title: Surgical training technology for cerebrovascular anastomosis.
abstract: Cerebrovascular anastomosis (for example in the management of Moyamoya disease or complex aneurysms) is a rarely performed but essential procedure in neurosurgery. Because of the complexity of this technique and the infrequent clinical opportunities to maintain skills relevant to this surgery, laboratory training is important to develop a consistent and competent performance of cerebrovascular anastomosis. We reviewed the literature pertaining to the training practices surrounding cerebrovascular anastomosis in order to understand the ways in which trainees should best develop these skills. A wide variety of training methods have been described. These may be classified into five general categories, according to training materials used, being synthetic material, living animal, animal carcass, human cadaver, and computer simulation. Ideally, a novice begins training with non-biological material. After gaining sufficient dexterity, the trainee will be able to practice using biological materials followed by high fidelity models prior to actual surgery. Unfortunately, the effectiveness of each model has generally, to our knowledge, only been judged subjectively. Objective quantification methods are necessary to accelerate the acquisition of competence.
authors: The Australian School of Advanced Medicine, Macquarie University, Building F10A, Ground Floor, 2 Technology Place, NSW 2109, Australia; Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Masakazu
authors: M
authors: Higurashi
authors: The Australian School of Advanced Medicine, Macquarie University, Building F10A, Ground Floor, 2 Technology Place, NSW 2109, Australia. Electronic address: yi.qian@mq.edu.au.
authors: Yi
authors: Y
authors: Qian
authors: Advanced Research Institute for Science and Engineering, Waseda University, Tokyo, Japan.
authors: Massimiliano
authors: M
authors: Zecca
authors: Institute of Advanced Biomedical Engineering and Science, TWIns, Tokyo Women's Medical University, Tokyo, Japan.
authors: Young-Kwang
authors: YK
authors: Park
authors: Institute of Advanced Biomedical Engineering and Science, TWIns, Tokyo Women's Medical University, Tokyo, Japan.
authors: Mitsuo
authors: M
authors: Umezu
authors: The Australian School of Advanced Medicine, Macquarie University, Building F10A, Ground Floor, 2 Technology Place, NSW 2109, Australia.
authors: Michael Kerin
authors: MK
authors: Morgan
mesh_terms: D000714:Anastomosis, Surgical / Q000193:education*; D000818:Animals; D001921:Brain / Q000601:surgery*; D001927:Brain Diseases / Q000601:surgery*; D002102:Cadaver; D003198:Computer Simulation; D005246:Feedback; D006801:Humans; D008866:Microsurgery / Q000193:education; D017145:Models, Educational; D008959:Models, Neurological; D019635:Neurosurgical Procedures / Q000193:education*
keywords: Anastomosis; Cerebrovascular surgeon; Competence; Microscope; Simulation; Surgical training; Vascular