TissueDB/Simulators/Cranial Burr Hole and Craniotomy Simulator (Bakhshi)

The Cranial Burr Hole and Craniotomy Simulator (Bakhshi) is a 3D-printed ABS skull used for practising two fundamental cranial-access skills: drilling burr holes and performing a craniotomy.^[1] The simulator was used during a national neurosurgery bootcamp for PGY-1 residents in Karachi, Pakistan. Trainees used a cranial perforator for burr-hole drilling and an electronic craniotome and cutter for craniotomy practice.

Bakhshi et al. (2022) identifies the simulator as a 3D-printed adult cranium made from acrylonitrile butadiene styrene (ABS).

The publication does not provide:

• an STL or CAD file;
• a source URL for the skull geometry;
• printer make or model;
• nozzle diameter;
• layer height;
• infill;
• wall thickness;
• print orientation;
• support settings;
• slicing profile; or
• total printing time.

For this reason, the publication alone is not sufficient to reproduce the exact Bakhshi skull geometry or print configuration. A separately verified digital model would be required for faithful reconstruction.

Step 1. Obtain an adult cranium geometry suitable for 3D printing.

Source limitation: the exact geometry used by Bakhshi et al. is not published. Do not describe an independently obtained skull model as the original Bakhshi STL.

Step 2. Fabricate the cranial model in ABS using an appropriate 3D-printing process.

Source limitation: Bakhshi et al. identifies ABS as the material but does not publish print settings or printing time.

Before use, inspect the printed skull for gross defects that would prevent the intended burr-hole or craniotomy exercise. The source does not prescribe this as an acceptance criterion.

Step 1. Position the printed skull so that the cranial vault is accessible for drilling.

Source limitation: Bakhshi et al. does not describe a frame, skull holder, clamp, fixation device or mounting method.

Editorial setup requirement: stabilise the skull sufficiently for the planned supervised drilling exercise using an appropriate local method. This requirement follows from the physical task but is not presented as a source-described Bakhshi component.

Step 1. Use the cranial perforator to practise making burr holes in the 3D-printed skull.

Step 2. Repeat the supervised skill as required by the training session. In the published bootcamp, participants performed each skill at least three times.

Evidence note: burr-hole performance was one of the four skills formally assessed with mOSATS. First- and third-attempt scores were compared by the study.

Step 1. Use the electronic craniotome and cutter to practise the craniotomy task on the ABS skull.

Step 2. Repeat the supervised skill as required by the training session.

Evidence note: craniotomy was also one of the four skills formally assessed with mOSATS. The study reported improvement between first and third attempts across the assessed cranial-skill domains.

• The simulator represents the bony cranium only.
• It does not reproduce the dura, brain, vessels or other intracranial tissues.
• Exact STL/CAD geometry and 3D-print settings are not published.
• Total printing or construction time is not stated.
• The published performance findings apply to the specifically assessed burr-hole and craniotomy exercises and must not be generalized to all twelve skills taught during the bootcamp.
• Operating-room skills transfer and patient outcomes were not evaluated.
• The paper reports an ABS melting-point value of 145.2 °F. That value is retained as a source anomaly and is not used here as a fabrication specification or silently replaced with an externally derived ABS property.

• Lumbar Laminectomy and Dural Closure Simulator (Bakhshi) — the spine-surgery simulator from the same neurosurgery bootcamp.