Simulating Endoscopic Transsphenoidal Surgery in a 3D Model and the Cadaver: A Preliminary Comparative Study.

Abstract

Numerous challenges remain in surgical training for endoscopic endonasal and transnasal procedures. Three-dimensional simulators are being developed to allow rapid and cost-effective acquisition of endoscopic surgical skills and anatomical knowledge. However, validation studies are limited. This study aims to evaluate the role and effectiveness of the new UpSurgeOn TNSBox (transnasal transsphenoidal surgical simulator) in enhancing surgical skills compared to cadaveric dissection. A total of 34 subjects, including neuro- and head and neck surgeons (both residents and junior consultants), were divided into two groups. Group 1 completed a dissection on a 3D simulator, followed by a cadaveric dissection, while group 2 dissected only a cadaver. A training program covering several surgical steps was conducted and recorded. At the end of the course, each participant completed a structured questionnaire. Performance was evaluated by six blinded experts using the validated Endoscopic Surgery Rating Scale. Performance scores were analyzed using Student's t-tests. This study demonstrated that both specialists and residents beginning their training in endoscopic transsphenoidal surgery significantly improve their surgical skills when they undergo a simulation-based initial training program. The new UpSurgeOn TNSBox can contribute to a hybrid training model that combines simulation with cadaveric dissection, enhancing the acquisition of basic endoscopic surgical skills.