Step-up Establishment of Neurosurgical Laboratory Starting with Limited Resources—Tips and Tricks

Background: Neurosurgical diseases have a devastating impact on society. It is estimated that approximately 14 million essential neurosurgical cases develop worldwide annually, of which more than 80% arise in low- and middle-income countries. Neurosurgical cadaveric dissection remains largely unexploited as a learning tool for the training of surgeons in developing countries, often because of the assumed high costs. Methods: The minimum requirements to establish a neurosurgical cadaver laboratory are the availability of minimally equipped environment to perform dissection, respecting safety requirements, fitting surgical instruments, anatomic samples, and materials to be used for preservation and preparation of anatomical specimens. Moving from these basic foundations, we established our Neurosurgical Dissection Laboratory at Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome, Italy. The laboratory is located at the Institute of Public Health Section of Legal Medicine of University. Results: After reviewing relevant literature and discussing our experience, we provide advice for setting up a neurosurgical dissection cadaver laboratory with specific focus on suitable location identification, surgical equipment procurement, fresh cadaver and frozen specimen acquisition, and preparation and description of a step-up strategy to progressively enrich the laboratory. Conclusions: Our study demonstrates the feasibility of establishing a neurosurgical cadaver dissection laboratory for training and research purposes even in presence of limited resources. The introduction of cost-effective guidelines and targeted funding could represent an added value to target the unmet neurosurgical disease need by promoting development of local neurosurgical expertise with the aim of providing health coverage for the treatment of common neurosurgical pathologies in developing countries.