"Live Cadaver" Model for Internal Carotid Artery Injury Simulation in Endoscopic Endonasal Skull Base Surgery

Area of Science:

• Neurosurgery
• Surgical Simulation
• Anatomical Training

Background:

• Intraoperative injury to the internal carotid artery (ICA) is a critical complication in endoscopic endonasal surgery (EES).
• Current training methods for managing ICA injuries during EES are limited due to the impossibility of practicing in live operative settings.

Purpose of the Study:

• To evaluate a pulsatile perfusion-based live cadaver model for simulating ICA injuries in a laboratory environment.
• To assess methods for controlling acute bleeding and the practical utility of this model for surgical training.

Main Methods:

• Five embalmed cadaveric heads were perfused with artificial blood using a pulsatile pump system.
• Endoscopic endonasal surgery approaches were utilized to create various ICA injuries.
• Management techniques including packing, clipping, and trapping were evaluated, and participant feedback was collected via questionnaires.

Main Results:

• The model successfully simulated intraoperative ICA injury scenarios, allowing for practice in all ICA segments.
• Techniques for managing ICA injuries, including clip-based reconstruction, were effectively performed.
• All participants reported enhanced knowledge and learned new techniques, confirming the model's significant educational value.

Conclusions:

• A pulsatile perfusion live cadaver model offers realistic training for major vessel injuries during EES.
• This innovative model can substantially improve the training of surgeons in managing intraoperative vascular injuries in EES.