Rural neurosurgical and spinal laboratory setup.

BACKGROUND Increasing focus has been placed on the use of simulation in neurosurgical and spinal surgical training worldwide, with the establishment of many surgical laboratories dedicated to such purpose. So far, the opportunities for hands-on cadaveric training in the areas of neurosurgery and spine surgery remain limited in Australia, owing to various factors, including the abolition of dissection in many medical schools, high maintenance requirements and widespread geographical distribution of surgical trainees. METHODS We established a cadaver-based neurosurgical laboratory based at the medical school of the University of New England in Armidale, Australia, which is used by the surgical dissection course for junior surgical trainees offered by the university. We reported our experiences in setting up a neurosurgical research laboratory, and explored the feasibility of establishing a cost-effective anatomical research facility in a rural setting in Australia. RESULTS We found that Genelyn(TM)-fixed cadavers had limited movements of the head as required for adequate surgical positioning and exposure. Furthermore, we discovered that bodies embalmed via the femoral vein had poorly perfused heads after surgical exposure, and thus decapitation had to be performed unfortunately for our purpose. Cadaver samples and surgical equipment were sourced from various veterinary practices and commercial companies. Using human and animal cadavers, this laboratory provided trainees with hands-on opportunities to improve their surgical skills and neuroanatomical knowledge, as well as develop familiarity with highly specialized surgical equipment. CONCLUSIONS We demonstrated the feasibility of establishing a cost-effective neurosurgical research laboratory in Australia and discussed various aspects of its maintenance.

[1]  P. Mertens,et al.  Latex Injection of Cadaver Heads: Technical Note , 2010, Neurosurgery.

[2]  T. Hıcdonmez,et al.  A laboratory training model for interhemispheric-transcallosal approach to the lateral ventricle , 2006, Neurosurgical Review.

[3]  N. Kitchen,et al.  Perceptions of neurosurgery: a survey of medical students and foundation doctors , 2011, British journal of neurosurgery.

[4]  Mahdi Saleh Attracting the top medical students to a career in neurosurgery , 2013, British journal of neurosurgery.

[5]  M. Cusimano,et al.  Operative techniques and instrumentation for neurosurgery. , 2004, Neurosurgery.

[6]  Morgan R. Pokorny,et al.  Inexpensive home‐made laparoscopic trainer and camera , 2004, ANZ journal of surgery.

[7]  M. Ammirati,et al.  Setting up a microneurosurgical skull base lab: technical and operational considerations , 2011, Neurosurgical Review.

[8]  C. Fisher,et al.  A cost-effective approach to establishing a surgical skills laboratory. , 2007, Surgery.

[9]  H. Brem,et al.  Preparing Hopkins medical students for a career in academic neurosurgery. , 2003, Surgery.

[10]  K. Seex,et al.  Lateral extent and ventral laminar attachments of the lumbar ligamentum flavum: cadaveric study. , 2014, The spine journal : official journal of the North American Spine Society.

[11]  M. Tschabitscher,et al.  Practical guidelines for setting up an endoscopic/skull base cadaver laboratory. , 2013, World neurosurgery.

[12]  M. Yașargil,et al.  New laboratory model for neurosurgical training that simulates live surgery. , 2002, Journal of neurosurgery.

[13]  B. Luca,et al.  Intracranial Injectable Tumor Model: Technical Advancements , 2014, Journal of Neurological Surgery—Part B.

[14]  K. Seex,et al.  Reply to commentary on "lateral extent and ventral laminar attachments of the lumbar ligamentum flavum: cadaveric study". , 2015, The spine journal : official journal of the North American Spine Society.