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J Neurosurg. 2016 May;124(5):1238-44. doi: 10.3171/2015.1.JNS141583. Epub 2015 Oct 9.

Face, content, and construct validity of human placenta as a haptic training tool in neurointerventional surgery.

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Department of Surgery, Federal University of Minas Gerais, Brazil;
Department of Neurosurgery, Neurosurgical Simulation Research and Training Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec;
Surgical Simulation Centre, Mount Sinai Hospital, University of Toronto, Ontario, Canada; and.
Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia.


OBJECT The development of neurointerventional treatments of central nervous system disorders has resulted in the need for adequate training environments for novice interventionalists. Virtual simulators offer anatomical definition but lack adequate tactile feedback. Animal models, which provide more lifelike training, require an appropriate infrastructure base. The authors describe a training model for neurointerventional procedures using the human placenta (HP), which affords haptic training with significantly fewer resource requirements, and discuss its validation. METHODS Twelve HPs were prepared for simulated endovascular procedures. Training exercises performed by interventional neuroradiologists and novice fellows were placental angiography, stent placement, aneurysm coiling, and intravascular liquid embolic agent injection. RESULTS The endovascular training exercises proposed can be easily reproduced in the HP. Face, content, and construct validity were assessed by 6 neurointerventional radiologists and 6 novice fellows in interventional radiology. CONCLUSIONS The use of HP provides an inexpensive training model for the training of neurointerventionalists. Preliminary validation results show that this simulation model has face and content validity and has demonstrated construct validity for the interventions assessed in this study.


GDC = Guglielmi detachable coil; HP = human placenta; interventional neuroradiology; placenta; surgical simulation validation; training model; vascular disorders

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