DOI: 10.1016/j.wneu.2024.01.027

World Neurosurg. (2024). Training in Skull Base Endonasal Endoscopic Surgery: Development and Validation of a Novel Low-Cost Simulation with Animal Cadaveric Model. 1878-8769.

In an innovative stride within the realm of neurosurgery, a team of resourceful researchers from the prestigious hospitals in Buenos Aires, Argentina, announces the development and successful validation of an inventive low-cost training simulator for skull base endonasal endoscopic surgery. This novel simulation leverages a swine cadaveric model to provide a realistic and effective educational platform for neurosurgeons, addressing the complex learning curve associated with this advanced surgical technique.

A Leap towards Enhanced Endonasal Endoscopic Proficiency

Endoscopic skull base surgery represents a paradigm of technical evolution, characterized by intricate procedures that demand utmost precision. Matassa-Patrone Jerónimo J and colleagues have been at the forefront of this domain, dedicating their expertise to the enhancement of surgical training methods. As the scope of this surgical technique expands, so does the necessity for practitioners to attain a high proficiency level outside the operating room to mitigate risks to patients.

Understanding that traditional training methods carry a substantial risk, the group embarked on creating a simulation that could faithfully replicate surgical scenarios while being economically feasible and easily replicated elsewhere. The novel training simulator featured fresh Pietrain swine heads as a model, providing a suitably complex anatomical structure for surgical exercises of varying difficulty.

Scientific Validation and Remarkable Trainee Satisfaction

The study’s objective evaluation involved ten participants—five neurosurgery residents and five experienced neurosurgeons—engaged in meticulously designed training exercises. By developing a Specific Technical Skills and Knowledge Scale, the researchers were able to benchmark proficiency gains. The results demonstrated statistically significant differences in performance favoring those with former endoscopic experience.

Post-simulation, a questionnaire was administered to assess the face validity of the simulator. The results bore testament to the simulator’s high fidelity, as evidenced by an impressive overall score of 28.7 out of 30. Trainee feedback was overwhelmingly positive, with unanimous acknowledgment of the simulator’s potential to benefit endoscopic education.

The validated animal model simulator has emerged as a pivotal educational tool. By facilitating the transition from theory to practice, it supports the nurturing of essential surgical skills away from the live patient environment, ultimately enhancing patient safety.

Impact on the Future of Neurosurgical Education

The Argentinian team’s novel simulator has set a benchmark in surgical skills training, demonstrating that high-quality education need not be prohibitively expensive or dependent on actual operative exposure. The simulator, with its capacity to recreate the demanding environment of endonasal endoscopy, augurs well for the future of neurosurgical education. It echoes a shift towards structured, risk-free, and resource-sensitive learning modules that can significantly improve surgical outcomes.

Moreover, this innovation not only upholds patient safety but also stands as a testimony to the progressive ethos in surgical education, aligning with global trends that advocate for patient-first practices.


1. Matassa-Patrone, J. J., et al. (2024). Training in Skull Base Endonasal Endoscopic Surgery: Development and Validation of a Novel Low-Cost Simulation with Animal Cadaveric Model. World Neurosurgery.
2. Harvey, R. J., et al. (2020). Endoscopic Endonasal Skull Base Surgery: Analysis of Complications in the Literature. Journal of Neurosurgery.
3. Gardner, P. A., et al. (2018). The Learning Curve for Endoscopic Endonasal Approaches to Skull Base Tumors. Operative Neurosurgery.
4. Zada, G., et al. (2013). A Review of the Current Applications and Future Direction of Three-Dimensional Printing in Neurosurgery. Surgical Neurology International.
5. Couldwell, W. T., et al. (2019). A Historical Perspective of the Evolution of Instrumentation for Endonasal Transsphenoidal Surgery. Journal of Neurosurgery.


1. Skull Base Endoscopic Training
2. Surgical Simulation Innovation
3. Neurosurgical Education Tools
4. Endonasal Surgery Simulator
5. Low-Cost Surgical Training

This article stands as an illustrious example of the tenacity and ingenuity embedded in the sphere of neurosurgical education. It symbolizes a future where surgical learning is more accessible, streamlined, and safe—ushering in an era where training programs can confidently prepare surgeons for the complexities of endonasal endoscopic procedures. The generation of such innovative training methods marks an elevated milestone in surgical training, signifying a steadfast commitment to excellence in surgical practice and a relentless pursuit of patient safety.