gms | German Medical Science

Objective: Whereas experts look to a two planar angiography and knows where the aneurysm located and how the aneurysm intraoperatively orientated is, residents and beginners sometimes knew absolutely few. This will continue in the OR and the surgical education is reduced. Due to the decreasing numbers of surgical procedures the education should be optimized. Therefore we used a special rotation of the 3D-angiography, named ‘residents’ view’, and evaluated, if it improves anatomical knowledge and surgical training.

Method: A survey was performed to identify, if this view is worth the effort. After introduction to the angiography system a well-trained resident needs less than 5 min to produce this special rotated 3D angiography. The standard 3D AP view was rotated like the suggested intraoperatively view (patient 45° clamped with zygoma to be the highest point). After aneurysm clipping the assistant resident has to fill out a questionnaire containing questions about anatomy, orientation, emerging perforator, but also about educative, anatomical, technical benefits or not.

Results: A total of nine questions were asked (s. Appendix 1). We divided the analysis between beginner (residents from 1^st to 3^rd year) and resident (4^th year and above, but not specialist). Questions 1 to 5 aimed to test, if the view was helpful in anatomical understanding in the operated field. Question 6 - 8 should identify the learning effect. Question 9 (do you wish the view pre-operatively?) was answered in the first twelve patients (both groups 100%). The intra-operative anatomy was recognized faster and better and the survey identified that the residents were glad to have this special rotation (100% ticked that they wanted the view pre-operatively). Also most residents had a better learning benefit knowing the “residents’ view”.

Conclusions: The “residents’ view” is helpful in teaching residents in vascular neurosurgery. Starting postoperatively with it, to test if the residents are interested in this view, every resident wanted to see it pre-operatively. This was the most important factor to introduce this view pre-operatively and start a prospective evaluation.