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THE MODEL FOR NEUROSURGICAL SKILLTRAINING

THE MODEL FOR NEUROSURGICAL SKILLTRAINING. THE INNOVATION Supakij Sanguandekul MD. Phramongkutkloa hospital. BACKGROUND. PMK GOAL: EXCELLENCE NEUROSURGICAL TRAINING CENTER GOOD KNOWNLEDGE,SKILL,MORAL ALL IATROGENIC COMPLICATION SHOULD BE PREVENTED AND REDUCED

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THE MODEL FOR NEUROSURGICAL SKILLTRAINING

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  1. THE MODEL FOR NEUROSURGICAL SKILLTRAINING THE INNOVATION SupakijSanguandekul MD. Phramongkutkloahospital

  2. BACKGROUND • PMK GOAL: EXCELLENCE NEUROSURGICAL TRAINING CENTER • GOOD KNOWNLEDGE,SKILL,MORAL • ALL IATROGENIC COMPLICATION SHOULD BE PREVENTED AND REDUCED • EVEN SIMPLE PROCEDURE SUCH AS VENTRICULAR PUNCTURE THAT MAY CAUSE SERIOUS COMPLICATION SHOULN’T BE NEGLECTED • THE SKILL TRAINING FOR NEUROSURGICAL PROCEDURE IS ESSENTIAL BEFORE OPERATED ON HUMAN BRAIN

  3. BACKGROUND • THIS IS THE FIRST TIME IN OUR INSTITUTE PHRAMONGKUTKLOA ARMY HOSPITAL TO CREATED THE SIMPLE MOLDABLE INTRACRANIAL MODEL FOR NEUROSURGICAL SKILL TRAINING • TO CORRECT THE DISADVANTAGE OF OTHER METHOD AND TO USE INSTEAD OF CADARVER,ANIMAL,3D COMPUTER ASSIST IN THE FUTURE • NOT ONLY TEACH ANATOMY BUT CAN USE FOR NEUROSURGICAL PROCEDURE AND CAN CHANGE THE FORM OF THE INTERESTED INTRACRANIAL STRUCTURES

  4. OBJECTIVE • AIM TO USE THE MODEL INSTEAD OF ANIMAL,CADARVER FOR SKILL TRAINING AND TO SOLVE THE IATROGENIC COMPLICATION • TO CREATED THE SIMPLE MODEL FOR NEUROSURGICAL OPERATION :VENTRICULAR PUNCTURE CRANIECTOMY,EXPLORATORY BURR HOLE, • TO EVALUATED THE RESULT OF VENTRICULAR PUNCTURE TRAINING BY QUESTIONARE AND THE INCIDENCE OF IATROGENIC COMPLICATION

  5. MATERIAL&METHOD • DESIGN: INNOVATION & PILOT STUDY THE USE OF THE MODEL MODELTHE INCIDENCE OF IATROGENIC COMPLICATION FROM VENTRICULAR PUNCTURE IN THE HYDROCEPHALIC PATIENTS WAS REVEALED BEFORE THE USE OF THE MODEL AND AFTER SKILL TRAINING • THE DATA OF 80 HYDROCEPHALIC PATIENTS 100 VENTRICULAR PUNCTURES WERE ANALYSED TO DETECT IATROGENIC COMPLICATION(40 pts 8 months BEFORE & 40 pts 8 months AFTER TRAINING) • THE QUESTIONARES WERE COLLECTED FROM 7 NEUROSURGICAL RESIDENTS TO EVALUATE THEIR PERFORMANCE ,IATROGENIC COMPLICATION AND SATISFACTION (Linkert’s numeric rating scale)

  6. MATERIAL&METHOD • THE SIMPLE MODEL WAS CREATED FROM THE CONCEPT OF CHEAP,EASY,READY TO USE,REUSE,EFFECTIVE FOR NEUROSURGICAL PROCEDURE ,THE RESULT CAN BE CHECKED IMMEDIATELY AFTER TRAINING AND THE INTRACRANIAL STRUCTURE CAN BE CHANGEDFOR INTERESTED PART OF THE BRAIN • THE MODEL CONSISTED OF 2 PARTS 1)FRAMEWORK : HEAD THAT CAN BE PUNCTURED AND OPEN TO CHECK THE VENTRICULAR TARGET 2)INTRACRANIAL ORGAN : IN THIS STUDY VENTRICULAR STRUCTURE WAS MADE IN THE FORM OF CAVITY & SOLID

  7. MATERIAL&METHOD • THESKILL TRAINING OF VENTRICULAR PUNCTURE WAS BEGIN ON SEPTEMBER 2006 • 7 RESIDENTS WERE TEACHED ABOUT THE ENTRY ,TARGET,TECHNIC OF THE VENTRICULAR PUNCTURE AND THEY MUST DO AND CHECK THEIR OPERATION IMMEDIATELY, BEFORE OPERATE ON HUMAN • THE RESULT OF TRAINING WAS EVALUATED BY QUESTIONARE AND INCIDENCE OF IATROGENIC COMPLICATION

  8. VENTRICULOSTOMY

  9. VENTRICULOSTOMY

  10. CRANIOTOMY&EXPLORATORY BURR HOLE

  11. CRANIECTOMY REMOVE BLOOD CLOT

  12. RESULT • THE NEUROSURGICAL RESIDENTS HAVE IMPROVE THEIR SKILL AND UNDERSTANDING ABOUT VENTRICULAR STRUCTURE,OPERATIVE TECHNIC • THE INCIDENCE OF IATROGENIC COMPLICATIONWAS REDUCED FROM 5% TO 0% AFTER TRAINING • FROM THE QUESTIONARE ALL NEUROSURGICAL RESIDENTED WERE SATISFIED TO USE THIS MODEL (Numeric rating scale 4)AND WANT TO LEARN MORE ABOUT OTHER NEUROSURGICAL PROCEDURE

  13. CONCLUSION • IT’S SEEM SIMPLY BUT HIGHLY EFFECTIVE TO SOLVE IATROGENIC COMPLICATION &STRENGTHENING NEUROSURGICAL RESIDENCY TRAININGWITH SKILL TRAINING • THIS MODEL IS CHEAPER(500:20000),EASIER TO MADE AND USE,REUSE,EFFECTIVE FOR NEUROSURGICAL SKILL TRAINING ,MOLDABLE THAN CADARVER,ANIMAL,COMMERCIAL MODEL • THE SKILL TRAINING IS ESSENTIAL FOR THE INEXPERIECE NEUROSURGEON TO REDUCE THE IATROGENIC COMPLICATION • IN THE FUTURE THE MODEL SHOULD BE DEVELOPED FOR OTHER NEUROSURGICAL PROCEDURE AND USE INSTEAD OF CADARVER , ANIMAL, 3D COMPUTER ASSIST

  14. THANK YOU AUDIENCES &ALL PARTICIPATION S EVERYTHING SHOULD BE MADE SIMPLY & CONTINUE EVOLUTION

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