■神经外科是最复杂的外科学科之一,其中精神运动技能和深厚的解剖学和神经学知识得到最大的表达。要获得扎实的理论背景和技术技能,必须经过长时间的准备,提高手动灵活性和视觉空间能力,并尝试改进手术技术。此外,学习和外科实践都是深入理解神经解剖学的必要条件,结构之间的关系,和三维(3D)方向是神经外科医生准备的核心。由于所有这些原因,一个显微外科神经解剖学实验室与人类尸体标本的结果在一个独特的和不可替代的训练工具,使病人的位置再现,3D解剖学,组织的一致性,一步一步的外科手术几乎和真正的一样。
■我们描述了我们在建立新的显微外科神经解剖学实验室(IRCCSNeuromed,Pozzilli,意大利),专注于制定培训活动计划和显微外科里程碑,以培训下一代外科医生。列出了所有需要的材料和仪器。
■根据居住年份设计了六个能力等级,为每个能力水平定义的培训练习和程序:(1)软组织解剖,骨钻孔,和显微外科缝合;(2)基本开颅手术和神经血管解剖;(3)白质解剖;(4)颅底经颅入路;(5)内窥镜入路;和(6)微吻合。提供了带有里程碑的清单。
■对人体尸体标本进行显微外科解剖是在手术室安全进行神经解剖学和神经外科手术之前进行学习和培训的最佳方法。我们为神经外科住院医师提供了一本“神经外科手册”,其中包含了逐步发展的里程碑。这一循序渐进的计划可以提高培训质量,并保证各国获得平等的技能。我们认为,应该做出更多努力来创建新的显微外科实验室,普及遗体捐献的重要性,并在大学和实验室之间建立网络,以引入强制性的手术培训计划。
UNASSIGNED: Neurosurgery is one of the most complex surgical disciplines where psychomotor skills and deep anatomical and neurological knowledge find their maximum expression. A long period of preparation is necessary to acquire a solid theoretical background and technical skills, improve manual dexterity and visuospatial ability, and try and refine surgical techniques. Moreover, both studying and surgical practice are necessary to deeply understand neuroanatomy, the relationships between structures, and the three-dimensional (3D) orientation that is the core of neurosurgeons\' preparation. For all these reasons, a microsurgical neuroanatomy laboratory with human cadaveric specimens results in a unique and irreplaceable training tool that allows the reproduction of patients\' positions, 3D anatomy, tissues\' consistencies, and step-by-step surgical procedures almost identical to the real ones.
UNASSIGNED: We describe our experience in setting up a new microsurgical neuroanatomy lab (IRCCS Neuromed, Pozzilli, Italy), focusing on the development of training activity programs and microsurgical milestones useful to train the next generation of surgeons. All the required materials and instruments were listed.
UNASSIGNED: Six competency levels were designed according to the year of residency, with training exercises and procedures defined for each competency level: (1) soft tissue dissections, bone drilling, and microsurgical suturing; (2) basic craniotomies and neurovascular anatomy; (3) white matter dissection; (4) skull base transcranial approaches; (5) endoscopic approaches; and (6) microanastomosis. A checklist with the milestones was provided.
UNASSIGNED: Microsurgical dissection of human cadaveric specimens is the optimal way to learn and train on neuroanatomy and neurosurgical procedures before performing them safely in the operating room. We provided a \"neurosurgery booklet\" with progressive milestones for neurosurgical residents. This step-by-step program may improve the quality of training and guarantee equal skill acquisition across countries. We believe that more efforts should be made to create new microsurgical laboratories, popularize the importance of body donation, and establish a network between universities and laboratories to introduce a compulsory operative training program.