Surgical Skills Research Articles

Murine model of minimally invasive nasal depot (MIND) technique for central nervous system delivery of blood-brain barrier-impermeant therapeutics.

The blood-brain barrier (BBB) poses a substantial obstacle to the successful delivery of therapeutics to the central nervous system (CNS). The transnasal route has been extensively explored, but success rates have been modest due to challenges related to the precise anatomical placement of drugs, the small volumes that the olfactory cleft can accommodate and short drug residence times due to mucociliary clearance. Here, to address these issues, we have developed a surgical technique known as the minimally invasive nasal depot (MIND), which allows the accurate placement of depot drugs into the submucosal space of the olfactory epithelium of rats. This technique exploits the unique anatomy of the olfactory apparatus to enable transnasal delivery of drugs into the CNS, bypassing the BBB. In our rat model, a bony window is created in the animal snout to expose the submucosal space. Using the MIND technique, we have successfully delivered oligonucleotides to the CNS in Sprague-Dawley and Long-Evans rats, leading to an upregulation of brain-derived neurotrophic factor in the substantia nigra and hippocampus. In this Protocol, we describe the procedural steps for MIND. This procedure takes about 45 min and can be performed by researchers with basic surgical skills. We additionally describe modifications to perform MIND in mice, which are anatomically smaller. The MIND procedure represents a unique platform that can be used to overcome the limitations posed by the BBB. This technique can potentially expand the therapeutic toolkit in the treatment of neurological diseases.

The impact of surgical simulation and training technologies on general surgery education.

The landscape of general surgery education has undergone a significant transformation over the past few years, driven in large part by the advent of surgical simulation and training technologies. These innovative tools have revolutionized the way surgeons are trained, allowing for a more immersive, interactive, and effective learning experience. In this review, we will explore the impact of surgical simulation and training technologies on general surgery education, highlighting their benefits, challenges, and future directions. Enhancing the technical proficiency of surgical residents is one of the main benefits of surgical simulation and training technologies. By providing a realistic and controlled environment, With the use of simulations, residents may hone their surgical skills without compromising patient safety. Research has consistently demonstrated that training with simulations enhances surgical skills., reduces errors, and enhances overall performance. Furthermore, simulators can be programmed to mimic a wide range of surgical scenarios, enabling residents to cultivate the essential critical thinking and decision-making abilities required to manage intricate surgical cases. Another area of development is incorporating simulation-based training into the wider surgical curriculum. As simulation technologies become more widespread, they will need to be incorporated into the fabric of surgical education, rather than simply serving as an adjunct to traditional training methods. This will require a fundamental shift in the way surgical education is delivered, with a greater emphasis on simulation-based training and assessment.

Possibly more favorable short‐term outcomes with minimally invasive surgery than with open surgery in total gastrectomy for locally advanced gastric cancer: A single high‐volume center study

AbstractBackgroundMinimally invasive total gastrectomy (MTG) requires advanced surgical skills and is still associated with a higher rate of postoperative complications than other types of gastrectomy. Additionally, the short‐term outcomes of MTG compared to open total gastrectomy (OTG) for locally advanced gastric cancer have yet to be demonstrated.MethodsWe retrospectively compared short‐term outcomes between MTG and OTG for locally advanced gastric and esophago‐gastric junctional cancer, performed at the Cancer Institute Hospital, Tokyo, during the period from January 2017 to March 2024. Propensity score matching (PSM) was conducted to adjust for potential confounders.ResultsIn total, 359 patients were included, with 190 remaining after PSM, resulting in 95 in each group. The MTG group experienced a significantly lower incidence of postoperative complications of Clavien–Dindo classification (C‐D) ≥3 than the OTG group (3.2% vs. 11.6%, p = 0.026). Moreover, the rate of postoperative intra‐abdominal infectious complications (IAIC) was significantly lower in the MTG than in the OTG group (C‐D ≥ 2; 7.4% vs. 17.9%, p = 0.029 and C‐D ≥ 3; 2.1% vs. 9.5%, p = 0.030, respectively). Subgroup analyses showed the odds ratios for IAIC with C‐D ≥ 2 to be more favorable for the MTG than the OTG group in male patients, those ≥70 years of age, patients without esophageal invasion, those without neoadjuvant chemotherapy, those diagnosed with cT≥3, and patients not undergoing combined resection of other organs except for the gallbladder or spleen.ConclusionsMTG for locally advanced gastric cancer may provide improved short‐term outcomes compared to OTG, when performed or supervised by surgeons with high proficiency in laparoscopic techniques.

