Development of a Placenta-Based Microsurgical Training Model for Vestibular Schwannoma Resection.

BACKGROUND: Vestibular schwannoma resection is among the most technically demanding procedures in neurosurgery. Reduced operative exposure during residency has increased the need for realistic and accessible simulation models. METHODS: A training model was created by combining human placenta with a 3D-printed retrosigmoid craniotomy to simulate vestibular schwannoma resection. Placental and amniotic tissues were configured to reproduce the tumor capsule, facial nerve, lower cranial nerves, cisterna magna, and dura mater. The simulator reproduced dural opening and cerebrospinal fluid drainage, tumor resection, facial nerve preservation, final cavity inspection, and dural closure. Two expert neurosurgeons and two senior residents evaluated the model using a 5-point Likert scale questionnaire. RESULTS: The model could be assembled in a mean time of 21 minutes with standard instrumentation. Multiple tumors were obtained from a single placenta, up to a maximum of 9, allowing repeated simulations using the same specimen. The evaluators rated the simulator favorably for perceived microsurgical training value, bimanual coordination, instrument handling, and simulation of a narrow and deep operative corridor. Scores for anatomical realism reflected the inherent technical challenges in replicating the highly intricate cerebellopontine angle anatomy and its vascular structures. CONCLUSIONS: The described simulator represents the first placenta-based model specifically designed for vestibular schwannoma surgery. Based on these preliminary observations, the model may provide a complementary platform for practicing fundamental microsurgical maneuvers, particularly during the early stages of neurosurgical training.