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Surgical and Simulation

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https://www.readbyqxmd.com/read/28108975/3d-printed-soft-tissue-physical-models-of-renal-malignancies-for-individualized-surgical-simulation-a-feasibility-study
#1
Michael M Maddox, Allison Feibus, James Liu, Julie Wang, Raju Thomas, Jonathan L Silberstein
To construct patient-specific physical three-dimensional (3D) models of renal units with materials that approximates the properties of renal tissue to allow pre-operative and robotic training surgical simulation, 3D physical kidney models were created (3DSystems, Rock Hill, SC) using computerized tomography to segment structures of interest (parenchyma, vasculature, collection system, and tumor). Images were converted to a 3D surface mesh file for fabrication using a multi-jet 3D printer. A novel construction technique was employed to approximate normal renal tissue texture, printers selectively deposited photopolymer material forming the outer shell of the kidney, and subsequently, an agarose gel solution was injected into the inner cavity recreating the spongier renal parenchyma...
January 20, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28108064/stent-and-leaflet-stresses-in-a-26-mm-first-generation-balloon-expandable-transcatheter-aortic-valve
#2
Yue Xuan, Kapil Krishnan, Jian Ye, Danny Dvir, Julius M Guccione, Liang Ge, Elaine E Tseng
OBJECTIVE: Transcatheter aortic valve replacement is established therapy for high-risk and inoperable patients with severe aortic stenosis, but questions remain regarding long-term durability. Valve design influences durability. Increased leaflet stresses in surgical bioprostheses have been correlated with degeneration; however, transcatheter valve leaflet stresses are unknown. From 2007 to 2014, a majority of US patients received first-generation balloon-expandable transcatheter valves...
December 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28107242/an-in-vitro-biomechanical-study-evaluating-cervical-extension-plates-for-stabilizing-degenerated-adjacent-levels
#3
Kamran Majid, Mark Moldavsky, Saif Khalil, Manasa Gudipally
STUDY DESIGN: To evaluate the biomechanical stability of 2 extender plates in a human cervical cadaveric model. OBJECTIVES: To evaluate 2 extender plates, placed adjacent to initially implanted plates and to compare their biomechanical stability with traditional techniques. SUMMARY OF BACKGROUND DATA: Traditionally, adjacent level degeneration is surgically treated by removing the previously implanted plate and extending the instrumentation to the new degenerated level...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106892/theoretical-study-on-the-need-for-laser-iridotomy-in-an-implantable-collamer-lens-with-a-hole-using-computational-fluid-dynamics
#4
T Kawamorita, K Shimizu, N Shoji
PurposeAlthough one of the advantages of the Hole-ICL implantation is that laser iridotomy (LI) is unnecessary, the evidence have not been reported from the viewpoint of aqueous humor circulation. We investigated the effect of laser iridotomy (LI) on the fluid dynamics of aqueous humor in an implantable collamer lens (ICL) with a central hole, that is, a Hole-ICL using computational fluid dynamics.MethodsA fluid dynamics simulation was performed using the thermal-hydraulic analysis software FloEFD (Mentor Graphics Corp...
January 20, 2017: Eye
https://www.readbyqxmd.com/read/28106647/estimation-of-uterine-size-how-accurate-are-we
#5
Tanya P Hoke, Babak Vakili
OBJECTIVE: To evaluate the accuracy of gynecologic surgeons at estimating uterine dimensions and weight. METHODS: Six model uteri of various sizes were created to simulate the size and consistency of a uterus and displayed at 3 stations. The visual station (VS) comprised 2 specimens placed on an unmarked table. The laparoscopic station (LS) consisted of 2 model uteri, each placed in a separate simulated abdomen with a 0 degree laparoscope and 2 operative trocars with standard instruments...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28104293/debriefing-decreases-mental-workload-in-surgical-crisis-a-randomized-controlled-trial
#6
Sylvain Boet, Bharat Sharma, Ashlee-Ann Pigford, Emily Hladkowicz, Neil Rittenhouse, Teodor Grantcharov
BACKGROUND: Mental workload is the amount of mental effort involved in performing a particular task. Crisis situations may increase mental workload, which can subsequently negatively impact operative performance and patient safety. This study aims to measure the impact of learning through debriefing and a systematic approach to crisis on trainees' mental workload in a simulated surgical crisis. METHODS: Twenty junior surgical residents participated in a high-fidelity, simulated, postoperative crisis in a surgical ward environment (pretest)...
