Simulation tools in neuro-oncological surgery: a scoping review of perioperative and training applications

Neuro-oncological surgery has lagged other neurosurgical subspecialties in integrating simulation technologies for training and surgical planning. This study provides a comprehensive scoping review of the current landscape of simulation tools in neuro-oncological surgery, mapping existing research, identifying technological advancements, and highlighting gaps in surgical training and perioperative planning.

We formulated the research question: "What is the effect of perioperative simulation and neuro-oncological training on surgical skill acquisition, patient outcomes, and safety among neurosurgeons, compared to traditional or no training methods?" A comprehensive search was conducted on PubMed, Scopus and ClinicalTrials.gov, with the final search completed in May 2024. The quality of training studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI), and the Cochrane ROBINS-I tool was used to evaluate bias in simulation studies.

The search yielded 5,518 records, with 51 studies meeting the inclusion criteria. These were categorized into six groups: (1) 3D Models in Presurgical Planning and Intraoperative Navigation: 5 articles; (2) Augmented Reality (AR) in Presurgical Planning and Intraoperative Navigation: 25 articles; (3) Mixed Reality (MR) in Presurgical Planning and Intraoperative Navigation: 6 articles; (4) Virtual Reality (VR) in Presurgical Planning and Intraoperative Navigation: 4 articles; (5) AR in Surgical Training: 5 articles; (6) VR in Surgical Training: 6 articles.

While the number of studies on simulation in neuro-oncological surgery is increasing, their analytical depth remains limited. Simulation holds promise for advancing the field, but a significant journey lies ahead before achieving universal academic validation.