P.012 Spinal durotomy repair simulator for deliberate microsurgical practice: Integration into a residency training module
Published in Canadian Journal of Neurological Sciences / Journal Canadien Des Sciences Neurologiques, 2016
Recommended citation: Lau JC, Denning L, Lownie SP, Peters TM, Chen ECS, (2016). "P.012 Spinal durotomy repair simulator for deliberate microsurgical practice: Integration into a residency training module"; in Canadian Journal of Neurological Sciences / Journal Canadien Des Sciences Neurologiques, 43(S2), pp. S24. https://doi.org/10.1017/cjn.2016.118
Background: Deliberate practice is one aspect of gaining competency in surgical skills. We have previously integrated a vascular microsurgery module into our residency training curriculum, and have recently described our experience with constructing patient-specific spine models for simulating lumbar spinal durotomy repair. The goal of this project is to develop the necessary infrastructure to facilitate practice on the spine model during residency.
Methods: A 3D-printed plastic lumbar spine model was created from a patient computed tomography scan. L2 was manually laminectomized, and paraspinal tissues were simulated using Polyvinyl Chloride (PVC) Plastisol. Harvested bovine pericardium was sewn into tubular form as a dural substitute. The pericardial tubes were tied at either end and attached to intravenous tubing to create a closed loop water system.
Results: We are developing a video tutorial describing how to setup and use the model. Residents will be recorded while performing a 1.5 cm durotomy and repair using a surgical microscope available in our training laboratory (Drake-Hunterian Neurovascular Laboratory, London, Ontario, Canada). Residents are asked to grade the realism of the model using a questionnaire. Metrics of quality are to be determined.
Conclusions: Our proposed model is a cost-effective, easy-to-prepare lumbar spinal simulator that facilitates microsurgical practice during neurosurgical residency.