January 16, 2017: Surgery
https://www.readbyqxmd.com/read/28103335/construction-of-a-low-cost-homemade-laparoscopic-simulator-for-use-in-a-caribbean-setting
#7
S Persaud, I Hosein, D Dan, P S Griffith
Introduction: To the modern surgeon in training, the acquisition of laparoscopic skills is essential. Laparoscopic simulators are effective but in the often resource poor setting of the Caribbean, the cost of these simulators is often prohibitive. We describe the construction of a simulator which is cheap, easy to assemble and effective. It is also relatively easy to mass produce for use in training programmes across the region. Materials and methods: The simulator is constructed using a semi-transparent plastic box...
June 13, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/28101675/operative-planning-aid-for-optimal-endoscopic-third-ventriculostomy-entry-points-in-pediatric-cases
#8
Zsolt Zador, David J Coope, Abteen Mostofi, Ian D Kamaly-Asl
OBJECT: Endoscopic third ventriculostomy (ETV) uses anatomical spaces of the ventricular system to reach the third ventricle floor and create an alternative pathway for cerebrospinal fluid flow. Optimal ETV trajectories have been previously proposed in the literature, designed to grant access to the third ventricle floor without a displacement of eloquent periventricular structures. However, in hydrocephalus, there is a significant variability to the configuration of the ventricular system, implying that the optimal ETV trajectory and cranial entry point needs to be planned on a case-by-case basis...
January 18, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28101185/hypokalemic-myopathy-in-primary-aldosteronism-a-case-report
#9
Chuifen Wu, Jun Xin, Minghua Xin, Hai Zou, Lie Jing, Caoyong Zhu, Wenhui Lei
Primary aldosteronism (PA) is a rare disorder. The majority of patients with PA present with typical features and are easily diagnosed. This disorder is usually diagnosed with hypokalemia, hypertension or an adrenal mass. However, patients with atypical symptoms may present a challenge for diagnosis and treatment. In the present study, a case of PA is described that presented with hypokalemic myopathy simulating polymyositis. The patient was a 44-year-old woman who presented with weakness and difficulty walking...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28096110/bra-sizing-and-the-plastic-surgery-herd-effect-are-breast-augmentation-patients-getting-accurate-information
#10
Christopher R Costa, Kevin H Small, William P Adams
BACKGROUND: Bra sizing is a common method to preoperatively select implants for breast augmentation; however, no series has analyzed the accuracy of this modality postoperatively. Alternatively, previous investigations have validated the accuracy and utility of three-dimensional (3D) imaging for preoperative simulation in breast augmentation. OBJECTIVES: This investigation utilizes 3D analysis to determine if preoperative bra sizing provides equivocal information compared to surgical 3D simulation for patient education and planning prior to a breast augmentation...
January 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28093837/effects-of-simulation-education-on-oral-care-practices%C3%A2-%C3%A2-a-randomized-controlled-trial
#11
Miia M Jansson, Hannu P Syrjälä, Pasi P Ohtonen, Merja H Meriläinen, Helvi A Kyngäs, Tero I Ala-Kokko
BACKGROUND: Implementation of evidence-based oral care protocols, nurse education programmes and assessment tools may reduce the risk of developing ventilator-associated pneumonia by increasing critical care nurses' knowledge and skills in adhering to current oral care recommendations. AIMS: To evaluate the longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on critical care nurses' knowledge and skills in adhering to current oral care recommendations...
January 16, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28090509/innovations-in-surgery-simulation-a-review-of-past-current-and-future-techniques
#12
REVIEW
Ido Badash, Karen Burtt, Carlos A Solorzano, Joseph N Carey
As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28089473/box-or-virtual-reality-trainer-which-tool-results-in-better-transfer-of-laparoscopic-basic-skills-a-prospective-randomized-trial
#13
Christian Brinkmann, Mathias Fritz, Ulrich Pankratius, Ralf Bahde, Philipp Neumann, Steffen Schlueter, Norbert Senninger, Emile Rijcken
OBJECTIVE: Simulation training improves laparoscopic performance. Laparoscopic basic skills can be learned in simulators as box- or virtual-reality (VR) trainers. However, there is no clear recommendation for either box or VR trainers as the most appropriate tool for the transfer of acquired laparoscopic basic skills into a surgical procedure. DESIGN: Both training tools were compared, using validated and well-established curricula in the acquirement of basic skills, in a prospective randomized trial in a 5-day structured laparoscopic training course...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28087244/practice-makes-perfect-correlations-between-prior-experience-in-high-level-athletics-and-robotic-surgical-performance-do-not-persist-after-task-repetition
#14
Kevin Shee, Fady M Ghali, Elias S Hyams
OBJECTIVE: Robotic surgical skill development is central to training in urology as well as in other surgical disciplines. Here, we describe a pilot study assessing the relationships between robotic surgery simulator performance and 3 categories of activities, namely, videogames, musical instruments, and athletics. DESIGN: A questionnaire was administered to preclinical medical students for general demographic information and prior experiences in surgery, videogames, musical instruments, and athletics...
