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Surgical and Simulation

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https://www.readbyqxmd.com/read/29146510/relative-contributions-of-the-midcarpal-and-radiocarpal-joints-to-dart-thrower-s-motion-at-the-wrist
#1
Patrick M Kane, Bryan G Vopat, P Kaveh Mansuripur, Michael P Gaspar, Scott W Wolfe, Joseph J Crisco, Christopher Got
PURPOSE: To identify the relative contributions of the radiocarpal (RC) and midcarpal (MC) joints to dart-thrower's motion (DTM) of the wrist. METHODS: Six cadaveric upper extremities were fixed to a custom-designed loading jig allowing for pure moment-rotation analysis in 24 different directions of wrist motion. Each specimen was tested in 3 states: intact, simulated radiocarpal fusion (sRCF) and simulated pancarpal fusion (sPCF). Moments of ± 1.5 Nm were applied at each of 24 directions for each state and the resulting wrist rotation recorded...
November 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29146107/cardiovascular-anatomy-in-children-with-bidirectional-glenn-anastomosis-regarding-the-transcatheter-fontan-completion
#2
Aleksander Sizarov, Francesca Raimondi, Damien Bonnet, Younes Boudjemline
BACKGROUND: Transcatheter stent-secured completion of total cavopulmonary connection (TCPC) after surgical preparations during the Glenn anastomosis procedure has been reported, but complications from this approach have precluded its clinical acceptance. AIMS: To analyse cardiovascular morphology and dimensions in children with bidirectional Glenn anastomosis, regarding the optimal device design for transcatheter Fontan completion without special surgical "preconditionings"...
November 13, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29145968/effectiveness-of-a-step-by-step-oral-recount-before-a-practical-simulation-of-fracture-fixation
#3
Marcelo Abagge, Christiano Saliba Uliana, Sergei Taggesell Fischer, Kodi Edson Kojima
OBJECTIVE: To evaluate the effectiveness of a step-by-step oral recount by residents before the final execution of a practical exercise simulating a surgical fixation of a radial diaphyseal fracture. MATERIAL AND METHODS: The study included 10 residents of orthopaedics and traumatology (four second- year and six first-year residents) divided into two groups with five residents each. All participants initially gathered in a room in which a video was presented demonstrating the practical exercise to be performed...
October 2017: Injury
https://www.readbyqxmd.com/read/29145284/effectiveness-of-bariatric-surgical-procedures-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#4
Jenny H Kang, Quang A Le
BACKGROUND: Bariatric surgery has proved to be an effective strategy in treating obesity. However, randomized controlled trials (RCTs) of 3 most common bariatric surgery procedures, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric band (LAGB), reported inconsistent results. We performed a systematic review and network meta-analysis to synthesize evidence of effectiveness of the 3 common bariatric procedures from relevant RCTs. METHODS: The present study was a systematic review and network meta-analysis of RCTs...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144584/3d-printed-anchoring-sutures-for-permanent-shaping-of-tissues
#5
Wei Wei, Yuxiao Li, Huazhe Yang, Reza Nassab, Fatemeh Shahriyari, Ali Akpek, Xiaofei Guan, Yanhui Liu, Shahrouz Taranejoo, Ali Tamayol, Yu Shrike Zhang, Ali Khademhosseini, Hae Lin Jang
Sutures are one of the most widely used devices for adhering separated tissues after injury or surgery. However, most sutures require knotting, which can create a risk of inflammation, and can act as mechanically weak points that often result in breakage and slipping. Here, an anchoring suture is presented with a design that facilitates its propagation parallel to the suturing direction, while maximizing its resistive force against the opposite direction of external force to lock its position in tissues. Different microstructures of suture anchors are systematically designed using orthogonal arrays, and selected based on shape factors associated with mechanical strength...
