A Novel Low-Cost Exoscopy Station for Training Neurosurgeons and Neurosurgery Trainees

Abstract

The loss of stereopsis and the need for markedly enhanced hand-eye coordination are obstacles to overcome when performing exoscopic procedures, but both should improve with training. Our objectives were to describe an exoscopy training station and to compare time and performance of a given microsurgical technique among neurosurgery residents and junior neurosurgeons. We designed a low-cost exoscopy training station featuring a notebook computer, a webcam, and a light-emitting diode source. Surgeons and surgical trainees with no experience in exoscopy were enrolled and divided into 2 groups (trainees and controls). Performance and time in suture placement were evaluated by a skilled observer in both groups at baseline and 3 days later. Between evaluations, trainees completed an exoscopy training module. There were 22 participants divided equally into 2 groups. At baseline, trainees had a greater percentage of proper sutures than controls (58% vs. 35%), but they were also slower (32 minutes vs. 25 minutes). On final evaluation, not only were trainees approximately 14 minutes faster than at baseline (P= 0,03), but also their successful suture rate had increased by 18% (final rate 76%, P= 0.02). Moreover, controls were faster compared with baseline by 6 minutes (P= 0.003), but their percentage of successful sutures did not increase (final rate 38%, P= 0.49). The change from baseline to final evaluation favored trainees for both outcomes (P= 0.03 and P=0.02). Using the exoscopy training station, the trainees were able to improve their time and performance of exoscopy compared with the controls.