抄録
Although surgery for cerebrovascular disease is an important field for neurosurgeons, the number of operations is decreasing due to the developments of endovascular intervention (techniques). Recently, due to innovative training methods, novice neurosurgeons have been able to obtain necessary surgical skills by working on smaller numbers of cases. Here, we present our surgical education methods, which are designed to facilitate efficient, safe and reliable neurovascular surgery while utilizing a minimum number of actual clinical cases. Additionally, the author discloses the surgical results which occurred during his own training period.
Our educational methods consisted of hands-on training, students drawing surgical illustrations, and audiovisual simulations. Hands-on education is the first step to developing basic microsurgical skills. Creating operative illustrations before surgery is the most effective way for learners to confirm microsurgical anatomy, and is vital in allowing for simulation of individual cerebrovascular surgeries. Operative illustrations are created using digital techniques that can provide surgeons with three-dimensional images of surgical anatomy. Our audio-visual training is derived from records of several surgical maneuvers, and allows both trainers and trainees to manipulate microsurgical instruments in order to replicate the conditions of microsurgery. These audio-visual records are synchronized and edited on the same screen, so that trainees can watch sessions repeatedly, thereby learning to emulate neurosurgical techniques efficiently.
Using the educational methods described above, the author completed 28 clippings (11 cases of unruptured cerebral aneurysms; 17 cases of ruptured cerebral aneurysms), and 25 cerebral vascular anastomoses (23 cases of superficial temporal-middle cerebral artery [STA-MCA] anastomoses; 2 cases of occipital artery-to-posterior inferior cerebellar artery [OA-PICA] anastomoses). These results occurred during the neurosurgical training period in the third and fourth years of his surgical residency. All cases were resolved successfully. We emphasize the importance of neurosurgical education in environments where current neurosurgeons are practicing.
