Document Detail

A Perfusion-based Human Cadaveric Model for Management of Carotid Artery Injury during Endoscopic Endonasal Skull Base Surgery.
MedLine Citation:
PMID:  25301092     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Objective To create and develop a reproducible and realistic training environment to prepare residents and trainees for arterial catastrophes during endoscopic endonasal surgery. Design An artificial blood substitute was perfused at systolic blood pressures in eight fresh human cadavers to mimic intraoperative scenarios. Setting The USC Keck School of Medicine Fresh Tissue Dissection Laboratory was used as the training site. Participants Trainees were USC neurosurgery residents and junior faculty. Main Outcome A 5-point questionnaire was used to assess pre- and posttraining confidence scores. Results High-pressure extravasation at normal arterial blood pressure mimicked real intraoperative internal carotid artery (ICA) injury. Residents developed psychomotor skills required to achieve hemostasis using suction, cottonoids, and muscle grafts. Questionnaire responses from all trainees reported a realistic experience enhanced by the addition of the perfusion model. Conclusions The addition of an arterial perfusion system to fresh tissue cadavers is among the most realistic training models available. This enables the simulation of rare intraoperative scenarios such as ICA injury. Strategies for rapid hemostasis and implementation of techniques including endoscope manipulation, suction, and packing can all be rehearsed via this novel paradigm.
Martin Pham; Aydemir Kale; Yvette Marquez; Jesse Winer; Brian Lee; Brianna Harris; Michael Minnetti; Joseph Carey; Steven Giannotta; Gabriel Zada
Publication Detail:
Type:  Journal Article     Date:  2014-05-02
Journal Detail:
Title:  Journal of neurological surgery. Part B, Skull base     Volume:  75     ISSN:  2193-6331     ISO Abbreviation:  J Neurol Surg B Skull Base     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-10     Completed Date:  2014-10-10     Revised Date:  2014-10-12    
Medline Journal Info:
Nlm Unique ID:  101580780     Medline TA:  J Neurol Surg B Skull Base     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  309-13     Citation Subset:  -    
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