The auditory brainstem implant restores hearing by stimulating the brainstem directly (ie bypassing the ear, cochlea, and cochlear nerve. It is for patients who have no other hearing rehabilitation options- most commonly after removal of a tumor of the 8th cranial nerve in patients with neurofibromatosis type 2, as shown in this video.
Right modified transjugular approach (supracondylar/ transtubercular) approach for decompression of VII nerve. Note absence of any retractors, or traction on CN VIII.
Surgical video is an important educational tool for surgeons at any stage of their career. Viewing video of surgery after a successful procedure – and even more so after a procedure where something has gone wrong – is a critical component of analyzing and improving one’s own surgical technique.
Surgery has both intellectual skills (cognitive) and manual skills (technical). Cognitive surgical skills are those include making accurate diagnoses, knowing- who is/ isn’t a good candidate for surgery, and having a depth of understanding of surgical anatomy. Technical skills can be simply summarized as getting your hands to do what you want them to. There is a huge cognitive aspect to surgery, but in skull base and cerebrovascular surgery in particular there is also a very significant technical component.
Economy of motion – minimizing unnecessary maneuvers that might expose critical structures to unnecessary risk – adroitness, and manual sensitivity are all components to being a good “technical” surgeon.
These manual skills can only be achieved by repetition (practice). Think of it as similar to playing the piano. No amount of listening alone will enable you to play Chopin- you have to practice. This is why volume and experience are so important to achieving good outcomes in skull base and cerebrovascular surgery.
I believe that what what further separates an excellent surgeon from an average one is the willingness to bring the same focus and attention to detail in improving one’s own surgical technique that others might devote to time in the laboratory. Reviewing video is perhaps only one part of continuously improving one’s surgical techniques, but it is a very significant one.