Introduction: Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of validated scenarios have hindered wider integration of simulation in neurosurgical education.
Methods: Here, we demonstrate a novel, low-cost simulation platform that recreates the stress of intra-operative complications using a combination of hands-on and computer elements. The system can be easily reconfigured for novel simulation scenarios, and trainee skill on the scenario can be quantified using multiple performance measures.
Results: The platform uses a combination of computer software and physical models to simulate a critically ill patient during surgery. The software component is designed to be flexible and modular, programmed in Python with a design and structure that can adjust difficulty or create entirely new clinical scenarios. The software runs on a powerful but tiny microcomputer. Multiple sensors and actuators provide feedback to the software controller, which in turn adjusts both the visual output and physical elements of the model. The hands-on portion of the simulation uses low-cost, disposable 3D-printed sections of skull that faithfully mimic real bone when drilled. Within the skull, a soft brain and dura model tears and bleeds realistically and can be cut and sewn in fashion similar to real dura.
Conclusions: For our first demonstration of this modular and reconfigurable system, we simulated a superior sagittal sinus injury during surgery, complicated by an air embolism. In this scenario, the trainee is required to successfully create a craniotomy, repair a dural sinus tear, and rescue an acutely decompensating patient by recognizing and appropriately treating air embolism. This initial simulation provides hands-on training for operative emergencies and was purposefully designed to stress, test, and teach the resident without risking patient injury.
Patient Care: By using simulation to better prepare surgeons for intra-operative emergencies in a controlled environment we will improve patient outcomes when those emergencies do occur.
Learning Objectives: By the conclusion of this sessions, participants should be able to: 1)Describe the use of simulation in preparing residents for intraoperative emergencies. 2) Describe simulation of a dural venous sinus injury, and 3) Describe materials necessary to simulate cranial surgery