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Surgical and Simulation

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https://www.readbyqxmd.com/read/28805140/a-rat-model-for-the-in-vivo-assessment-of-biological-and-tissue-engineered-valvular-and-vascular-grafts
#1
Yukiharu Sugimura, Anna Kathrin Schmidt, Artur Lichtenberg, Alexander Assmann, Payam Akhyari
The demand for an improvement of the biocompatibility and durability of vascular and valvular implants requires translational animal models to study the in vivo fate of cardiovascular grafts. In the present article, a review on the development and application of a microsurgical rat model of infrarenal implantation of aortic grafts and aortic valved conduits is provided. By refinement of surgical techniques and inclusion of hemodynamic considerations, a functional model has been created, which provides a modular platform for the in vivo assessment of biological and tissue-engineered grafts...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28801924/foramen-epiploicum-mesh-closure-femc-through-a-ventral-midline-laparotomy
#2
T van Bergen, A Rötting, P Wiemer, S Schauvliege, K Vanderperren, F Ugahary, A Martens
BACKGROUND: Preventive laparoscopic closure of the epiploic foramen (EF) has previously been described, but methods for EF closure during laparotomy for treatment of colic are lacking. OBJECTIVES: To describe the Foramen Epiploicum Mesh Closure (FEMC) technique through a ventral midline laparotomy in horses under general anaesthesia and its outcome. STUDY DESIGN: Terminal surgical experiment and in vivo study. METHODS: In a pilot study a standard ventral midline laparotomy was performed under general anaesthesia in 10 experimental horses and a three-dimensional expandable diabolo-shaped mesh construct was manually introduced through the EF into the omental vestibule...
August 12, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28801218/urology-residents-experience-and-attitude-towards-surgical-simulation-presenting-our-four-year-experience-with-a-multi-institutional-multi-modality-simulation-model
#3
Alexander Chow, B Sherer, E Yura, S Kielb, E Kocjancic, S Eggener, T Turk, S Park, S Psutka, M Abern, K Latchamsetty, C Coogan
OBJECTIVE: To evaluate the Urological resident's attitude and experience with surgical simulation in residency education using a multi-institutional, multi-modality model. MATERIALS AND METHODS: Residents from six area urology training programs rotated through simulation stations in four consecutive sessions from 2014 to 2017. Workshops included GreenLight photovaporization of the prostate(PVP), ureteroscopic stone extraction, laparoscopic peg transfer, 3-dimensional laparoscopy rope pass, transobturator sling placement, intravesical injection, high definition video system trainer (VITOM), vasectomy, and Urolift...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#4
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28796072/one-visualization-simulation-operation-system-for-distal-femoral-fracture
#5
Dan Wang, Ning Li, Ming Luo, Yao-Kun Chen
A computer-aided 3-dimensional (3D) visualization operation simulation system based on computer-aided design (CAD) Unigraphics NX and Mimics software was established to provide orthopedic surgeons with an actual and reliable system in treating of distal femoral fracture.According to the preoperative CT data, 3D reconstruction of the distal femoral fracture could be achieved by the Mimics software. Then, the CAD Unigraphics NX software was used to measure the model function of all the related surgical instruments, including less invasive stabilization system (LISS) and retrograde intramedullary nail fixation...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28793829/methodological-shortcomings-in-the-literature-evaluating-the-role-and-applications-of-3d-training-for-surgical-trainees
#6
Milosz Kostusiak, Michael Hart, Damiano Giuseppe Barone, Riikka Hofmann, Ramez Kirollos, Thomas Santarius, Rikin Trivedi
AIM: There has been an increased interest in the use of three-dimensional (3D) technology in surgical training. We wish to appraise the methodological rigor applied to evaluating the role and applications of 3D technology in surgical training, in particular, on the validity of these models and assessment methods in simulated surgical training. METHODS: Literature search was performed using MEDLINE with the following terms: "3D"; "surgery"; and "training". Only studies evaluating the role of 3D technology in surgical training were eligible for inclusion and assessed for the level of evidence, validity of the simulation model, and assessment method used...
