A review of virtual reality simulators for neuroendoscopy
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REVIEW
A review of virtual reality simulators for neuroendoscopy Britty Baby 1,2 & Ramandeep Singh 1 & Ashish Suri 1,2 & Rohan Raju Dhanakshirur 2 & Argha Chakraborty 2 & Subodh Kumar 3 & Prem Kumar Kalra 3 & Subhashis Banerjee 3 Received: 9 April 2019 / Revised: 3 August 2019 / Accepted: 12 August 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Neurosurgery is a challenging surgical specialty that demands many technical and cognitive skills. The traditional surgical training approach of having a trainee coached in the operating room by the faculty is time-consuming, costly, and involves patient risk factors. Simulation-based training methods are suitable to impart the surgical skills outside the operating room. Virtual simulators allow high-fidelity repeatable environment for surgical training. Neuroendoscopy, a minimally invasive neurosurgical technique, demands additional skills for limited maneuverability and eye-hand coordination. This study provides a review of the existing virtual reality simulators for training neuroendoscopic skills. Based on the screening, the virtual training methods developed for neuroendoscopy surgical skills were classified into endoscopic third ventriculostomy and endonasal transsphenoidal surgery trainers. The study revealed that a variety of virtual reality simulators have been developed by various institutions. Although virtual reality simulators are effective for procedure-based skills training, the simulators need to include anatomical variations and variety of cases for improved fidelity. The review reveals that there should be multi-centric prospective and retrospective cohort studies to establish concurrent and predictive validation for their incorporation in the surgical educational curriculum. Keywords Neurosurgery . Virtual reality . Simulators . Neuroendoscopy . Skills . Training . Virtual endoscopy
Introduction Minimally invasive neurosurgical procedures are now widely accepted and practiced by neurosurgery fraternity. Surgeons require a unique skill-set for these procedures that account for bimanual dexterity, fulcrum effect, eye-hand coordination, and adaption of two-dimensional (2D) visualization. The traditional apprenticeship model for training of neurosurgeons
shows limited acceptance in the case of minimally invasive procedures. The ever-increasing number of patients, limited available time for teaching in the operating room (OR), ethical concerns, financial burdens, work hour restrictions, and seriously ill patients demanding skilled hands encourage the search for alternative training methods [1]. Even though live animal models are established methods for surgical training, political and social barriers motivate
* Ashish Suri [email protected]
Prem Kumar Kalra [email protected]
Britty Baby [email protected] Ramandeep Singh [email protected]
Subhashis Banerjee [email protected] 1
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
2
Amar Nath and Shashi Khosla School of Information
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