Evaluation of training models for intraventricular neuroendoscopy.

Structured surgical education has become increasingly important in recent years. Intraventricular neuroendoscopic procedures have been widely established. However, training surgical skills with these techniques is crucial for young residents due to the potential harm to adjacent tissue. Therefore, we evaluated two different training models.Participants in two different international workshops were trained on a prefixed cadaver model and on a living murine intraabdominal model. Crucial neuroendoscopic techniques such as membrane perforation and tissue biopsy were performed. A blinded questionnaire evaluated both models.Sixty-three participants were trained on the animal model. Forty of these were trained on the cadaver model. The training effect was evaluated almost equally, with 8.5/10 for the animal model and 8.9/10 for the cadaver model. The tissue properties were rated higher regarding realism in the animal model, whereas the anatomic realism was rated higher in the cadaver model.The animal model is a valid alternative to cadaver models for teaching endoscopic neurosurgical skills. This model benefits from the simulation of real surgical tissue properties, including bleeding. The low costs and availability of this technique make it more ubiquitous and can help train further generations of neurosurgeons.

Rapid Transition to Virtual Learning in Postgraduate Medical Education during the COVID-19 Pandemic in Tanzania: A Qualitative Study.

The effect of the progressive utilization of virtual learning (VL) in postgraduate medical education (PGME) is contentious. During the COVID-19 pandemic, VL was up-scaled to bridge the education delivery gap. How this impacted learning experiences in PGME is an area that needs to be explored for the progressive context-specific application of VL. This phenomenological study aimed to explore the postgraduate medical faculty's and residents' experiences with the rapid shift to VL. Through an interpretivist paradigm, this study used in-depth individual semi-structured interviews and prompts to explore the full breadth of the participants' experiences. A purposive sampling method was used, and qualitative content analysis was employed in an iterative process until data saturation. Data was collected between January 2021 and July 2021. Member checking was done to ensure validity. The AKU-ERC granted ethical approval, with reference AKU/2020/098/fb. Ten participants were recruited for the study. Positive experiences were greater access to learning materials and improved learner confidence. In contrast, limited supervision, and lack of assurance of participants' engagement emerged as a negative VL experience. The components of critical thinking and problem-solving skills were unaffected by virtual case-based learning. However, the aspects of acquiring clinical and surgical skills emerged as a difficulty in accepting VL as a valid mode for attaining these competencies. To improve experiences of VL, participants' drive, engagement, technological inadequacies, and instructional design should be optimized.

What's Important (Arts & Humanities): Temple of Healing.

This literary investigation dives into the complex combination of scientific knowledge, creative expertise, surgical skills, and fundamental humanistic qualities that constitute the orthopaedic profession. This poetic perspective conveys the essence of orthopaedic surgery techniques by figuratively describing the processes involved in bone and joint operations and commenting on the meticulous labor that doctors undertake with sinews, sockets, tendons, and bones. It emphasizes the human body's resilience and the restorative power of orthopaedic interventions, depicting how surgeons navigate the complexities of human anatomy to repair injuries and alleviate degenerative conditions, not only restoring physical strength but also giving patients a renewed sense of life and mobility. "Temple of Healing" is a dedication to orthopaedic surgeons, stressing the combination of art and science in their work and highlighting the enormous influence of orthopaedic surgery on patient quality of life.

Spatial-temporal attention for video-based assessment of intraoperative surgical skill

Accurate, unbiased, and reproducible assessment of skill is a vital resource for surgeons throughout their career. The objective in this research is to develop and validate algorithms for video-based assessment of intraoperative surgical skill. Algorithms to classify surgical video into expert or novice categories provide a summative assessment of skill, which is useful for evaluating surgeons at discrete time points in their training or certification of surgeons. Using a spatial-temporal neural network architecture, we tested the hypothesis that explicit supervision of spatial attention supervised by instrument tip locations improves the algorithm’s generalizability to unseen dataset. The best performing model had an area under the receiver operating characteristic curve (AUC) of 0.88. Augmenting the network with supervision of spatial attention improved specificity of its predictions (with small changes in sensitivity and AUC) and led to improved measures of discrimination when tested with unseen dataset. Our findings show that explicit supervision of attention learned from images using instrument tip locations can improve performance of algorithms for objective video-based assessment of surgical skill.

