Multitask Box Trainer for Endoscopic Endonasal Skull Base Surgery: ENDOtrainer

[Journal]

World Neurosurgery, 101, May 2017, 304-307

Pablo Sanromán-Álvarez, Juan Antonio Simal-Julián, Alfonso García-Piñero, Pablo Miranda-Lloret

Over the last decade, endoscopic endonasal approaches to skull base (SB) have experienced a meteoric rise. To perform these approaches, the endoscopic surgeon needs to acquire radically different skills apart from microsurgical ones, given the reduced mobility resulting from the small field available, the use of long instruments that hamper a surgeon’s fine movements, and the need to become accustomed to a new anatomical perspective and 2-dimensional view. These endoscopic skills can be differentiated into basic (hande eye coordination or depth perception) and more specific to endonasal surgery (raising vascularized flaps, intradural/arachnoid dissection, and control of the pressure exerted during drilling on the SB), but all of them benefit from creating a learning program that ensures their mastery before performing real surgeries. The objective of this paper is to describe our learning program created to develop specific skills needed in SB endoscopic surgery refined with a multitask model box called ENDOtrainer.