Rowena

ROWENA (Realistic Operative Workstation for Educating Neurosurgical Apprentices) is the original 4-part neurosurgical simulator for teaching adult and pediatric surgical techniques and anatomical approaches. Designed by UK neurosurgeon Richard Ashpole FRCS and utilised in leading centres worldwide, this versatile and cost effective system has benefited from 10 years of development to reflect all current neurosurgical training needs. Examples include:

Replaceable upper cranium with scalp, bone and dural layers that incorporate realistic vascular markings.

A fully conformed brain with standard sized or enlarged ventricles, enabling placement of catheters, endoscopy and other types of ventricular access.

Additional brain modules with specific aspects such as super enlarged vents, tumours and falx.

Replaceable sinus module with mucosa and pituitary tumour.

There are four components to the ROWENA system, as outlined below:

Head Base

This is the permanent base of the simulator and incorporates all the internal skull base anatomy, a hollow flexible nose and nasal cavity and flexible ears.

It also incorporates a posteriorly placed screw to anchor the skull vault in place.

Brain

This is made of soft plastic with a realistic brain 'feel', and contains a fluid filled ventricular system enabling CF access procedures and euroendoscopy to be mimicked. It also incorporates the Falx, enabling realistic approaches across and up to the midline, as well as containing two 'tumours' which can be identified on CT/MRI and use for trajectory planning and biopsying. This is inserted into the skull vault by gently compressing it laterally and carefully sliding it into position. With care this component should be utilisable for many training sessions as the brain tends to reseal well after ventricular catheterisation.

Skull Vault

This consists of the bony skull vault covered in a flexible plastic 'scalp' layer, and lined by the 'dura'.

All the appropriate bony markings feature inside the skull vault and both scalp and dura peel away from the bone with a realistic degree of adherence.

Cranium

This module drops into the skull base enabling transsphenoidal procedures to be simulated via the hollow flexible nasal apertures.

It features all the intranasal bony anatomy as well as a layer of covering 'mucosa'. The sphenoid sinus can be entered and beyond that is a soft 'tumour' in the pituitary fossa. The module is fully CT and MRI compatible for image guided approaches. Once drilled and dissected to destruction it can be inexpensively replaced.

Care & Cleaning

After use it is recommended that the heads are disassembled into their three component parts. All can be given a gentle wash in water to remove 'bone dust', dirt etc, and then allowed to dry. When dry the head bases and brains can be returned to their box for safe storage.

Dry storage so the brains can breathe is better than in a plastic bag. Prior to further use the ventricular systems can be refilled with water, if necessary, by inserting a narrow needle alongside the plug in the brainstem.

General Usage & Imaging Compatability

The whole head assembly is fully compatible with both CT and MRI imaging modalities the metal screw and thread fixing the top to the base are both brass) making it ideal for teaching image guided procedures.

Obviously every brain and ventricles is slightly different, as will be the exact position of the brain once it has been inserted into the head. For maximum fidelity for image quided procedures therefore we recommend setting up a complete Rowena simulator prior to the training session, scanning it directly with MRI/CT and then using that model and scan for image guided training.

This method is regularly used with excellent results and accuracy, including tumour location and image guided ventricular catheterisation. The Rowena head is designed to be used with the 3-point headrest, or just a head ring, depending on the procedure.