J Neurol Surg B Skull Base 2014; 75 - a226
DOI: 10.1055/s-0034-1384128

Live-Surgery at Neurosurgical Training Courses: Essential Infrastructure, Technical Setup and Educational Considerations

F. Roser 1, G. Pfister 2, Florian Ebner 2, B. Hirt 2
  • 1Cleveland Clinic, Abu Dhabi, United Arab Emirates
  • 2University of Tuebingen, Germany

Objective: To report about the infrastructure and technical setup for live-surgeries at neurosurgical training courses. Methods: From 2007 to 2013, 13 neurosurgical training courses with live surgeries have been organized at the department of neurosurgery. Here, we share our experience and report the essential setup. Results: Our department organized seven skull base, five cervical-spine, and one spinal-cord-stimulation hands-on dissection course with live surgeries. The course structure includes lectures, cadaver dissections, and live surgeries. The technical setup includes video transmission via an IP-based network with fiber glass backbone between OR and lecture room. Up to four video signals may be transmitted contemporaneously (microscope, endoscope, X-ray, overview). Two bidirectional audio streams allow a continuous interaction. In the anatomy, master-piece dissections and personal tutorials for a group of four participants are essential to achieve an adequate educational level. During surgery bidirectional discussions offer the participant to interfere and ask on the point. Important issues are careful selection of live operated patients with a well presentable pathology, plan always with a buffer of at least one patient, and chose didactic cases to show the technique. The live-surgery should include intraoperative setup, positioning, anesthesiological procedures, and handling of intraoperative situations. Matching the awareness for ecological protection and educational demands in medicine the courses can be transmitted as a web stream to faculties worldwide to offer participation without traveling, which is a rewarding option for neurosurgeons in developing countries. Conclusion: A professionally prepared step-by-step education including surgical anatomy, cadaver dissection with masterpiece, and live surgeries with online discussion offers a high level training with enrichment of both participants and tutors.