caa a22 4500 60621545X CHVBK 20210128101059.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00701-015-2544-z doi (NATIONALLICENCE)springer-10.1007/s00701-015-2544-z A basic model for training of microscopic and endoscopic transsphenoidal pituitary surgery: the Egghead [Elektronische Daten] [Doortje Engel, Andrea Ferrari, Abel-Jan Tasman, Raphael Schmid, Ralf Schindel, Sarah Haile, Luigi Mariani, Jean-Yves Fournier] Background: Transsphenoidal endoscopic surgery has gained popularity in the last 2 decades and is becoming a standard technique for resection of pituitary adenomas. In contrast to their ENT colleagues, neurosurgical residents have practically no endoscopic experience when they reach the training stage for transsphenoidal procedures. We have developed an affordable method for repetitive training in endoscopic (and microscopic) work in a narrow channel, allowing training of the basic movements needed for resection of pituitary adenoma. Methods: In collaboration with colleagues in the ENT Department, Cantonal Hospital St. Gall, and the Technical University of Zurich, a three-dimensional model of the nasal cavity was developed and patented. The Egghead model consists of a 3D synthetic reconstruction of the head nasal cavity and sphenoid sinus. A boiled egg represents the sella. For validation, 17 neurosurgical residents from the Department of Neurosurgery, University Hospital of Basel, and Department of Neurosurgery, Cantonal Hospital of St. Gall, St. Gall, Switzerland, and two experts performed a standardized procedure mimicking a transsphenoidal pituitary procedure by dissecting a corridor to the egg yolk and resecting it, respecting the surrounding egg white. This procedure was performed under both microscopic and video-endoscopic visualization. A score for the precision and speed of the surgical performance was developed and used. Results: The model allows repetitive training of the resection of the egg yolk under sparing of the egg white after careful opening of the shell. The validation data showed a steeper learning curve using the endoscopic technique than performing the same task using the microscope. After three repetitions, the quality of resection was better with the endoscopic technique. Conclusions: Our model, the Egghead, is affordable, offers tactile feedback and allows infinite repetitions in basic training for pituitary surgery. It can be used for training of advanced neurosurgical residents, who thus far have very few possibilities of acquiring endoscopic experience. Springer-Verlag Wien, 2015 Neurosurgery training nationallicence Training model nationallicence Pituitary surgery nationallicence Endoscopy nationallicence Microscopy nationallicence Engel Doortje Department of Neurosurgery, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut Ferrari Andrea Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland aut Tasman Abel-Jan Department of ENT, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut Schmid Raphael Inspire® - ETH Zurich, St. Gall, Switzerland aut Schindel Ralf Inspire® - ETH Zurich, St. Gall, Switzerland aut Haile Sarah Clinical Trials Unit, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut Mariani Luigi Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland aut Fournier Jean-Yves Department of Neurosurgery, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut Acta Neurochirurgica Springer Vienna 157/10(2015-10-01), 1771-1777 0001-6268 157:10<1771 2015 157 701 https://doi.org/10.1007/s00701-015-2544-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2544-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Engel Doortje Department of Neurosurgery, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut NATIONALLICENCE 700 1- Ferrari Andrea Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Tasman Abel-Jan Department of ENT, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut NATIONALLICENCE 700 1- Schmid Raphael Inspire® - ETH Zurich, St. Gall, Switzerland aut NATIONALLICENCE 700 1- Schindel Ralf Inspire® - ETH Zurich, St. Gall, Switzerland aut NATIONALLICENCE 700 1- Haile Sarah Clinical Trials Unit, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut NATIONALLICENCE 700 1- Mariani Luigi Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland aut NATIONALLICENCE 700 1- Fournier Jean-Yves Department of Neurosurgery, Cantonal Hospital of St. Gall, St. Gall, Switzerland aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/10(2015-10-01), 1771-1777 0001-6268 157:10<1771 2015 157 701