THE THE MODEL FOR NEUROSURGICAL MODEL FOR NEUROSURGICAL SKILLTRAININGSKILLTRAINING

THE INNOVATIONTHE INNOVATIONSupakij Sanguandekul MD.Supakij Sanguandekul MD.Phramongkutkloa hospitalPhramongkutkloa hospital

BACKGROUNDBACKGROUNDPMK GOAL: EXCELLENCE NEUROSURGICAL TRAINING CENTERPMK GOAL: EXCELLENCE NEUROSURGICAL TRAINING CENTER GOOD KNOWNLEDGE,SKILL,MORALGOOD KNOWNLEDGE,SKILL,MORALALL IATROGENIC COMPLICATION SHOULD BE PREVENTED AND ALL IATROGENIC COMPLICATION SHOULD BE PREVENTED AND REDUCEDREDUCEDEVEN SIMPLE PROCEDURE SUCH AS VENTRICULAR PUNCTURE EVEN SIMPLE PROCEDURE SUCH AS VENTRICULAR PUNCTURE THAT MAY CAUSE SERIOUS COMPLICATION SHOULN’T BE THAT MAY CAUSE SERIOUS COMPLICATION SHOULN’T BE NEGLECTEDNEGLECTEDTHE SKILL TRAINING FOR NEUROSURGICAL PROCEDURE IS THE SKILL TRAINING FOR NEUROSURGICAL PROCEDURE IS ESSENTIAL BEFORE OPERATED ON HUMAN BRAINESSENTIAL BEFORE OPERATED ON HUMAN BRAIN

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

OBJECTIVEOBJECTIVEAIM TO USE THE MODEL INSTEAD OF ANIMAL,CADARVER FOR AIM TO USE THE MODEL INSTEAD OF ANIMAL,CADARVER FOR SKILL TRAINING AND TO SOLVE THE IATROGENIC COMPLICATIONSKILL TRAINING AND TO SOLVE THE IATROGENIC COMPLICATIONTO CREATED THE SIMPLE MODEL FOR NEUROSURGICAL TO CREATED THE SIMPLE MODEL FOR NEUROSURGICAL OPERATION :VENTRICULAR PUNCTURE OPERATION :VENTRICULAR PUNCTURE CRANIECTOMY,EXPLORATORY BURR HOLE,CRANIECTOMY,EXPLORATORY BURR HOLE,TO EVALUATED THE RESULT OF VENTRICULAR PUNCTURE TO EVALUATED THE RESULT OF VENTRICULAR PUNCTURE TRAINING BY QUESTIONARE AND THE INCIDENCE OF IATROGENIC TRAINING BY QUESTIONARE AND THE INCIDENCE OF IATROGENIC COMPLICATIONCOMPLICATION

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

MATERIAL&METHODMATERIAL&METHODTHE SIMPLE MODEL WAS CREATED FROM THE CONCEPT OF THE SIMPLE MODEL WAS CREATED FROM THE CONCEPT OF CHEAP,EASY,READY TO USE,REUSE,EFFECTIVE FOR CHEAP,EASY,READY TO USE,REUSE,EFFECTIVE FOR NEUROSURGICAL PROCEDURE ,THE RESULT CAN BE CHECKED NEUROSURGICAL PROCEDURE ,THE RESULT CAN BE CHECKED IMMEDIATELY AFTER TRAINING AND THE INTRACRANIAL IMMEDIATELY AFTER TRAINING AND THE INTRACRANIAL STRUCTURE CAN BE CHANGEDSTRUCTURE CAN BE CHANGED FOR INTERESTED PART OF THE FOR INTERESTED PART OF THE BRAINBRAIN THE MODEL CONSISTED OF 2 PARTSTHE MODEL CONSISTED OF 2 PARTS

1)FRAMEWORK : HEAD THAT CAN BE PUNCTURED AND OPEN TO 1)FRAMEWORK : HEAD THAT CAN BE PUNCTURED AND OPEN TO CHECK THE VENTRICULAR TARGETCHECK THE VENTRICULAR TARGET

2)INTRACRANIAL ORGAN : IN THIS STUDY VENTRICULAR 2)INTRACRANIAL ORGAN : IN THIS STUDY VENTRICULAR STRUCTURE WAS MADE IN THE FORM OF CAVITY & SOLIDSTRUCTURE WAS MADE IN THE FORM OF CAVITY & SOLID

MATERIAL&METHODMATERIAL&METHODTHETHE SKILL TRAINING OF VENTRICULAR PUNCTURE WAS BEGIN ON SKILL TRAINING OF VENTRICULAR PUNCTURE WAS BEGIN ON SEPTEMBER 2006SEPTEMBER 20067 RESIDENTS WERE TEACHED ABOUT THE 7 RESIDENTS WERE TEACHED ABOUT THE ENTRY ,TARGET,TECHNIC OF THE VENTRICULAR PUNCTURE AND ENTRY ,TARGET,TECHNIC OF THE VENTRICULAR PUNCTURE AND THEY MUST DO AND CHECK THEIR OPERATION IMMEDIATELY, THEY MUST DO AND CHECK THEIR OPERATION IMMEDIATELY, BEFORE OPERATE ON HUMANBEFORE OPERATE ON HUMANTHE RESULT OF TRAINING WAS EVALUATED BY QUESTIONARE AND THE RESULT OF TRAINING WAS EVALUATED BY QUESTIONARE AND INCIDENCE OF IATROGENIC COMPLICATIONINCIDENCE OF IATROGENIC COMPLICATION

VENTRICULOSTOMYVENTRICULOSTOMY

VENTRICULOSTOMYVENTRICULOSTOMY

CRANIOTOMY&EXPLORATORY BURR HOLECRANIOTOMY&EXPLORATORY BURR HOLE

CRANIECTOMY REMOVE BLOOD CLOTCRANIECTOMY REMOVE BLOOD CLOT

RESULTRESULTTHE NEUROSURGICAL RESIDENTS HAVE IMPROVE THEIR SKILL THE NEUROSURGICAL RESIDENTS HAVE IMPROVE THEIR SKILL AND UNDERSTANDING ABOUT VENTRICULAR AND UNDERSTANDING ABOUT VENTRICULAR STRUCTURESTRUCTURE ,OPERATIVE TECHNIC ,OPERATIVE TECHNICTHE INCIDENCE OF IATROGENIC COMPLICATIONTHE INCIDENCE OF IATROGENIC COMPLICATION WAS REDUCED WAS REDUCED FROM 5% TO 0% AFTER TRAININGFROM 5% TO 0% AFTER TRAININGFROM THE QUESTIONARE ALL NEUROSURGICAL RESIDENTED FROM THE QUESTIONARE ALL NEUROSURGICAL RESIDENTED WERE SATISFIED TO USE THIS MODEL (Numeric rating scale 4)AND WERE SATISFIED TO USE THIS MODEL (Numeric rating scale 4)AND WANT TO LEARN MORE ABOUT OTHER NEUROSURGICAL WANT TO LEARN MORE ABOUT OTHER NEUROSURGICAL PROCEDUREPROCEDURE

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

THANK YOU THANK YOU AUDIENCES &AUDIENCES &ALL PARTICIPATION SALL PARTICIPATION S

EVERYTHING SHOULD BE EVERYTHING SHOULD BE MADE SIMPLY & MADE SIMPLY & CONTINUE EVOLUTIONCONTINUE EVOLUTION