Perceptions of readiness for independent practice among graduating orthopedic surgery residents in Ontario in the last 30 years.

There is increasing concern regarding the lack of physicians and underresourcing of the medical system in Canada. The training of orthopedic surgeons has emerged as an area of particular concern. The purpose of this study was to gain insight into the outcomes of graduates of orthopedic surgery residency programs in Ontario in the last 30 years. We invited graduates of orthopedic surgery residency programs in Ontario from 1992 to 2020 to participate in our survey regarding their practice patterns and career choices. Participants were asked whether they believed their residency had prepared them for independent practice and were asked about their practice patterns after graduation, including whether they completed fellowships. A total of 618 graduates met the inclusion criteria. We had a response rate of 40.9% (n = 253). A total of 62.8% of participants reported feeling ready to enter independent practice, which was less than the 80% expected threshold. This proportion varied by program and, overall, those who had graduated more recently reported feeling less ready. Nearly all participants had completed at least 1 fellowship, with most trainees having completed 2 fellowships. Earlier graduates were less likely to complete 2 or more fellowships. Completing a fellowship did not help with comfort in practice nor with earlier employment. Most respondents reported that their current surgical skills were primarily influenced by fellowship training, regardless of comfort level in entering practice directly out of residency. A substantial proportion of orthopedic graduates reported not feeling comfortable entering practice directly out of residency, with only 62.8% of participants reporting feeling ready for independent practice after graduation. Furtermore, graduates are incurring a significant opportunity cost completing 1 or often 2 fellowships. These findings necessitate an appraisal of our goals in residency education.

Sacrospinous Hysteropexy-Video Tutorial of Construction and Application of a Feasible and Inexpensive Teaching Model for Simulation.

Sacrospinous hysteropexy is one of the preeminent uterus-preserving surgical techniques for treating pelvic organ prolapse supported by level one evidence. As training on models greatly improves surgical skills and outcomes, we developed a simple and inexpensive model to simulate sacrospinous hysteropexy. A step-by-step instruction for the production of the model is available to be viewed online. To keep production costs low, readily available materials were used, with a total cost per model of about 2 EUR (Austria, August 2023). All important anatomical landmarks (prolapsing uterus, vagina, ischial spine and sacrospinous ligament) were all represented. We present a detailed instructional video on how to construct the model and the practical training, detailing the individual steps of a successful sacrospinous hysteropexy, available online. Thus, trainees are able to practice the individual movements of the entire surgical procedure on this simulator model guided by the tutorial video. In this way, trainees will be able to practice the entire surgical procedure. An introduction to the model with explanation of all anatomical landmarks and a standardised explanation of the surgery with its individual steps (handout distributed). The presented video showcases the feasibility of the easy construction and application of a model for the surgical skill training of sacrospinous hysteropexy. Easily accessible, inexpensive material and its simple build make this a reproducible model regardless of geographic or socioeconomic resources.

Suturing techniques

The act of suturing wounds on the skin has been done for thousands of years. Closing dead space, supporting and strengthening wounds until healing increases their tensile strength, approximating skin edges for an esthetically pleasing and functional result, and minimizing the risks of bleeding and infection remain the primary goals of suture techniques, even though suture materials and techniques have changed. A well-planned closure or flap may have its post-operative appearance jeopardized if the wrong suture technique is used or if the procedure is not performed well. On the other hand, poor surgical skills cannot entirely be made up for by careful suturing. Poor incision placement with respect to relaxed skin tension lines, excessive removal of tissue, or inadequate undermining may limit the surgeon’s options in wound closure and suture placement. Gentle handling of the tissue is also important to optimize wound healing. The choice of suture technique depends on the type and anatomic location of the wound, thickness of the skin, degree of tension, and desired cosmetic result. Proper placement of sutures enhances the precise approximation of the wound edges, which helps minimize and redistribute skin tension. Wound eversion is essential to maximize the likelihood of good epidermal approximation. Eversion is desirable to minimize the risk of scar depression secondary to tissue contraction during healing. Usually, inversion is not desirable, and it probably does not decrease the risk of hypertrophic scarring in an individual with a propensity for hypertrophic scars. To maximize the esthetic and functional outcomes, dead space must be removed, natural anatomic shapes must be restored, and stitch marks must be minimized. This page describes the methods for placing sutures for different kinds of stitches, goes over why certain suture techniques are better than others and goes over the benefits and drawbacks of each suture technique. For the best possible closure of a wound, multiple suture techniques are frequently required. After reading this article, the reader ought to comprehend the basic techniques for inserting each type of suture as well as how and why specific sutures are selected.

