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Grapefruit Training Model for Distal Anterior Cerebral Artery Side-to-Side Bypass.

Abstract：

OBJECTIVE:Simulation models enable trainees to master microsurgical skills before performing surgeries. Vascular bypass is a critical component of cerebrovascular and many nonneurologic procedures. However, most available bypass training models lack important spatial, tactile, and physiologic aspects of real surgery. Animal and placental models provide true physiology but are expensive. While some models adequately simulate superficial temporal artery-middle cerebral artery bypass, there is no model for side-to-side distal anterior cerebral artery bypass. The objective is to create a realistic and inexpensive training model for this important procedure. METHODS:The depth of interhemispheric fissures in cadaver brains was compared with the grapefruit radii. Grapefruits were dissected to simulate the operative field within the deep and narrow interhemispheric fissure. Pericallosal arteries were mimicked with chicken wing vessels or synthetic tubing, with an aquarium pump providing closed circulation. Twelve board-certified neurosurgeons who were given bypass training using the grapefruit model were blindly surveyed on model realism and training suitability. RESULTS:Grapefruit depths from pith to central column were comparable with interhemispheric cadaveric fissure depths. Approximate preparation time of grapefruit training models was 5-10 minutes. Surveyed neurosurgeons rated the model a better replicate for cerebral artery bypass (P < 0.02) and more challenging than common training models (P < 0.01). They also rated the grapefruit model as likely to be superior for improving surgical skills before surgery (P < 0.05). CONCLUSIONS:This grapefruit model provides a realistic simulation of side-to-side distal anterior cerebral artery bypass procedure that can be inexpensively and easily implemented in nearly any resource environment.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Cikla U,Rowley P,Jennings Simoes EL,Ozaydin B,Goodman SL,Avci E,Baskaya MK,Patel NJ

doi

10.1016/j.wneu.2020.02.107

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

39-51

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(20)30382-X

journal_volume

138

pub_type

杂志文章

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Grapefruit Training Model for Distal Anterior Cerebral Artery Side-to-Side Bypass.