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| Challenges and management strategies in clinical teaching of neurosurgery |
| FAN Cungang LIU Ruen |
| Department of Neurosurgery, Peking University People′s Hospital，Beijing 100044, China |
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Abstract Based on the characteristics of neurosurgery, this article discusses the clinical teaching dilemma of neurosurgery from the two aspects of neurosurgery, including basic theory and clinical skills. With regard to the basic theory of neurosurgery, the author focused on the learning dilemmas in neuroanatomy, neurological examination and neuroimaging technology. In terms of clinical skills in neurosurgery, the emerging auxiliary diagnostic technology places higher requirements on the continuous learning ability of beginners; the delicate neural tissue and microsurgical techniques of neurosurgery significantly extend the surgical training period for surgeons; the limited compensatory volume of the cranial cavity and spinal canal may lead to brain hernia and even endanger the life of the patient in the perioperative period due to tens of milliliters of bleeding in surgical field, necessitating higher demands on the responsibility of neurosurgeons; the specialized instruments and equipment designed for microsurgery operations of neurosurgery are significantly different from common tools used in general surgery, thereby require continuous learning and adaptation of operators; the limited surgical field exposed in neurosurgery and the premise of protection of neurological functions results in the resection principle of neural tumors of “initial intra-capsule decompression and then piece meal resection of the tumor capsule” seems to contradict the “en bloc resection” tumor-free principle of traditional oncology. Based on a systematic analysis and in-depth discussion of the above-mentioned difficulties in teaching of neurosurgery, combined with years of teaching experience in neurosurgery of the authors, the corresponding treatment strategies are proposed in order to provide reference for the clinical teaching of neurosurgery.
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