Automated assessment of non-technical skills by heart-rate data.

Observer-based scoring systems, or automatic methods, based on features or kinematic data analysis, are used to perform surgical skill assessments. These methods have several limitations, observer-based ones are subjective, and the automatic ones mainly focus on technical skills or use data strongly related to technical skills to assess non-technical skills. In this study, we are exploring the use of heart-rate data, a non-technical-related data, to predict values of an observer-based scoring system thanks to random forest regressors. Heart-rate data from 35 junior resident orthopedic surgeons were collected during the evaluation of a meniscectomy performed on a bench-top simulator. Each participant has been evaluated by two assessors using the Arthroscopic Surgical Skill Evaluation Tool (ASSET) score. A preprocessing stage on heart-rate data, composed of threshold filtering and a detrending method, was considered before extracting 41 features. Then a random forest regressor has been optimized thanks to a randomized search cross-validation strategy to predict each score component. The prediction of the partially non-technical-related components presents promising results, with the best result obtained for the safety component with a mean absolute error of 0.24, which represents a mean absolute percentage error of 5.76%. The analysis of feature important allowed us to determine which features are the more related to each ASSET component, and therefore determine the underlying impact of the sympathetic and parasympathetic nervous systems. In this preliminary work, a random forest regressor train on feature extract from heart-rate data could be used for automatic skill assessment and more especially for the partially non-technical-related components. Combined with more traditional data, such as kinematic data, it could help to perform accurate automatic skill assessment.

Deep learning for surgical instrument recognition and segmentation in robotic-assisted surgeries: a systematic review

Applying deep learning (DL) for annotating surgical instruments in robot-assisted minimally invasive surgeries (MIS) represents a significant advancement in surgical technology. This systematic review examines 48 studies that utilize advanced DL methods and architectures. These sophisticated DL models have shown notable improvements in the precision and efficiency of detecting and segmenting surgical tools. The enhanced capabilities of these models support various clinical applications, including real-time intraoperative guidance, comprehensive postoperative evaluations, and objective assessments of surgical skills. By accurately identifying and segmenting surgical instruments in video data, DL models provide detailed feedback to surgeons, thereby improving surgical outcomes and reducing complication risks. Furthermore, the application of DL in surgical education is transformative. The review underscores the significant impact of DL on improving the accuracy of skill assessments and the overall quality of surgical training programs. However, implementing DL in surgical tool detection and segmentation faces challenges, such as the need for large, accurately annotated datasets to train these models effectively. The manual annotation process is labor-intensive and time-consuming, posing a significant bottleneck. Future research should focus on automating the detection and segmentation process and enhancing the robustness of DL models against environmental variations. Expanding the application of DL models across various surgical specialties will be essential to fully realize this technology’s potential. Integrating DL with other emerging technologies, such as augmented reality (AR), also offers promising opportunities to further enhance the precision and efficacy of surgical procedures.

The short-term outcomes of laparoscopic enucleation of pancreatic tumors with exposing the Wirsung duct.

It is widely believed that the prerequisite for safely performing enucleation is that the distance between the tumor and the main pancreatic duct (MPD) is at least 2-3mm. However, enucleating a deep pancreatic tumor adjacent to the MPD remains challenging, particularly when exposure or repair of the MPD is necessary. This study reported our initial experience with this procedure and demonstrated the feasibility and safety of the MPD exposure or repair. Patients who underwent laparoscopic enucleation (LapEN) with exposing the MPD from January 2017 to August 2023 were collected and analyzed in this retrospective cohort study. Data from procedures of laparoscopic middle pancreatectomy (LMP) and LapEN for superficial tumors were collected for comparative analyses. A total of 26 patients were enrolled, 27 tumors were enucleated. Tumor located in the pancreatic head and neck (n = 20), and the body (n = 7). The mean tumor size, operating time, and blood loss were 2.3cm, 163min, and 63ml, respectively. MPD injuries occurred in 8 cases due to the need for complete tumor resection, which were repaired or reconstructed using 6-0 PDS-II with or not inserting a plastic stent. 10 cases (38.5%) developed surgical-related complications, seven (26.9%) were classified as Clavien-Dindo grade I, and three (11.5%) were Clavien-Dindo grade IIIa. Biochemical leakage occurred in 16 cases (61.5%), clinically relevant pancreatic fistula (CR-POPF) occurred in 10 cases (38.5%). Two patients (7.7%) experiencedpost-pancreatectomy hemorrhage. Further analyses indicated LapEN with MPD exposure had a longer operating time and higher incidence of CR-POPF compared to LapEN for superficial tumors, but a shorter operating time and less blood loss compared to LMP (P < 0.05). Laparoscopic enucleation with exposing the MPD is feasible and safe with the support of precise preoperative assessments, meticulous intraoperative dissection, well familiarity with the anatomy of the MPD, and excellent surgical skills.

