Article (Scientific journals)
A basic model for training of microscopic and endoscopic transsphenoidal pituitary surgery: the Egghead
Engel, Doortje; Ferrari, Andrea; Tasman, Jan-Abel et al.
2015In Acta Neurochirurgica
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Keywords :
Neurosurgery training; Training model; Pituitary surgery; Endoscopy; Microscopy
Abstract :
[en] Background Transsphenoidal endoscopic surgery has gained popularity in the last 2 decades and is becoming a standard technique for resection of pituitary adenomas. In contrast to their ENT colleagues, neurosurgical residents have practically no endoscopic experience when they reach the training stage for transsphenoidal procedures.We have developed an affordable method for repetitive training in endoscopic (and microscopic) work in a narrow channel, allowing training of the basic movements needed for resection of pituitary adenoma. Methods In collaboration with colleagues in the ENT Department, Cantonal Hospital St. Gall, and the Technical University of Zurich, a three-dimensional model of the nasal cavity was developed and patented. The Egghead model consists of a 3D synthetic reconstruction of the head nasal cavity and sphenoid sinus. A boiled egg represents the sella. For validation, 17 neurosurgical residents from the Department of Neurosurgery, University Hospital of Basel, and Department of Neurosurgery, Cantonal Hospital of St. Gall, St. Gall, Switzerland, and two experts performed a standardized procedure mimicking a transsphenoidal pituitary procedure by dissecting a corridor to the egg yolk and resecting it, respecting the surrounding egg white. This procedure was performed under both microscopic and video-endoscopic visualization. A score for the precision and speed of the surgical performance was developed and used. Results The model allows repetitive training of the resection of the egg yolk under sparing of the egg white after careful opening of the shell. The validation data showed a steeper learning curve using the endoscopic technique than performing the same task using the microscope. After three repetitions, the quality of resection was better with the endoscopic technique. Conclusions Our model, the Egghead, is affordable, offers tactile feedback and allows infinite repetitions in basic training for pituitary surgery. It can be used for training of advanced neurosurgical residents, who thus far have very few possibilities of acquiring endoscopic experience.
Disciplines :
Surgery
Author, co-author :
Engel, Doortje;  Hôpital Cantonal de St Gall > Neurochirurgie > Interne
Ferrari, Andrea;  Hôpital Cantonal de St Gall > Neurochirurgie > Interne
Tasman, Jan-Abel;  Hôpital Cantonal de St Gall > ORL > Médecin-Chef Adjoint
Schmid, Raphael;  Ecole Polytechnique Fédérale de Zurich > IRPD > Ingénieur
Schindel, Ralph;  Ecole Polytechnique fédérale de Zurich - EPFZ > IRPD > Ingénieur
Haile, Sarah;  Hòpital Cantonal de St Gall > Clinical Trial Unit > Statistique > Interne
Mariani, Luigi;  Université de Bâle > Neurochirurgie > Professeur, médecin chef de service
Fournier, Jean Yves Alain ;  Université de Liège - ULiège > Doct. sc. méd. (paysage)
Language :
English
Title :
A basic model for training of microscopic and endoscopic transsphenoidal pituitary surgery: the Egghead
Publication date :
21 August 2015
Journal title :
Acta Neurochirurgica
ISSN :
0001-6268
eISSN :
0942-0940
Publisher :
Springer Wien, Vienna, Austria
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 06 June 2017

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