August 9, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28791559/laparoscopic-lens-fogging-solving-a-common-surgical-problem-in-standard-and-robotic-laparoscopes-via-a-scientific-model
#7
Todd G Manning, Nathan Papa, Marlon Perera, Shannon McGrath, Daniel Christidis, Munad Khan, Richard O'Beirne, Nicholas Campbell, Damien Bolton, Nathan Lawrentschuk
BACKGROUND: Laparoscopic lens fogging (LLF) hampers vision and impedes operative efficiency. Attempts to reduce LLF have led to the development of various anti-fogging fluids and warming devices. Limited literature exists directly comparing these techniques. We constructed a model peritoneum to simulate LLF and to compare the efficacy of various anti-fogging techniques. MATERIALS AND METHODS: Intraperitoneal space was simulated using a suction bag suspended within an 8 L container of water...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28791464/a-computed-tomographic-anatomical-study-of-the-upper-sacrum-application-for-a-user-guide-of-pelvic-fixation-with-iliosacral-screws-in-adult-spinal-deformity
#8
Arnaud Dubory, Houssam Bouloussa, Guillaume Riouallon, Stéphane Wolff
PURPOSE: Widely used in traumatic pelvic ring fractures, the iliosacral (IS) screw technique for spino-pelvic fixation remains anecdotal in adult spinal deformity. The objective of this study was to assess anatomical variability of the adult upper sacrum and to provide a user guide of spino-pelvic fixation with IS screws in adult spinal deformity. METHODS: Anatomical variability of the upper sacrum according to age, gender, height and weight was sought on 30 consecutive pelvic CT-scans...
August 8, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28790474/possible-vascular-injury-due-to-screw-eccentricity-in-minimally-invasive-total-hip-arthroplasty
#9
Nishant Kumar Singh, Sanjay Kumar Rai, Amit Rastogi
BACKGROUND: Vascular injury during minimally invasive total hip arthroplasty (THA) is uncommon, yet a well-recognized and serious issue. It emerges because of non-visibility of vascular structures proximal to the pelvic bone during reaming, drilling holes, and fixing of screws. Numerous studies have found that screw fixation during cementless THA is beneficial for the initial stability of cup; yet, no anatomical guidelines support angular eccentric screw fixation. MATERIALS AND METHODS: In this study, we obtained the pelvic arterial-phase computed tomographic data of thirty eight humans and reconstructed the three-dimensional models of osseous and vessel structures...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28790407/employing-high-frequency-alternating-magnetic-fields-for-the-non-invasive-treatment-of-prosthetic-joint-infections
#10
Rajiv Chopra, Sumbul Shaikh, Yonatan Chatzinoff, Imalka Munaweera, Bingbing Cheng, Seth M Daly, Yin Xi, Chenchen Bing, Dennis Burns, David E Greenberg
Treatment of prosthetic joint infection (PJI) usually requires surgical replacement of the infected joint and weeks of antibiotic therapy, due to the formation of biofilm. We introduce a non-invasive method for thermal destruction of biofilm on metallic implants using high-frequency (>100 kHz) alternating magnetic fields (AMF). In vitro investigations demonstrate a >5-log reduction in bacterial counts after 5 minutes of AMF exposure. Confocal and scanning electron microscopy confirm removal of biofilm matrix components within 1 minute of AMF exposure, and combination studies of antibiotics and AMF demonstrate a 5-log increase in the sensitivity of Pseudomonas aeruginosa to ciprofloxacin...
August 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28783069/energy-based-metrics-for-arthroscopic-skills-assessment
#11
Behnaz Poursartip, Marie-Eve LeBel, Laura C McCracken, Abelardo Escoto, Rajni V Patel, Michael D Naish, Ana Luisa Trejos
Minimally invasive skills assessment methods are essential in developing efficient surgical simulators and implementing consistent skills evaluation. Although numerous methods have been investigated in the literature, there is still a need to further improve the accuracy of surgical skills assessment. Energy expenditure can be an indication of motor skills proficiency. The goals of this study are to develop objective metrics based on energy expenditure, normalize these metrics, and investigate classifying trainees using these metrics...
August 5, 2017: Sensors
https://www.readbyqxmd.com/read/28782911/simulation-of-aortopulmonary-collateral-flow-in-fontan-patients-for-use-in-prediction-of-interventional-outcomes
#12
Petter Frieberg, Pia Sjöberg, Johan Revstedt, Einar Heiberg, Petru Liuba, Marcus Carlsson
PURPOSE: Patients with complex congenital heart disease may need to be converted to a Fontan circulation with systemic venous return surgically connected to the pulmonary circulation. These patients frequently form aortopulmonary collaterals (APC), that is arterial inflows to the pulmonary artery vascular tree. The aim of this study was to develop a method to calculate the effect of APC on the pulmonary flow distribution based on magnetic resonance imaging (MRI) measurements and computational fluid dynamics simulations in order to enable prediction of interventional outcomes in Fontan patients...
August 7, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28782115/optical-coherence-tomography-image-guided-smart-laser-knife-for-surgery
#13
Nitesh Katta, Austin B McElroy, Arnold D Estrada, Thomas E Milner
BACKGROUND AND OBJECTIVE: Surgical oncology can benefit from specialized tools that enhance imaging and enable precise cutting and removal of tissue without damage to adjacent structures. The combination of high-resolution, fast optical coherence tomography (OCT) co-aligned with a nanosecond pulsed thulium (Tm) laser offers advantages over conventional surgical laser systems. Tm lasers provide superior beam quality, high volumetric tissue removal rates with minimal residual thermal footprint in tissue, enabling a reduction in unwanted damage to delicate adjacent sub-surface structures such as nerves or micro-vessels...
