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Updated: Oct 30, 2025
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
The effect of COVID-19 on trainee operative experience at a multihospital academic neurosurgical practice: A first
Asham Khan1, Jennifer Z Mao1, Mohamed A R Soliman1,2
1Department of Neurosurgery, University at Buffalo, Buffalo, New York, United States.
Insights
The COVID-19 pandemic significantly reduced surgical case volumes, impacting neurosurgical trainee operative experience. Further research is needed to fully understand these effects.
Area of Science:
- Neurosurgery
- Medical Education
- Public Health
Background:
- The COVID-19 pandemic led to widespread lockdowns and cessation of elective surgeries to curb virus transmission.
- Neurosurgical training programs faced disruptions due to the cancellation of elective procedures.
- This study investigates the impact of these cancellations on trainee operative experience.
Purpose of the Study:
- To evaluate the effect of COVID-19-related surgical cancellations on trainee operative experience.
- To quantify the decrease in surgical case volumes during the lockdown period.
Main Methods:
- Retrospective review of case volumes over 54 days pre-lockdown and 54 days post-lockdown.
- Data categorized into cranial, spine, functional, peripheral nerve, pediatrics, and endovascular procedures.
- Comparison of mean daily case volumes before and after the lockdown implementation.
Main Results:
- Overall daily surgical cases decreased significantly from 12.26 to 7.78 (P=0.01).
- Spine (3.13 to 0.96, P<0.001) and functional (1.31 to 0.11, P<0.001) case volumes saw statistically significant reductions.
- Cranial, peripheral nerve, pediatric, and endovascular case volumes decreased but not to a statistically significant level.
Conclusions:
- The COVID-19 pandemic significantly impacted neurosurgical operative training due to reduced case volumes.
- The decline in surgical procedures is a multifactorial consequence of the pandemic.
- Additional research is necessary to generalize findings and fully comprehend the pandemic's long-term effects on surgical education.
Background:
COVID-19 has had a significant impact on the economy, health care, and society as a whole. To prevent the spread of infection, local governments across the United States issued mandatory lockdowns and stay-at-home orders. In the surgical world, elective cases ceased to help "flatten the curve" and prevent the infection from spreading to hospital staff and patients. We explored the effect of the cancellation of these procedures on trainee operative experience at our high-volume, multihospital neurosurgical practice.
Methods:
Our department cancelled all elective cases starting March 16, 2020, and resumed elective surgical and endovascular procedures on May 11, 2020. We retrospectively reviewed case volumes for 54 days prelockdown and 54 days postlockdown to evaluate the extent of the decrease in surgical volume at our institution. Procedure data were collected and then divided into cranial, spine, functional, peripheral nerve, pediatrics, and endovascular categories.
Results:
Mean total cases per day in the prelockdown group were 12.26 ± 7.7, whereas in the postlockdown group, this dropped to 7.78 ± 5.5 (P = 0.01). In the spine category, mean cases per day in the prelockdown group were 3.13 ± 2.63; in the postlockdown group, this dropped to 0.96 ± 1.36 (P < 0.001). In the functional category, mean cases per day in the prelockdown group were 1.31 ± 1.51, whereas in the postlockdown group, this dropped to 0.11 ± 0.42 (P < 0.001). For cranial (P = 0.245), peripheral nerve (P = 0.16), pediatrics (P = 0.34), and endovascular (P = 0.48) cases, the volumes dropped but were not statistically significant decreases.
Conclusion:
The impact of this outbreak on operative training does appear to be significant based solely on statistics. Although the drop in case volumes during this time can be accounted for by the pandemic, it is important to understand that this is a multifactorial effect. Further studies are needed for these results to be generalizable and to fully understand the effect this pandemic has had on trainee operative experience.
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