1007. A NOVEL LOW-COST PORTABLE NEUROSURGERY INTRAOPERATIVE CATASTROPHE SIMULATOR FOR ANEURYSM INTRAOPERATIVE RUPTURE AND ENDOSCOPIC CAROTID RUPTURE CONTROL
Authors: Matthew Welz; Matthew Welz, MS; Devi Patra; Andrew Pines; Ryan Hess, BSE; Brian Kalen, BSE; Karl Abi-Aad, MD; Tanmoy Maiti; Evelyn Turcotte, BS; Jamal McClendon Jr, MD; Chandon Krishna, MD; Bernard Bendok (Phoenix, AZ)
While simulation platforms have grown in neurosurgery, catastrophe simulators remain sparse. Our approach to simulation has focused on low cost, portability, association with a curriculum, face validity, construct validity, patient specific anatomic characteristics when feasible, objective assessments with feedback, and interrater reliability. We have developed a low-cost simulator for carotid artery rupture during transnasal endoscopic exposure, and intracranial aneurysm rupture during microsurgical exposure.
The nasal anatomy for carotid rupture and the cranial segment for aneurysm rupture were created using an anonymized CT scan. The scan allowed us to keep the parameters and dimensions the same as in vivo. A silicon cast of a carotid artery with the same diameter mimics the carotid artery in the cavernous space. A full circle of Willis silicone cast was created from an anonymized MRI to represent an anatomically correct aneurysm. Both nasal and cranial anatomy is fastened to a plate that allows pivoting to achieve desirable angle. The plate sits above a reservoir that houses a pump. As fluid leaks, it is contained in the reservoir and re-pumped back through allowing for a self-contained system. These models will be validated using a modified OSATS scale designed specifically for these models.
Neurosurgeons with different skill levels will be assessed. Their knowledge of initial reaction, understanding of tools, bleeding control and dexterity will be verified. These key elements will be graded from poor average and excellent. The design of the simulator allows for easy repair and switching of vasculature to enhance training on different patients.
We have developed a portable, low cost catastrophe neurosurgical simulator with the hopes of enhancing education on rare but potentially morbid and life-threatening intraoperative complications.