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.
| Field | Details |
|---|---|
| Features and Basic Operation | Learners practise burr-hole drilling and craniotomy on a 3D-printed skull using standard neurosurgical cranial-access instruments. During the bootcamp, participants performed each skill at least three times. Burr-hole and craniotomy were two of the four skills formally evaluated with the modified Objective Structured Assessment of Technical Skills (mOSATS). |
| Current Development Status | Used in a national neurosurgery bootcamp attended by 22 PGY-1 residents. Burr-hole drilling and craniotomy were specifically evaluated by faculty using mOSATS, comparing first and third attempts. The study reported significant improvement across the assessed cranial-skill domains. This is supervised bootcamp performance evidence; transfer to independent operating-room performance or patient outcomes was not evaluated. |
| Estimated Build Time and Cost | Not stated in source US$57 per 3D-printed skull. |
| Specialized Tools and Equipment | A 3D printer capable of printing ABS is required to fabricate the skull, but the source does not specify the printer or print settings. For training use, the source used a cranial perforator for burr holes and an electronic craniotome and cutter for craniotomy. Perforators and cutters were reused from the operating room after sterilisation; the electronic craniotome was supplied free of charge by vendors during the bootcamp and is not part of the US$57 skull cost. |
| Version | Version 1 |
| Development Team Contact Information | Saqib Kamran Bakhshi, Medical College, Aga Khan University, Karachi, Pakistan; saqib.bakhshi@aku.edu. The simulator was used within the national neurosurgery bootcamp reported by Bakhshi et al. (2022). |
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Bone | 1 adult cranium | 3D-printed Acrylonitrile Butadiene Styrene (ABS) | US$57 | The source explicitly states that burr holes and craniotomies were performed on 3D-printed ABS skulls. The skull represents the bony cranium only. No Dura Mater or Brain representation is present in this simulator. |
Bakhshi et al. (2022) identifies the simulator as a 3D-printed adult cranium made from acrylonitrile butadiene styrene (ABS).
The publication does not provide:
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.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Cranial Burr Hole and Craniotomy Simulator (Bakhshi)". Appropedia. Retrieved September 29, 2026. |