January 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28079687/periocular-amyloidosis-manifesting-as-pseudopemphigoid-treated-with-mitomycin-c
#15
Kaveh Vahdani, Vladimir T Thaller, Giorgio Albanese, Andrew F Dean
PURPOSE: To describe an unusual cicatrizing manifestation of periocular amyloid and the utility of adjuvant antimetabolite therapy. METHODS: This is a case report of a 49-year old woman with progressive bilateral upper lid ptosis, who was found to have bilateral inferior forniceal masses with thickening of the conjunctiva. Conjunctival and eyelid biopsies showed evidence of amyloid deposition. Systemic evaluation did not reveal any evidence of systemic amyloidosis...
January 11, 2017: Cornea
https://www.readbyqxmd.com/read/28079471/pre-implant-modeling-of-depth-lead-placement-in-white-matter-for-maximizing-the-extent-of-cortical-activation-during-direct-neurostimulation-therapy
#16
Leopoldo Cendejas Zaragoza, Richard W Byrne, Marvin A Rossi
INTRODUCTION: The objective of this work was to predict preoperatively the maximum extent to which direct stimulation therapy can propagate through an epileptic circuit for stabilizing refractory focal-onset epilepsy. A pre-surgical workflow is presented which comprises a computationally intensive process for calculating the volume of cortical activation (VOCA) surrounding cylindrical depth contacts virtually placed in white matter. The process employs an activation function (AF) derived from cable modeling of an axon...
January 12, 2017: Neurological Research
https://www.readbyqxmd.com/read/28078455/retention-of-laparoscopic-and-robotic-skills-among-medical-students-a-randomized-controlled-trial
#17
Megan S Orlando, Lauren Thomaier, Melinda G Abernethy, Chi Chiung Grace Chen
BACKGROUND: Although simulation training beneficially contributes to traditional surgical training, there are less objective data on simulation skills retention. OBJECTIVE: To investigate the retention of laparoscopic and robotic skills after simulation training. METHODS: We present the second stage of a randomized single-blinded controlled trial in which 40 simulation-naïve medical students were randomly assigned to practice peg transfer tasks on either laparoscopic (N = 20, Fundamentals of Laparoscopic Surgery, Venture Technologies Inc...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28076623/low-cost-simulator-for-heart-surgery-training
#18
Roberto Rocha E Silva, Artur Lourenção, Maxim Goncharov, Fabio B Jatene
Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28071714/three-dimensional-surgical-simulation-improves-the-planning-for-correction-of-facial-prognathism-and-asymmetry-a-qualitative-and-quantitative-study
#19
Cheng-Ting Ho, Hsiu-Hsia Lin, Eric J W Liou, Lun-Jou Lo
Traditional planning method for orthognathic surgery has limitations of cephalometric analysis, especially for patients with asymmetry. The aim of this study was to assess surgical plan modification after 3-demensional (3D) simulation. The procedures were to perform traditional surgical planning, construction of 3D model for the initial surgical plan (P1), 3D model of altered surgical plan after simulation (P2), comparison between P1 and P2 models, surgical execution, and postoperative validation using superimposition and root-mean-square difference (RMSD) between postoperative 3D image and P2 simulation model...
January 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28070866/finite-element-analysis-of-patient-specific-mitral-valve-with-mitral-regurgitation
#20
Thuy Pham, Fanwei Kong, Caitlin Martin, Qian Wang, Charles Primiano, Raymond McKay, John Elefteriades, Wei Sun
Functional mitral regurgitation (FMR) is a significant complication of left ventricular dysfunction and strongly associated with a poor prognosis. In this study, we developed a patient-specific finite element (FE) model of the mitral apparatus in a FMR patient which included: both leaflets with thickness, annulus, chordae tendineae, and chordae insertions on the leaflets and origins on the papillary muscles. The FE model incorporated human age- and gender-matched anisotropic hyperelastic material properties, and MV closure at systole was simulated...
January 9, 2017: Cardiovascular Engineering and Technology
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