• Vikas Singh, Salman Shaikh, Prakash Shetty, and Aliasgar Moiyadi.
• Neurosurgical Oncology Services, Department of Surgical Oncology, Tata Memorial Hospital, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India.
• World Neurosurg. 2020 Nov 1; 143: 564-571.e2.

BackgroundPractical ultrasound (US) training is essential to overcome operator dependence and optimize image acquisition. For intraoperative neurosurgical application, in addition to hand-eye coordination, ultrasound training should incorporate training for visuomotor and visuospatial skills, as well as 3-dimensional depth orientation. Our agar-based, low-cost model has been developed keeping these skill sets in mind.Materials And MethodsWe have described preparation of an agar-based, low-cost customizable model using commonly available echogenic objects as targets, which allows the clinician to perform various training tasks like depth insonation, target localization, and biopsy and resection cavity insonation. This low-cost model was implemented for internal training and validated at an international training course.ResultsThe cost of the model was 4 USD, and its preparation time was <1 hour. It can be used for performing multiple US training tasks and provides realistic images and good tactile feedback. However, the model is perishable and artifacts are occasionally visible. Feedback survey results showed that >80% of participants felt the model was useful for US training.ConclusionsOur customizable low-cost US training model is an effective and efficient tool for US training with high acceptance by neurosurgeons. It faithfully mimics various intraoperative tasks and helps clinicians gain confidence to use intraoperative ultrasound as an adjunct during the procedures. This model can be used by individual surgeons/departments for ongoing training, as well as for larger training courses and workshops.Copyright © 2020 Elsevier Inc. All rights reserved.

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