosurgical training and innovations laboratory, and describe ongoing initiatives to build 3D video archives; virtual reality and simulation models; and broadcasting capability for disseminating educational, research, and reference materials to institutions around the world.