Neurosurgery Blog

Acta Neurochir (2010) 152:1337–1341. DOI 10.1007/s00701-010-0663-0

In the current climate of increasing awareness, patients are demanding more knowledge about forthcoming operations. The patient information accounts for a considerable part of the physician’s daily clinical routine. Unfortunately, only a small percentage of the information is understood by the patient after solely verbal elucidation. To optimise information delivery, different auxiliary materials are used.

Methods In a prospective study, 52 consecutive stationary patients, scheduled for an elective lumbar disc operation were asked to use a web-based audiovisual patient information system. A combination of pictures, text, tone and video about the planned surgical intervention is installed on a tablet personal computer presented the day before surgery. All patients were asked to complete a questionnaire.

Results Eighty-four percent of all participants found that the audiovisual patient information system lead to a better understanding of the forthcoming operation. Eighty-two percent found that the information system was a very helpful preparation before the pre-surgical interview with the surgeon. Ninety percent of all participants considered it meaningful to provide this kind of preoperative education also to patients planned to undergo other surgical interventions. Eighty-four percent were altogether “very content” with the audiovisual patient information system and 86% would recommend the system to others.

Conclusions This new approach of patient information had a positive impact on patient education as is evident from high satisfaction scores. Because patient satisfaction with the informed consent process and understanding of the presented information improved substantially, the audiovisual patient information system clearly benefits both surgeons and patients.

Neurosurgery 65:719–726, 2009 DOI: 10.1227/01.NEU.0000354350.88899.07

OBJECTIVE: With improvements in endovascular techniques, fewer aneurysms are treated by surgical clipping, and those aneurysms targeted for open surgery are often complex and difficult to treat. We devised a hollow, 3-dimensional (3D) model of individual cerebral aneurysms for preoperative simulation and surgical training. The methods and initial experience with this model system are presented.

METHODS:The 3D hollow aneurysm models of 3 retrospective and 8 prospective cases were made with a prototyping technique according to data from 3D computed tomographic angiograms of each patient. Commercially available titanium clips used in our routine surgery were applied, and the internal lumen was observed with an endoscope to confirm the patency of parent vessels. The actual surgery was performed later.

RESULTS: In the 8 prospective cases, the clips were applied during surgery in the same direction and configuration as in the preoperative simulation. Fine adjustments were necessary in each case, and 2 patients needed additional clips to occlude the atherosclerotic aneurysmal wall. With these 3D models, it was easy for neurosurgical trainees to grasp the vascular configuration and the concept of neck occlusion. Practicing surgery with these models also improved their handling of the instruments used during

aneurysm surgery, such as clips and appliers.

CONCLUSION: Using the hollow 3D models to simulate clipping preoperatively, we could treat the aneurysms confidently during live surgery. These models allow easy and concrete recognition of the 3D configuration of aneurysms and parent vessels.

Knut Wester

Acta Neurochir (2009) 151:1013–1024

We are delighted to open registration for the EANS Young Neurosurgeons Meeting, to be held in February 2010.   This is intended as an event which will combine fierce scientific discussion and time to socialise in an informal atmosphere – please submit your application as soon as possible – the initial response to this event has been excellent, and we anticipate a good deal of interest.

However there is always a financial risk attached to the organisation of a new event, particularly in the current economic climate, and we need the firm financial commitment of a minimum number of participants by the end of the preliminary registration period (20^th September 2009) if we are definitely to go ahead with the event.

This is intended as an event organised by Young Neurosurgeons for Young Neurosurgeons – so please, register now and play your part in making our event happen, keeping in mind that we have limited places available. We hope that many alumni from the EANS Training Courses will choose to attend, and are seeking to cultivate a similar atmosphere  – however we will also be delighted to welcome those who did not attend the courses, and those from outside Europe.

The morning sessions will consist of lectures from leading figures in European Neurosurgery and a series of “Challenging Topics” in which the merits of different approaches are considered, while the evening sessions will offer a valuable opportunity for recently qualified neurosurgical specialists to present their own work (abstracts to be submitted).

We hope that both sessions will give rise to animated discussions between both participants and faculty members – which can be continued during the afternoon on the ski slopes, when we anticipate that many people will choose to take advantage of the special ski deal which we have negotiated – though Innsbruck itself also has plenty to offer non skiers.

The event is focused particularly on those who have recently qualified, and the submission of abstracts is restricted to those within six years of specialist qualification.  However registration is open to those of all ages, and we hope that the event will provide the opportunity for discussion not only with your peers, but also with senior faculty members.

Please submit your registration form to Susie Hide susie.hide@btinternet.com as soon as possible.   Susie will then send you a link to our online payment facility.  As explained above, we need your firm financial commitment prior to September 20th, and will therefore require a minimum deposit of 300 Euros to be paid within this period.