BASIC NEUROSURGERY SKILLS COURSE 20-22 February 2012

VENUE: Surgical Training Centre Ground Floor (near Women’s Hospital Entrance) University Hospital Coventry and Warwickshire Clifford Bridge Road COVENTRY CV2 2DX

PROGRAMME

Programme Day 1- Monday 20 February 2012 08.30 09.00 09.20 10.45 11.00 12.45 13.45 15.15 15.30 15.40

Registration and refreshments Welcome and introduction High Speed Drill Workshop Part I Tea and coffee High speed drill Workshop Part II Lunch High Speed Drill Part III Tea and Coffee Brief lecture: How to use a microscope for both teams

Team A-Microscope exercise At the 1) 2) 3)

15.40 16-15

CSB 2nd Floor STC STC STC (LR) STC CSB 2nd Floor STC STC (LR) STC

end of this exercise participants would be able to: Use the microscope safely and effectively Outline the principles of microsurgery Demonstrate a simulation of removing a parenchymal brain tumour

Team B- High Speed Drill Workshop Part IV Team B-Microscope exercise

STC STC

As above

16.15 17.00

Team A-High Speed Drill Workshop Part IV Close

STC

ABBREVIATIONS CSB STC STC(LR)

Clinical Science Building Surgical Training Centre Surgical Training Centre Lecture Room

COURSE DINNER 6.00 7.30

Assemble at CSB RECEPTION DINNER

Departure for dinner, venue TBA TBA

2

Programme Day 2- Tuesday 21 February 2012 08.00 08.30

Refreshments Introduction of the Faculty

08.45

CERVICAL SPINE- ANTERIOR APPROACH Brief Lecture about the approach

09.00

Cadaver exercise:

All faculty

CSB 2nd Floor STC

DEMONSTRATOR TBA

STC

Participants would learn: Indications-anterior approach to cervical spine. Anatomy of the anterior approach to cervical spine incl. Facial and muscle layers of the neck, vertebral bodies, discs, uncovertebral joints, dura, nerve roots, sympathetic chain, carotid & vertebral arteries, trachea, oesophagus Basic principles and steps of Anterior cervical discectomy with principles of bone grafting. Complications of this approach.

10.30 10.45 11.00

Tea and coffee CERVICAL SPINE- POSTERIOR APPROACH Brief lecture about the approach

STC (LR) TBA

STC

Cadaver exercise: Participants would learn: Indications-posterior approach to cervical spine. Anatomy of the posterior approach to cervical spine incl. muscle attachments of the neck, laminae, pedicles, ligamentum flavum, dura, dentate ligament, nerve roots. C1-C2 junction special anatomy. Basic principles and steps of Posterior cervical laminectomy and posterior cervical foraminotomy. Complications of this approach.

12.45

Lunch

CSB 2nd Floor

Programme Day 2- Tuesday 21 February 2012 contd…. 13.30

LUMBAR SPINE- POSTERIOR APPROACH AND ANTERIOR APPROACH

TBA

STC

Brief lecture about both approaches 14.00

Cadaver Exercise: Participants would learn a) Posterior Approach Indications-posterior approach to lumbar spine. Basic principles and steps of Lumbar laminectomy and lumbar micro-discectomy and exposure needed for pedicle screw fixation. Complications of this approach. The Instructor would demonstrate the Anatomy of the posterior approach to lumbar spine incl. layers to go through, laminae, pedicles, transverse processes, attachment of ligamentum flavum, dura, relationship of the nerve roots to the pedicles.

15.15

b) Cadaver Exercise: Anterior approach Indications-Anterior approach to lumbar spine. Basic principles and steps of exposing the vertebral bodies and discs from the front. Complications of this approach. The Instructor would demonstrate the Anatomy of the anterior approach to lumbar spine including abdominal wall, layers to go through, blood vessels in front of the spinal column, ALL, viscera

15.45 15.45 16.00

Tea and Coffee

STC (LR)

PARASAGITTAL FLAP Brief Lecture Cadaver exercise: Participants would learn Indications-for parasagittal approach Basic principles and steps of this approach including going across the midline The Anatomy of the Sagittal sinus, cortical veins draining into the sinus, falx cerebri, corpus callosum, pericallosal arteries, roof of the third ventricle, internal cerebral veins, septum pallucidum. Principles of dural closure, duraplasty, rigid fixation of the bone flap

17.30

Close 4

TBA

STC

Programme Day 3- Wednesday 22 February 2012 08.00

TBA

CSB 2nd Floor STC

TBA

STC (LR) STC

Refreshments

08.30

BIFRONTAL CRANIOTOMY Brief Lecture about the approach

08.45

Cadaver exercise: Participants would learn: Indications-bi-frontal approach to the brain Anatomy of the bi-frontal approach to brain incl. bony landmarks, anatomy of frontal air sinuses, anterior cranial fossa, anterior sagittal sinus, falx cerebri, cribriform plate, frontal lobes, anterior pituitary fossa, optic nerves/chiasm and anterior cerebral arteries. The safe method of taking the craniotomy flap without injuring the superior sagittal sinus. How to use the peri-cranium for repair of anterior fossa dural defects, and exteriorise the exposed frontal sinus. Basic principles and surgical steps of this approach Complications of this approach.

10.30 10.45 11.00

Tea and coffee TRAUMA FLAP/PTERIONAL CRANIOTOMY Brief Lecture about the approach Cadaver exercise: Participants would learn: Indications- Pterional/Trauma approach Anatomy of scalp and skull including surface anatomy. Anatomy of middle meningeal artery, dura, brain (temporal and frontal lobes), anterior circle of Willis, optic nerves and chiasm, lateral ventricle, temporal and frontal horns and foramen of Monroe. The safe approach to the pterion using hand (Hudson brace, bone nibblers) and electric drills. Use of exploratory burr holes and relate them to standard trauma. Basic principles and surgical steps of this approach. Complications of this approach.

12.45

CSB 2nd Floor

Lunch 5

Programme Day 3- Wednesday 22 February 2012 contd… 13.30

TBA

OCCIPITAL CRANIOTOMY Brief Lecture about the approach

STC

Cadaveric exercise: Participants would learn Indications- Occipital approach Anatomy of skull including surface anatomy of the transverse sinus. Muscle attachments at the superior nuchal line, Difference between occipital and suboccipital approach. Anatomy of the venous sinuses, falx cerebri, tentorium, occipital lobe, occipital horn of the lateral ventricle. Basic principles and surgical steps of this approach. Complications of this approach.

15.45

Tea and Coffee

15.45

POSTERIOR FOSSA CRANIECTOMY/CRANIOCERVICAL APPROACH. Brief Lecture about the approach

16.00

Cadaver exercise: Participants would learn

TBA

Indications-for this approach Basic principles and surgical steps of this approach Surgical anatomy of the approach including Boundaries of the craniectomy, Muscle attachments at the superior nuchal line, venous sinuses, inferior surface of the tentorium, free edge, cerebellar hemispheres, vermis, cranial nerves in the CP angle, internal acoustic meatus, IV ventricle, floor of the IV ventricle, cistrena magna, anatomy of the cranio-cervical junction, vertebral artery at the level of the Atlas, entering the foramen magnum, PICA, brain stem. Complications of this approach

17.30 17.45

FEEDBACK and CERTIFICATES CLOSE

6

Mr A Saxena

STC (LR) STC