November 16, 2017: Macromolecular Bioscience
https://www.readbyqxmd.com/read/29142619/the-formation-of-extragraft-bone-bridging-after-anterior-cervical-discectomy-and-fusion-a-finite-element-analysis
#6
Shin Won Kwon, Chi Heon Kim, Chun Kee Chung, Tae Hyun Park, Su Heon Woo, Sung-Jae Lee, Seung Heon Yang
Objective: In addition to bone bridging inside a cage or graft (intragraft bone bridging, InGBB), extragraft bone bridging (ExGBB) is commonly observed after anterior cervical discectomy and fusion (ACDF) with a stand-alone cage. However, solid bony fusion without the formation of ExGBB might be a desirable condition. We hypothesized that an insufficient contact area for InGBB might be a causative factor for ExGBB. The objective was to determine the minimal area of InGBB by finite element analysis...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29140596/florence-robotic-intracorporeal-neobladder-florin-a-new-reconfiguration-strategy-developed-following-the-ideal-guidelines
#7
Andrea Minervini, Davide Vanacore, Gianni Vittori, Martina Milanesi, Agostino Tuccio, Giampaolo Siena, Riccardo Campi, Andrea Mari, Andrea Gavazzi, Marco Carini
OBJECTIVE: To describe our step-by-step technique for robotic intracorporeal neobladder configuration, including the stages of conception, development and exploration of this surgical innovation, according to the IDEAL Collaboration guidelines. PATIENTS AND METHODS: FloRIN neobladder was performed after the following main surgical steps: isolation of 50 cm of ileum; bowel anastomosis; urethro-ileal anastomosis creating an asymmetrical U shape (30 cm distally and 20 cm proximally to anastomosis), ileum detubularisation; posterior wall reconfiguration as an L; bladder neck reconstruction; anterior folding of the posterior plate to reach the 12 o'clock position; uretero-enteral "orthotopic" bilateral anastomosis...
November 15, 2017: BJU International
https://www.readbyqxmd.com/read/29139057/cadaveric-simulation-a-review-of-reviews
#8
REVIEW
M Yiasemidou, E Gkaragkani, D Glassman, C S Biyani
BACKGROUND: Traditional surgical training, largely based on the Halstedian model "see one, do one, teach one" is not as effective in the era of working time restrictions and elaborate shift-patterns. As a result, contemporary surgeons turned to educational methods outside the operating theatre such as simulation. Cadavers are high fidelity models but their use has ethical and cost implications and their availability may be limited. In this review, we explore the role of cadaveric simulation in modern surgical education...
November 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29138071/a-mathematical-network-of-seizure-activity-how-pre-surgical-simulation-can-predict-post-surgical-success
#9
Reid Hoshide, Zain Jandial, Michael Levy
No abstract text is available yet for this article.
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137721/current-robotic-curricula-for-surgery-residents-a-need-for-additional-cognitive-and-psychomotor-focus
#10
Courtney A Green, Hueylan Chern, Patricia S O'Sullivan
BACKGROUND: Current robot surgery curricula developed by industry were designed for expert surgeons. We sought to identify the robotic curricula that currently exist in general surgery residencies and describe their components. METHODS: We identified 12 residency programs with robotic curricula. Using a structured coding form to identify themes including sequence, duration, emphasis and assessment, we generated a descriptive summary. RESULTS: Curricula followed a similar sequence: learners started with online modules and simulation exercises, followed by bedside experience during R2-R3 training years, and then operative opportunities on the console in the final years of training...
November 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29137720/improving-surgical-residents-communication-in-disclosing-complications-a-qualitative-analysis-of-simulated-physician-and-patient-surrogate-conversations
#11
Carolina Fernandez Branson, Jeffrey G Chipman
BACKGROUND: In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS: We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surrogates. After identifying problematic communication patterns, we apply communication theory to discuss our findings and provide suggestions for improvement...
November 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29137579/assessment-of-the-reliability-of-intubation-and-ease-of-use-of-the-cook-staged-extubation-set-an-observational-study
#12
C Furyk, M L Walsh, I Kaliaperumal, S Bentley, C Hattingh
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29131559/diagnostic-challenges-and-problem-cases-in-salivary-gland-cytology-a-20-year-experience
#13
Sajad Salehi, Zahra Maleki
BACKGROUND: Fine-needle aspiration (FNA) is routinely performed to evaluate salivary gland lesions, and provides valuable information regarding the cytomorphologic features of the lesions. Occasionally, there are overlaps between benign and malignant conditions due to heterogeneity of the cell types, metaplastic changes, and sampling issues. Herein, the authors present a retrospective study of diagnostic pitfalls in salivary gland cytology and the simulating conditions. METHODS: A 20-year retrospective review (1995-2015) of medical records was performed searching for the cytology reports of patients who underwent FNA of the salivary gland with the words "amendment" or "revision...
