Abstract
Neurosurgeons require considerable expertise and practical experience in dealing with the critical situations commonly encountered during difficult surgeries; however, neurosurgical trainees seldom have the opportunity to develop these skills in the operating room. Therefore, physical simulators are used to give trainees the experience they require. In this study, we created a physical simulator to assist in training neurosurgeons in aneurysm clipping and the handling of emergency situations during surgery. Our combination of additive manufacturing with molding technology, elastic material casting, and ultrasonication-assisted dissolution made it possible to create a simulator that realistically mimics the brain stem, soft brain lobes, cerebral arteries, and a hollow transparent Circle of Willis, in which the thickness of vascular walls can be controlled and aneurysms can be fabricated in locations where they are likely to appear. The proposed fabrication process also made it possible to limit the error in overall vascular wall thickness to just 2–5%, while achieving a Young’s Modulus closely matching the characteristics of blood vessels (~5%). One neurosurgical trainee reported that the physical simulator helped to elucidate the overall process of aneurysm clipping and provided a realistic impression of the tactile feelings involved in this delicate operation. The trainee also experienced shock and dismay at the appearance of leakage, which could not immediately be arrested using the clip. Overall, these results demonstrate the efficacy of the proposed physical simulator in preparing trainees for the rigors involved in performing highly delicate neurological surgical operations.
Highlights
Neurosurgeons treating cerebral aneurysms require a thorough understanding of the position of the aneurysm relative to the parent artery and its branches, the surrounding brain regions, and neurocranium
We evaluated the transparency of five hollow tubes with identical dimensions fabricated using five different methods
The trainee described his strong emotional reaction when he realized that he was unable to halt the leaking. It appears that the proposed physical model performed as intended. This device can effectively assist trainees in learning to deal with situations one could expect to encounter in a real-world surgical environment
Summary
Neurosurgeons treating cerebral aneurysms require a thorough understanding of the position of the aneurysm relative to the parent artery and its branches, the surrounding brain regions, and neurocranium. They require highly developed surgical skills, which necessitates extensive practice [1]. Simulation tools used for the training of neurosurgeons have two types, including computer-based [6,7,8,9,10,11] or physical devices manufactured with rapid prototyping techniques [12,13,14,15,16,17,18,19]. Gmeiner et al [11]
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