{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:59:05Z","timestamp":1781330345674,"version":"3.54.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"HMU Health and Medical University Potsdam GmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Resident physicians should be integrated early into a broad spectrum of surgical procedures during postgraduate training. At the same time, medical standards must be maintained and patient safety ensured. This study investigates whether resident involvement in stereotactic brain biopsy affects perioperative performance and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, two-center study compared 217 consecutive patients undergoing navigated frameless and frame-based stereotactic brain biopsies performed either by a supervised neurosurgery resident (teaching cases) or by a BCFN (non-teaching cases). The primary endpoint was the occurrence of a complication. Operation and anesthesia time as well as hospitalization length served as secondary endpoints. Categorical data were analyzed using Pearson\u2019s chi-square and Fisher test, and continuous data using the Mann\u2013Whitney U Test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 217 biopsies were stratified into\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200960 (27.6%) teaching cases and\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009157 (72.4%) non-teaching cases. Complication rates (asymptomatic hemorrhages) were comparable with 1\/60 (1.7%) for resident-performed cases and 3\/157 (1.9%) for BCFN cases. Mean operation time for navigated stereotactic biopsies was 38.1\u2009\u00b1\u200914.8\u00a0min for residents and 44.7\u2009\u00b1\u200922.6\u00a0min for BCFNs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.133). For frame-based biopsies, mean operation time performed by residents was 47.5\u2009\u00b1\u200932\u00a0min and 32.9\u2009\u00b1\u20099.9\u00a0min for BCFNs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047). Anesthesia time for navigated biopsies was 119.2\u2009\u00b1\u200939.6\u00a0min for residents and 124.7\u2009\u00b1\u200927.9\u00a0min for BCFNs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049). For frame-based biopsies, anesthesia time was 164.5\u2009\u00b1\u200998\u00a0min for residents and 111.8\u2009\u00b1\u200928.4\u00a0min for BCFNs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Residents completed frameless biopsies faster than frame-based ones in terms of anesthesia time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) whereas BCFN were faster with frame-based procedures (operative time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and anesthesia time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01)). Mean hospitalization time was significantly longer in the BCFN group with 12.5\u2009\u00b1\u200915 vs. 7.52\u2009\u00b1\u20098.8\u00a0days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). There was no significant correlation between neurosurgical residents' year of training and the above parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study supports the safety of supervised early surgical education for stereotactic brain biopsies. Residents require significantly more time for frame-based cases than BCFN, but complication rates remain comparable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-026-06948-7","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T14:26:22Z","timestamp":1781274382000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of training on navigated frameless and frame-based stereotactic brain biopsies: a retrospective comparison of staff neurosurgeon and trainee perioperative performance and complications"],"prefix":"10.1007","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3540-3910","authenticated-orcid":false,"given":"H.","family":"Joswig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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The study was registered in the German Clinical Trials Register (DRKS0003476).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Due to the retrospective nature of the study, informed consent was waived\/not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate declaration"}},{"value":"Sections of this manuscript were edited for grammar using Perplexity Pro.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"AI statement"}},{"value":"Medtronic has supported this study financially through the External Research Program (ERP-2024\u201313787) and was not involved in the study design, collection, analysis, and interpretation of the data. Holger Joswig accepted research as well as travel grants from Miethke and Nevro unrelated to this study. All other authors, declare no conflicts of interest.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"136"}}