August 7, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28780253/biomechanics-of-human-parietal-pleura-in-uniaxial-extension
#14
Luis E Morales Tenorio, Kelsey J Devine, Jayme Lee, Timothy M Kowalewski, Victor H Barocas
Tension pneumothorax, a major preventable cause of battlefield death, often arises from chest trauma and is treated by needle decompression to release trapped air from the pleural cavity. Surgical simulation mannequins are often employed to train medical personnel to perform this procedure properly. Accurate reproduction of the mechanical behavior of the parietal pleura, especially in response to needle penetration, is essential to maximize the fidelity of these surgical simulators. To date, however, the design of pleura-simulating material has been largely empirical and based on subjective practitioner feel rather than on the tissue properties, which have remained unknown...
July 29, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28776686/contralateral-r1-and-r2-components-of-the-laryngeal-adductor-reflex-in-humans-under-general-anesthesia
#15
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan
OBJECTIVES: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc. STUDY DESIGN: Case series. METHODS: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28776326/a-comprehensive-pipeline-for-multi-resolution-modeling-of-the-mitral-valve-validation-computational-efficiency-and-predictive-capability
#16
Andrew Drach, Amir H Khalighi, Michael S Sacks
Multiple studies have demonstrated that the pathological geometries unique to each patient can affect the durability of mitral valve (MV) repairs. While computational modeling of the MV is a promising approach to improve the surgical outcomes, the complex MV geometry precludes use of simplified models. Moreover, the lack of complete in-vivo geometric information presents significant challenges in the development of patient-specific computational models. There is thus a need to determine the level of detail necessary for predictive MV models...
August 3, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28775383/high-resolution-3-dimensional-imaging-of-the-human-cardiac-conduction-system-from-microanatomy-to-mathematical-modeling
#17
Robert S Stephenson, Andrew Atkinson, Petros Kottas, Filip Perde, Fatemeh Jafarzadeh, Mike Bateman, Paul A Iaizzo, Jichao Zhao, Henggui Zhang, Robert H Anderson, Jonathan C Jarvis, Halina Dobrzynski
Cardiac arrhythmias and conduction disturbances are accompanied by structural remodelling of the specialised cardiomyocytes known collectively as the cardiac conduction system. Here, using contrast enhanced micro-computed tomography, we present, in attitudinally appropriate fashion, the first 3-dimensional representations of the cardiac conduction system within the intact human heart. We show that cardiomyocyte orientation can be extracted from these datasets at spatial resolutions approaching the single cell...
August 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28775221/in-situ-medical-simulation-for-pre-implementation-testing-of-clinical-service-in-a-regional-hospital-in-hong-kong
#18
P P Chen, N Tk Tsui, A Sw Fung, A Hf Chiu, W Cw Wong, H T Leong, P Sf Lee, J Yw Lau
The implementation of a new clinical service is associated with anxiety and challenges that may prevent smooth and safe execution of the service. Unexpected issues may not be apparent until the actual clinical service commences. We present a novel approach to test the new clinical setting before actual implementation of our endovascular aortic repair service. In-situ simulation at the new clinical location would enable identification of potential process and system issues prior to implementation of the service...
August 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28769832/supporting-third-year-medical-students-skill-acquisition-and-self-efficacy-with-coping-models-and-process-feedback-during-laparoscopic-knot-tying-simulation
#19
Michael S Dempsey, Douglas F Kauffman
Background: During the third year general surgery clerkship, medical students are required to develop laparoscopic knot-tying skills. Knot-tying skills studies often rely on objective variables (e.g., time, materials used, number of iterations) that lend themselves to correlational analysis of pre- and post-intervention skill level. This study differs by examining how instructional interventions-role modeling and feedback-affect medical students' skill acquisition and self-efficacy during a laparoscopic surgical simulation training session...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28768919/pediatric-craniovertebral-junction-surgery
#20
Nobuhito Morota
The craniovertebral junction (CVJ) has attracted more attention in pediatric medicine in recent years due to the progress in surgical technologies allowing a direct approach to the CVJ in children. The CVJ is the site of numerous pathologies, most originating in bone anomalies resulting from abnormal CVJ development. Before discussing the surgical approaches to CVJ, three points should be borne in mind: first, that developmental anatomy demonstrates age-dependent mechanisms and the pathophysiology of pediatric CVJ anomalies; second, that CT-based dynamic simulations have improved our knowledge of functional anatomy, enabling us to locate CVJ lesions with greater certainty; and third, understanding the complex structure of the pediatric CVJ also clarifies the surgical anatomy...
August 1, 2017: Neurologia Medico-chirurgica
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