Accuracy of ventriculostomy catheter placement using a head- and hand-tracked high-resolution virtual reality simulator with haptic feedback.
ABSTRACT The purpose of this study was to evaluate the accuracy of ventriculostomy catheter placement on a head- and hand-tracked high-resolution and high-performance virtual reality and haptic technology workstation.
Seventy-eight fellows and residents performed simulated ventriculostomy catheter placement on an ImmersiveTouch system. The virtual catheter was placed into a virtual patient's head derived from a computed tomography data set. Participants were allowed one attempt each. The distance from the tip of the catheter to the Monro foramen was measured.
The mean distance (+/- standard deviation) from the final position of the catheter tip to the Monro foramen was 16.09 mm (+/- 7.85 mm).
The accuracy of virtual ventriculostomy catheter placement achieved by participants using the simulator is comparable to the accuracy reported in a recent retrospective evaluation of free-hand ventriculostomy placements in which the mean distance from the catheter tip to the Monro foramen was 16 mm (+/- 9.6 mm).
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ABSTRACT: Object There is increasing evidence that simulation provides high-quality, time-effective training in an era of resident duty-hour restrictions. Simulation may also permit trainees to acquire key skills in a safe environment, important in a specialty such as neurosurgery, where technical error can result in devastating consequences. The authors systematically reviewed the application of simulation within neurosurgical training and explored the state of the art in simulation within this specialty. To their knowledge this is the first systematic review published on this topic to date. Methods The authors searched the Ovid MEDLINE, Embase, and PsycINFO databases and identified 4101 articles; 195 abstracts were screened by 2 authors for inclusion. The authors reviewed data on study population, study design and setting, outcome measures, key findings, and limitations. Results Twenty-eight articles formed the basis of this systematic review. Several different simulators are at the neurosurgeon's disposal, including those for ventriculostomy, neuroendoscopic procedures, and spinal surgery, with evidence for improved performance in a range of procedures. Feedback from participants has generally been favorable. However, study quality was found to be poor overall, with many studies hampered by nonrandomized design, presenting normal rather than abnormal anatomy, lack of control groups and long-term follow-up, poor study reporting, lack of evidence of improved simulator performance translating into clinical benefit, and poor reliability and validity evidence. The mean Medical Education Research Study Quality Instrument score of included studies was 9.21 ± 1.95 (± SD) out of a possible score of 18. Conclusions The authors demonstrate qualitative and quantitative benefits of a range of neurosurgical simulators but find significant shortfalls in methodology and design. Future studies should seek to improve study design and reporting, and provide long-term follow-up data on simulated and ideally patient outcomes.Journal of Neurosurgery 06/2014; 121(2):1-19. DOI:10.3171/2014.5.JNS131766 · 3.23 Impact Factor
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ABSTRACT: BACKGROUND: Virtual reality (VR) simulation-based technologies play an important role in ne resident training. The Congress of Neurological Surgeons (CNS) Simulation Committee developed a simulation-based curriculum incorporating VR simulators to train residents in the management of common neurosurgical C disorders. OBJECTIVE: To enhance neurosurgical resident training for ventriculostomy placement using simulation-based training. METHODS: A course-based neurosurgical simulation curriculum was introduced at the Neurosurgical Simulation Symposium at the 2011 and 2012 CNS annual meetings. A trauma module was developed to teach ventriculostomy placement as one of the neurosurgical procedures commonly performed in the management of traumatic brain injury. The course offered both didactic and simulator-based instruction, incorporating written and practical pretests and posttests and questionnaires to assess improvement in skill level and to validate the simulators as teaching tools. RESULTS: Fourteen trainees participated in the didactic component of the trauma module. Written scores improved significantly from pretest (75%) to posttest (87.5%; P < .05). Seven participants completed the ventriculostomy simulation. Significant improvements were observed in anatomy (P < .04), burr hole placement (P < .03), final location of the catheter (P = .05), and procedure completion time (P < .004). Senior residents planned a significantly better trajectory (P < .01); junior participants improved most in terms of identifying the relevant anatomy (P < .03) and the time required to complete the procedure (P < .04). CONCLUSION: VR ventriculostomy placement as part of the CNS simulation trauma module complements standard training techniques for residents in the management of neurosurgical trauma. Improvement in didactic and hands-on knowledge by course participants demonstrates the usefulness of the VR simulator as a training tool.Neurosurgery 10/2013; 73:S66-S73. DOI:10.1227/NEU.0000000000000074 · 3.03 Impact Factor
- International Journal of Computer Assisted Radiology and Surgery 06/2014; DOI:10.1007/s11548-014-1091-z · 1.66 Impact Factor