Marcel A Kamp1, Johannes Knipps2, Hans-Jakob Steiger2, Marion Rapp2, Jan F Cornelius2, Stefanie Folke-Sabel3, Michael Sabel2. 1. Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. marcelalexander.kamp@med.uni-duesseldorf.de. 2. Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany. 3. Stem Cell Network North Rhine-Westphalia, Voelklinger Strasse 49, 40221, Duesseldorf, Germany.
Abstract
BACKGROUND: Resection of intrinsic and extrinsic brain tumours requires an understanding of sulcal and gyral anatomy, familiarity with tissue consistency and tissue manipulation. As yet, these skills are acquired by observation and supervised manipulation during surgery, thus accepting a potential learning curve at the expense of the patient in a live surgical situation. A brain tumour model could ensure optimised manual skills and understanding of surgical anatomy acquired in an elective and relaxed teaching situation. We report and evaluate a brain tumour model, regarding availability, realistic representation of sulcal and gyral anatomy and tissue consistency. METHOD: Freshly prepared agar-agar solution with different concentrations was added with highlighter ink and injected into fresh sheep brains. RESULTS: Hardened agar-agar solution formed masses comparable to malignant brain tumours. Variation of the agar-agar concentration influenced diffusion of agar-agar solution in the adjacent brain tissue. Higher concentrated agar-agar solutions formed sharply delimitated masses mimicking cerebral metastases and lower concentrated agar-agar solutions tended to diffuse into the adjacent cerebral tissue. Adding highlighter ink to the agar-agar solution produced fluorescence after blue light excitation comparable to the 5-ALA induced fluorescence of malignant glioma. CONCLUSIONS: The described in vitro sheep brain tumour model is simple and realistic, available practically everywhere and cheap. Therefore, it could be useful for young neurosurgical residents to acquire basic neuro-oncological skills, experiencing properties of the cerebral brain texture and its haptic perception and to learn handling of neurosurgical equipment.
BACKGROUND: Resection of intrinsic and extrinsic brain tumours requires an understanding of sulcal and gyral anatomy, familiarity with tissue consistency and tissue manipulation. As yet, these skills are acquired by observation and supervised manipulation during surgery, thus accepting a potential learning curve at the expense of the patient in a live surgical situation. A brain tumour model could ensure optimised manual skills and understanding of surgical anatomy acquired in an elective and relaxed teaching situation. We report and evaluate a brain tumour model, regarding availability, realistic representation of sulcal and gyral anatomy and tissue consistency. METHOD: Freshly prepared agar-agar solution with different concentrations was added with highlighter ink and injected into fresh sheep brains. RESULTS: Hardened agar-agar solution formed masses comparable to malignant brain tumours. Variation of the agar-agar concentration influenced diffusion of agar-agar solution in the adjacent brain tissue. Higher concentrated agar-agar solutions formed sharply delimitated masses mimicking cerebral metastases and lower concentrated agar-agar solutions tended to diffuse into the adjacent cerebral tissue. Adding highlighter ink to the agar-agar solution produced fluorescence after blue light excitation comparable to the 5-ALA induced fluorescence of malignant glioma. CONCLUSIONS: The described in vitro sheep brain tumour model is simple and realistic, available practically everywhere and cheap. Therefore, it could be useful for young neurosurgical residents to acquire basic neuro-oncological skills, experiencing properties of the cerebral brain texture and its haptic perception and to learn handling of neurosurgical equipment.
Authors: Michael Sabel; Johannes Knipps; Lisa Margarete Neumann; Max Kieslich; Hans-Jakob Steiger; Marion Rapp; Marcel A Kamp Journal: Neurosurg Rev Date: 2018-07-23 Impact factor: 3.042
Authors: Anne Sophie Grosch; Timo Schröder; Torsten Schröder; Julia Onken; Thomas Picht Journal: Acta Neurochir (Wien) Date: 2020-05-08 Impact factor: 2.216
Authors: Valentina Pieri; Marco Trovatelli; Marcello Cadioli; Davide Danilo Zani; Stefano Brizzola; Giuliano Ravasio; Fabio Acocella; Mauro Di Giancamillo; Luca Malfassi; Mario Dolera; Marco Riva; Lorenzo Bello; Andrea Falini; Antonella Castellano Journal: Front Vet Sci Date: 2019-10-16