Asino Foundation for Oncological Neurosurgery
3D Atlas of Neurosurgical Approaches

The first project funded by our foundation reflects two fundamental points of our mission.
- The first is the 'training of young neurosurgeons';
- The second is to reach the largest number of users.
Dr. Nicolosi presented an innovative project for a'3D Atlas of Transcranial Neurosurgical Approaches for Educational Use'.
The atlas is created using 3D reconstructions carried out through photogrammetry and based on step-by-step anatomical-surgical dissections. This means being able to reproduce a surgical approach in three dimensions. In the field of neurosurgery, the key element is anatomy, and especially surgical anatomy.
What are the difference?
The "classical" anatomy is the one we can learn from books and is often two-dimensional, "surgical" anatomy consists of reproducing a possible approach in three dimensions, it allows the surgeon to learn the real anatomy, then to memorise the various structures he will encounter through that specific route and thus simulate a surgical procedure.
To do this, it is necessary to use special photographic techniques and software capable of reconstruction. Regarding the need to reach as many users as possible and especially users in developing countries, it is necessary that the atlas becomes usable through an App that can be easily used on a mobile phone.
Interview with Dr Federico Nicolosi, neurosurgeon
Founder and CEO of UpSurgeOn, an Italian medtech, partner of the ASINO Foundation in the development of this project.
How did the Atlas Asino Project come about?
he idea for the Asino Atlas project began during the early years of my neurosurgery residency, and it further expanded in my first years as a specialist while working at Humanitas alongside Dr. Andrea Cardia. It all started from a scientific paper I had published a few years earlier on an innovative application of 3D photogrammetry in the operating room, together with Giannantonio Spena, with whom I co-founded UpSurgeOn in 2017. The genesis of Asino Atlas is thus the result of a combination of factors: a personal need for training, my passion for surgical education, a background in 3D modeling, UpSurgeOn's technological development capabilities, and the opportunity to meet Fabrizio Carretti in person and find inspiration in the work of the Asino Foundation. The creation of an innovative atlas like the one we developed was motivated by the increasing difficulty in accessing dissections on formalin-fixed specimens, due to high costs and limited access to anatomical labs. This work aims to serve as a gateway to training.
How does Asino Atlas work and who is it for?
The app allows users to explore 3D anatomical dissections of neurosurgical approaches performed on digitised cadavers. Medical students, neuroscience residents, specialists, patients or even the simply curious and enthusiastic can access a series of surgical approaches, broken down by step, offering a detailed and immersive perspective. A specific target group, of course, are developing countries, where access to certain educational resources is very limited and where the Internet and mobile technologies often become the only way to access training.
What are the main challenges you encountered in the development of Asino Atlas?
One of the main challenges during the development of the app was certainly to maintain a very high definition of the photographic 3D models on mobile devices such as smartphones and tablets. The realism of the models is astounding! This is thanks to the contribution of the talented artists and developers at UpSurgeOn and thanks to the fact that mobile technology has evolved significantly.
What is the impact of the App on neurosurgeon training?
The use of the app offers users the possibility to visualise and understand surgical approaches in detail, understanding the three-dimensionality of the steps and delving into theoretical information thanks to detailed accompanying texts. This allows users to acquire a deeper and more comprehensive preparation for real-life experiences, both on patients and on cadaveric preparations.
What are the possible future developments of Asino Atlas?
We are currently working on further expanding the range of surgical approaches available on the app. In addition, we have already realised an adaptation of the virtual room with preparations for the experience on VR devices through the use of headsets. In addition to this, we are organising new courses in developing countries to provide access to this valuable content, promoting training and professional development in international contexts.
You can help us grow this project: donate here!