Аннотация:Background Virtual reality (VR) is actively used in medicine for surgeon training, allowing the practice of complex procedures without risk to patients. In neurosurgery, VR is particularly relevant for procedures such as external ventricular drainage (EVD) placement, which require high precision. The aim of this study was to develop a VR simulator for EVD placement and evaluate its effectiveness in training surgeons with different levels of experience. Methods The simulator was developed using Meta Quest 3 VR headsets with motion tracking and controllers as well as Inobitec and Shapelab software for segmentation and 3D visualization based on computed tomography/magnetic resonance imaging data. The model included anatomical structures (skull, brain, and ventricles) and surgical tools (catheter, scalpel, and drill). This is a prospective cross-sectional simulation pilot with three expertise strata (experts, residents, and students). The study involved 15 surgeons (5 experienced, 5 residents, and 5 students) performing virtual EVD placement. The primary endpoint was the accuracy of catheter placement, assessed on a 6-point scale (I-VI) by a single independent expert who was blinded to the participant’s group. The secondary endpoints were the procedure time, the number of predefined error types (incorrect entry point, incorrect trajectory, etc.), error rates (the proportion of attempts in which at least one error was made), and the survey results. Results Experienced surgeons completed the procedure faster (113.4 ± 116.4 s) and with fewer errors (6%) compared to residents (176.3 ± 118.0 s) and students (140.8 ± 178.6 s), who had a 28% error rate. The most common errors were incorrect catheter placement (36% of cases) and wrong entry point selection (24%). A postexperiment survey revealed that 14 out of 93% of participants reported a positive training effect and would recommend the simulator for routine practice. Conclusion The study confirms that VR-based simulation of EVD placement is a feasible technique and shows evidence of construct validity. The technology allows surgeons to practice precision in a risk-free environment, reducing errors in real-world procedures. However, further research is needed to expand its clinical applications.
