The Craniotomy

This is a very practical, simple, and very effective exercise.

Relevance for your daily practice

It is highly relevant! It is the “opener” of brain tumor surgery. Mastering the craniotomy is essential for your integration into the surgical team and burdens you with true responsibility.

2.1
Objective

The objective of this chapter is to improve your practical skills in handling a basic neurosurgical procedure. Guiding a craniotome is in principle a very simple procedure. However, if you have never handled this type of instrument at all, you will feel uncomfortable and unsecure when you perform this for the first time on a patient. You will maneuver this powerful “jigsaw” near to the sinuses and might injure the brain by perforating the dura, observed by an impatient senior surgeon, with time pressure in your back. Therefore, it is best to get some manual experience in a controlled setting.

2.2
You Need

You need a coconut, a mobile drill, craniotome, a Mayfield clamp, a fixation system for the Mayfield clamp (a simple board), and a pen, as well as lots of irrigation and (to spare you a lot of cleaning work) drapes and a bucket, which collects the irrigation/coconut debris.

Ok, we know: you do not own a craniotome and a Mayfield clamp. Here comes your initiative into play. After all, you made it through med school and you made it into a Resident program. Talk to your chief and your head nurse. Explain what you plan to do, especially that you will not work with biological hazardous tissue, which would make the return of the instruments into the OR impossible (i.e., sheep brain).

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