A guideline and technical certification program for neuroendoscopic surgery

Neuroendoscopic surgery is performed using two-dimensional video monitors, which lack depth sensation thereby reducing virtual hand-eye co-ordination. So special training is required and different techniques than those used in other forms of microsurgery must be employed. Recently, various neuroendoscopic procedures such as third ventriculostomy, transsphenoidal surgery, evacuation of intracerebral hematoma, and so on, have been developed, but cases with severe complications have been reported sporadically. So the Japanese Society for Neuroendoscopy has organized a committee to establish a guideline and a technical certification system to develop safe neuroendoscopic surgeries. The guideline recommends that all novice neuroendoscopic surgeons only performe surgeries under the supervision of an experienced neuroendscopist and only after they have completed special training courses at hands-on seminars. Applicants for the technical certification are required to attend at least two separate of hands-on seminars and should master the basic knowledge of the instruments and common techniques necessary for performing neuroendoscopic surgeries including how to avoid and deal with complications. Then one can apply for the technical certification with at least 10 cases of experience as an assistant and 10 as an operator with an experienced neuroendoscopist. Categories include third ventriculostomy, transsphenoidal surgery, evacuation of intracerebral hematoma, endoscope-assisted microsurgery, or other neuroendoscopic surgeries. As this technical certification program requires only the basic knowledge and common techniques for neuroendoscopic surgeries in general, an advanced certification program for each category is under consideration.