Practice guidelines on endoscopic surgery for qualified surgeons by the endoscopic surgical skill qualification system: Esophagus.

Practice guidelines on endoscopic surgery for qualified surgeons by the endoscopic surgical skill qualification system: Esophagus.

Perspectives of Surgical Research Residents on Improving Their Reentry Into Clinical Training

Concerns exist about clinical and operative skill decay in surgery residents when they dedicate time away from clinical training to pursue research. However, it remains undetermined how to best prevent these negative impacts. Our study evaluated the perspectives of surgical research residents on interventions to improve their reentry into clinical training. An anonymous web-based survey was distributed between 5/01/2023 and 6/01/2023 to 102 current and former (within the previous 3 years) general surgery research residents from 4 academic medical centers in Boston, MA. Survey response rate was 35.3% (36/102 residents). About 22 of 36 residents (61.1%) felt that their clinical aptitude decreased during the research years, whereas 33 of 36 (91.7%) reported reduced surgical skills. When reflecting on their re-entry to residency, former research residents reported feeling anxious and less confident (3.84/5 on a 1-5 Likert scale) as well as being below the expected level of clinical performance (3.42/5). Most of them (12 of 17; 70.6%) reported that it took up to 6 months, whereas 5 of them (29.4%) up to 12 months to feel at the expected level. When compared to nonmoonlighting residents, those who moonlighted often and operated during moonlighting, denied a decrease in clinical and surgical skills, and reported less anxiety, higher confidence, and a quicker return to the expected level of performance. Interventions proposed for improving their clinical re-entry included individualized development plans for 3 months before returning to clinical training, established curriculum for clinical work throughout the research years, clinical preceptorships throughout the research years, and simulation curriculum throughout the research years. General surgery residents feel that their clinical and surgical skills decreased during the research years, leading to anxiety and lack of confidence when returning to residency. Therefore, comprehensive interventions are needed to improve the reentry of the research residents into clinical training.

Non-cadaveric spine surgery simulator training in neurosurgical residency

BackgroundSpine surgical training faces increasing challenges due to restricted working hours and greater subspecialization. Modern simulators offer a promising approach to teaching both simple and complex spinal procedures. This study evaluated the acceptance and efficacy of spine simulator training using a lumbar herniated disc model tested by 16 neurosurgical residents (PGY-1-6), and compared 3D and 2D teaching methods. MethodsSixteen residents utilized the Realists RealSpine L4/L5 disc simulator with both microscope and exoscope. A mixed-methods analysis assessed the efficacy and acceptance of the training. Six PGY-1 residents participated in a learning curve study, divided into exoscopic and microscopic cohorts. Each group watched a tutorial in either 3D or 2D, followed by three surgical sessions. Endpoints included surgical progress within 30 minutes and complication rates. Microsurgical skills and mental concepts were evaluated on a numeric Likert Scale. ResultsParticipants rated the simulator training favorably, with a median score of 8/10 across six categories. The learning curve study showed a 30% improvement in microsurgical performance. The completion rate of herniated disc removal increased from 50% at T2 to 100% at T3 and T4. Significant improvement in mental concept was observed (p=0.035), with slightly better consolidation in the exoscope group. Self-assessments revealed significantly improved skills across all participants. ConclusionSpine simulator training was well-received and resulted in improvements in both mental concept and microsurgical performance, with enhanced outcomes in the 3D teaching/exoscope group. This study supports the integration of spine simulators into spine surgical residency, particularly for early-stage training, to improve both cognitive and practical surgical skills.

Fowl Play Can Lead to Improved Surgical Skills: A Novel Simulation Model for Bladder Flap Creation, Colpotomy, and Vaginal Cuff Closure

Fowl Play Can Lead to Improved Surgical Skills: A Novel Simulation Model for Bladder Flap Creation, Colpotomy, and Vaginal Cuff Closure

Student Urology Conference Increases Participant Knowledge of Urology Match and Confidence in Research.