November 13, 2017: Cancer
https://www.readbyqxmd.com/read/29130876/efficacy-of-arthroscopic-teaching-methods-a-prospective-randomized-controlled-study
#14
Luke Robinson, Jonathon Spanyer, Zachary Yenna, Patrick Burchell, Andrew Garber, John Riehl
Arthroscopic education research recently has been focused on the use of skills labs to facilitate resident education and objective measure development to gauge technical skill. This study evaluates the effectiveness of three different teaching methods. Medical students were randomized into three groups. The first group received only classroom-based lecture. The second group received the same lecture and 28 minutes of lab-based hands-off arthroscopy instruction using a cadaver and arthroscopy setup. The final group received the same lecture and 7 minutes of hands-on arthroscopy instruction in the lab on a cadaver knee...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29129333/pitfalls-in-the-interpretation-of-specimens-from-patients-with-testicular-tumours-with-an-emphasis-on-variant-morphologies
#15
REVIEW
Thomas M Ulbright
Accurate diagnosis of primary and metastatic tumours is essential in testicular cancer. While many cases are straightforward, some pose difficulties, especially when variant morphologies occur. Seminoma with 'atypical' features, including increased nuclear pleomorphism and crowding and greater cytoplasmic density with loss of membrane definition, mimics embryonal carcinoma, although ancillary features (fibrous septa, lymphocytes) and immunohistochemistry are of great help. Other deceptive seminoma features include prominent to exclusive intertubular growth, microcystic/tubular patterns, and signet-ring tumour cells...
November 9, 2017: Pathology
https://www.readbyqxmd.com/read/29128877/the-location-of-the-medial-parapatellar-arthrotomy-influences-intraoperative-patella-tracking
#16
Scott R Nodzo, Maximilian Kasparek, Kilian Rueckl, Friedrich Boettner
PURPOSE: The medial parapatellar arthrotomy (MPPA) is a commonly utilized surgical approach; however, the placement of the arthrotomy and its influence on intraoperative patellar tracking has not been evaluated. METHODS: Six knees from three fresh frozen cadavers with transthoracic amputations were operated on. All underwent standard posterior stabilized total knee arthroplasty using a medial parapatellar approach placed at the border of the vastus medialis oblique (VMO)-quadriceps junction...
November 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29125417/loss-of-mechanosensitive-sclerostin-may-accelerate-cranial-bone-growth-and-regeneration
#17
Kyung Shin Kang, Jeff Lastfogel, Laurie L Ackerman, Andrew Jea, Alexander G Robling, Sunil S Tholpady
OBJECTIVE Cranial defects can result from trauma, infection, congenital malformations, and iatrogenic causes and represent a surgical challenge. The current standard of care is cranioplasty, with either autologous or allogeneic material. In either case, the intrinsic vascularity of the surrounding tissues allows for bone healing. The objective of this study was to determine if mechanotransductive gene manipulation would yield non-weight-bearing bone regeneration in a critical size calvarial defect in mice. METHODS A mouse model of Sost deletion in Sost knockout (KO) mice was created in which the osteocytes do not express sclerostin...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29125206/a-comparative-analysis-and-guide-to-virtual-reality-robotic-surgical-simulators
#18
Danielle Julian, Alyssa Tanaka, Patricia Mattingly, Mireille Truong, Manuela Perez, Roger Smith
BACKGROUND: Since the US Food and Drug Administration approved robotically assisted surgical devices for human surgery in 2000, the number of surgeries utilizing this innovative technology has risen. In 2015, approximately 650 000 robot-assisted procedures were performed worldwide. Surgeons must be properly trained to safely transition to using such innovative technology. Multiple virtual reality robotic simulators are now commercially available for educational and training purposes. There is a need for comparative evaluations of these simulators to aid users in selecting an appropriate device for their purposes...
November 10, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29122620/three-year-outcomes-of-the-prospective-randomized-controlled-rez%C3%A5-m-system-study-convective-radiofrequency-thermal-therapy-for-treatment-of-lower-urinary-tract-symptoms-due-to-benign-prostatic-hyperplasia
#19
Kevin T McVary, Claus G Roehrborn
OBJECTIVE: To report 3-year outcomes of a prospective, multi-center, randomized, blinded control trial after treatment with convective radiofrequency (RF) water vapor thermal therapy for moderate to severe lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Fifteen centers enrolled and randomized 197 men ≥50 years old with International Prostate Symptom Score (IPSS) ≥13, maximum flow rate (Qmax) ≤15 ml/s and prostate volume 30 to 80 cc to thermal therapy with Rezūm® System or control (2:1)...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29119728/a-framework-for-designing-patient-specific-bioprosthetic-heart-valves-using-immersogeometric-fluid-structure-interaction-analysis
#20
Fei Xu, Simone Morganti, Rana Zakerzadeh, David Kamensky, Ferdinando Auricchio, Alessandro Reali, Thomas J R Hughes, Michael S Sacks, Ming-Chen Hsu
Numerous studies have suggested that medical image derived computational mechanics models could be developed to reduce mortality and morbidity due to cardiovascular diseases by allowing for patient-specific surgical planning and customized medical device design. In this work, we present a novel framework for designing prosthetic heart valves using a parametric design platform and immersogeometric fluid-structure interaction (FSI) analysis. We parameterize the leaflet geometry using several key design parameters...
November 9, 2017: International Journal for Numerical Methods in Biomedical Engineering
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