• Britty Baby, Ramandeep Singh, Rajdeep Singh, Ashish Suri, Chetan Arora, Subodh Kumar, Prem Kumar Kalra, and Subhashis Banerjee.
• Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India; Amar Nath and Shashi Khosla School of Information Technology, Indian Institute of Technology-Delhi, New Delhi, India.
• World Neurosurg. 2020 May 1; 137: 398-407.

BackgroundMinimally invasive neurosurgical approaches reduce patient morbidity by providing the surgeon with better visualization and access to complex lesions, with minimal disruption to normal anatomy. The use of rigid or flexible neuroendoscopes, supplemented with a conventional stereoscopic operating microscope, has been integral to the adoption of these techniques. Neurosurgeons commonly use neuroendoscopes to perform the ventricular and endonasal approaches. It is challenging to learn neuroendoscopy skills from the existing apprenticeship model of surgical education. The training methods, which use simulation-based systems, have achieved wide acceptance. Physical simulators provide anatomic orientation and hands-on experience with repeatability. Our aim is to review the existing physical simulators on the basis of the skills training of neuroendoscopic procedures.MethodsWe searched Scopus, Google Scholar, PubMed, IEEE Xplore, and dblp. We used the following keywords "neuroendoscopy," "training," "simulators," "physical," and "skills evaluation." A total of 351 articles were screened based on development methods, evaluation criteria, and validation studies on physical simulators for skills training in neuroendoscopy.ResultsThe screening of the articles resulted in classifying the physical training methods developed for neuroendoscopy surgical skills into synthetic simulators and box trainers. The existing simulators were compared based on their design, fidelity, trainee evaluation methods, and validation studies.ConclusionsThe state of simulation systems demands collaborative initiatives among translational research institutes. They need improved fidelity and validation studies for inclusion in the surgical educational curriculum. Learning should be imparted in stages with standardization of performance metrics for skills evaluation.Copyright © 2020. Published by Elsevier Inc.

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