To study the impact of a student-specific urology conference for students considering a career in urology. The first symposium specifically for medical students interested in urology was designed to provide an opportunity to present their research, explore urological subspecialties, and network with faculty members, residents, and other students. Medical students and faculty at a U.S. medical school organized the inaugural New England Student Urology Symposium (NESUS). The conference consisted of presentations from faculty members on various urology subspecialties, invited keynote speakers from regional Urology faculty, student poster and oral presentations, a surgical skills fair, and student and faculty panels surrounding the Urology Match and impact on career decision-making. Surveys were administered both before and after the conference to assess student perspectives. 42 medical students attended the conference, representing 21 medical schools from 15 states across all major U.S. regions. Attending the conference was associated with increased knowledge surrounding the Urology Match for students at schools without urology clinical rotations and decreased certainty about pursuing urology as a specialty along with increased comfort with presenting research for all attendees. 100% of student attendees recommended the conference to medical students interested in urology. Our study demonstrates that conference attendees found NESUS to be a valuable opportunity to gain confidence in presenting research, strengthen knowledge about the match process and its competitiveness, and network with faculty, residents, and fellow students. Future student-focused conferences in urology and other specialties should be considered at the regional or national level.

Virtual reality-based simulation improves rotator cuff repair skill: a randomized transfer validity study.

Although virtual reality (VR) simulators have demonstrated their efficiency for basic technical skill training of healthcare professionals, validation for more complex and sequential procedures, especially in arthroscopic surgery, is still warranted. We hypothesized that the VR-based training simulation improves arthroscopic cuff repair skills when transferred to realistic visual and haptic conditions. VR-based training simulation improves arthroscopic cuff repair skills when transferred to realistic visual and haptic conditions. This study is prospective, multicentric and randomized. Thirty orthopedic surgery residents were enrolled in the study and randomized in two groups: VR training (VR+) and no VR training (VR-). Only the VR + group underwent a monthly VR-based training program for rotator cuff repair. The 1 -h VR training sessions were standardized and supervised by the same instructor. After six months, all participants performed a double-row arthroscopic rotator cuff repair procedure on a benchtop shoulder model providing realistic visual and haptic conditions with implants. Two independent surgeons with expertise in shoulder repair and blinded to the randomization rated the participants' performance using the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Demographic characteristics and surgical experience were comparable between the two groups. The ASSET global rating score was higher in the VR + group than in the VR- group (34.4 ± 3.1 and 30.5 ± 5.7, respectively; p = 0.046) and the VR+ group performed the procedure faster than the VR- group (27.3 ± 3.6 vs. 31.7 ± 0.4 minutes, respectively; p = 0,003). This study demonstrated that a monthly VR-based program for 6 months was better than standard peer training alone for mastering a complex and sequential rotator cuff repair when using the validated ASSET Score. Overall, nonspecific arthroscopic skills were also higher in the VR + group. II, therapeutic study.

Neurocircle microsurgery model: Description of simulation-based training and exoscope

Background: Microsurgery is crucial in neurosurgery, requiring precise skills for interventions on delicate structures. Effective training is essential for developing these skills. In Peru and Latin America, however, there is a notable shortage of specialized training centers and high costs associated with foreign simulators, hindering the development of neurosurgical skills. To address this issue, the NeuroZone3D Research Center has initiated a project to create a national dataset on Peruvian craniometry and develop locally adapted training models. Methods: The “NeuroCircle Microsurgery Model” was created through a multi-phase process. Phase 1 involved designing a simulation platform using a 3D printer. Phase 2 focused on creating a realistic biomodel with polyurethane and advanced modeling techniques. In Phase 3, the biomodel was assembled and integrated into the platform. Phase 4 included using a wooden module, a cost-effective exoscope simulation, and surgical instruments to provide a realistic training environment. Results: The “NeuroCircle Microsurgery Model” provided a stable and effective training environment. Feedback from training sessions with neurosurgery residents and medical students indicated significant improvements in microsurgical skills. Participants valued the model’s realism and its role in enhancing their surgical proficiency. Conclusion: The “NeuroCircle Microsurgery Model” is a significant advancement in microsurgery training for Peru and Latin America. Its development provides a valuable, locally adaptable tool for improving surgical skills and addresses the critical training gaps in the region.