Live surgery in neurosurgical training courses: essential infrastructure and technical set-up

Abstract

Training courses in neurosurgery are essential educational elements of residency. Teaching methods vary due to cultural differences, monetary restrictions and infrastructure conditions. Anatomical dissection courses combined with annotated live surgeries performed by senior surgeons have proved to be best accepted by students. In this technical note, we provide detailed information about the necessary requirements, resources and optimal performance of live surgeries in neurosurgical training courses. From 2007 to 2012, 12 neurosurgical training courses with live surgeries were organised at the Department of Neurosurgery. Here, we share our experience and report the essential set-up for these courses. Our department organised seven skull base, four cervical spine and one spinal cord stimulation hands-on dissection course with live surgeries. The course structure included lectures, cadaver dissections and live surgeries. The technical set-up included video transmission via an IP-based network with fibreglass backbone between the operating theatre (OR) and lecture room. During surgery, bidirectional discussions offered the participants the ability to interject and ask questions. Important issues included the careful selection of live operated patients with clearly presented pathology for the didactic cases used to demonstrate the technique. A live surgery should include the entire procedure: intraoperative set-up, positioning, anaesthesiological procedures and handling of intraoperative situations. A professionally prepared step-by-step educational program including surgical anatomy, cadaver dissection and live surgeries with online discussion offers a high level of training and enriches both the participants and instructors.