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Surgical and Simulation

Kimberly A Bagley, Sarah E Dunn, Eliseu Y Chuang, Victoria J Dorr, Julie A Thompson, Sophia K Smith
BACKGROUND: A community hospital combined its medical and surgical patients with cancer on one unit, which resulted in nurses not trained in oncology caring for this patient population. OBJECTIVES: The Oncology Intensives Initiative (ONCii) involved the (a) design and implementation of a daylong didactic boot camp class and a four-hour simulation session and (b) the examination of nurses' worries, attitudes, self-efficacy, and perception of interdisciplinary teamwork...
April 1, 2018: Clinical Journal of Oncology Nursing
P Stefan, M Pfandler, P Wucherer, S Habert, J Fürmetz, S Weidert, E Euler, U Eck, M Lazarovici, M Weigl, N Navab
Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions...
March 15, 2018: Der Unfallchirurg
Andras P Durko, Ruben L Osnabrugge, Nicolas M Van Mieghem, Milan Milojevic, Darren Mylotte, Vuyisile T Nkomo, A Pieter Kappetein
Aims: The number of transcatheter aortic valve implantation (TAVI) procedures is rapidly increasing. This has a major impact on health care resource planning. However, the annual numbers of TAVI candidates per country are unknown. The aim of this study was to estimate current and future number of annual TAVI candidates in 27 European countries, the USA and Canada. Methods and results: Systematic literature searches and meta-analyses were performed on aortic stenosis (AS) epidemiology and decision-making in severe symptomatic AS...
March 12, 2018: European Heart Journal
James R Thunes, Julie A Phillippi, Thomas G Gleason, David A Vorp, Spandan Maiti
High lethality of aortic dissection necessitates accurate predictive metrics for dissection risk assessment. The not infrequent incidence of dissection at aortic diameters <5.5 cm, the current threshold guideline for surgical intervention (Nishimura et al., 2014), indicates an unmet need for improved evidence-based risk stratification metrics. Meeting this need requires a fundamental understanding of the structural mechanisms responsible for dissection evolution within the vessel wall. We present a structural model of the repeating lamellar structure of the aortic media comprised of elastic lamellae and collagen fiber networks, the primary load-bearing components of the vessel wall...
February 8, 2018: Journal of Biomechanics
Long Chen, Wen Tang, Nigel W John, Tao Ruan Wan, Jian Jun Zhang
BACKGROUND AND OBJECTIVE: While Minimally Invasive Surgery (MIS) offers considerable benefits to patients, it also imposes big challenges on a surgeon's performance due to well-known issues and restrictions associated with the field of view (FOV), hand-eye misalignment and disorientation, as well as the lack of stereoscopic depth perception in monocular endoscopy. Augmented Reality (AR) technology can help to overcome these limitations by augmenting the real scene with annotations, labels, tumour measurements or even a 3D reconstruction of anatomy structures at the target surgical locations...
May 2018: Computer Methods and Programs in Biomedicine
Chengshuai Yang, Shunyao Shen, Jingyang Wu, Shilei Zhang
Mandibular reconstruction after partial or subtotal resection is considered a challenging procedure that is crucial for facial contour and function. Many reports regarding the reconstruction of mandibular defects have been published over the years. The fibula free flap has become a popular option for mandibular reconstruction since its introduction by Hidalgo in 1989. However, the locations of the reconstructed mandibular angle and the condyle of the fibular bone segments play a crucial role in facial symmetry and function...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Zhongkui Wang, Masamitsu Kido, Kan Imai, Kazuya Ikoma, Shinichi Hirai
Clinically in medializing calcaneal osteotomy (MCO), foot and ankle surgeons are facing difficulties in choosing appropriate surgical parameters due to the individual differences in deformities among flatfoot patients. Traditional cadaveric studies have provided important information regarding the biomechanical effects of tendons, ligaments, and plantar fascia, but limitations have been reached when dealing with individual differences and tailoring patient-specific surgeries. Therefore, this study aimed at implementing the finite element (FE) method to investigate the effect of different MCO parameters to help foot and ankle surgeons performing patient-specific surgeries...
March 15, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Andrea Moglia, Luca Morelli, Vincenzo Ferrari, Mauro Ferrari, Franco Mosca, Alfred Cuschieri
BACKGROUND: There is an increasing interest for a test assessing objectively the innate aptitude for surgery as a craft specialty to complement the current selection process of surgical residents. The aim of this study was to quantify the size of individuals with high, average, and low level of innate psychomotor skills among medical students. METHODS: A volunteer sample of 155 medical students, without prior experience with surgical simulator, executed five tasks at a virtual simulator for robot-assisted surgery...
March 14, 2018: Surgical Endoscopy
Yojiro Makino, Yoshihisa Shimada, Masaru Hagiwara, Masatoshi Kakihana, Jinho Park, Naohiro Kajiwara, Tatsuo Ohira, Norihiko Ikeda
OBJECTIVES: Emphysema is one of the main causes of respiratory complications in patients operated on for lung cancer. We have used three-dimensional computed tomography (3D CT) for surgical simulations, as well as for depicting emphysematous areas as low attenuation areas (LAAs) and visual scores based on the Goddard classification (Goddard score), which is a visual scale of the area of vascular disruption and LAA for each lung field. This study aimed to investigate the effectiveness of the 3D CT function for assessing emphysema severity and its association with respiratory complications...
March 12, 2018: European Journal of Cardio-thoracic Surgery
Jiyoo Chang, Xiaotian Wu, Peter W Kahng, Ryan J Halter, Joseph A Paydarfar
No abstract text is available yet for this article.
March 14, 2018: Laryngoscope
Temitope Adebayo, Michael Abendroth, Gaytri Gupta Elera, Allen Kunselman, Elizabeth Sinz, Amanda Ely, Amr Elkamshoushy, Ajay Soni
PURPOSE: To demonstrate that a nonbiologic strabismus surgery simulator is not inferior to a biologic wet lab for teaching the key steps of strabismus surgery. METHODS: A total of 41 medical students were randomly assigned to one of two groups: biologic wet lab or nonbiologic simulator. The students trained according to the group's protocol then participated in a recorded final assessment using a realistic strabismus surgery model. Two independent reviewers, masked to training method, graded the video recordings using three scoring systems: the International Council of Ophthalmology Approved-Ophthalmology Surgical Competency Assessment Rubric for Strabismus Surgery (ICO-OSCAR), the Global Rating Scale of Objective Structured Assessment of Technical Skills (OSATS), and the Alphabetic Summary Scale (ASS)...
March 10, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Hisanaga Horie, Koji Koinuma, Homare Ito, Ai Sadatomo, Daishi Naoi, Yoshihiko Kono, Yoshiyuki Inoue, Mitsuaki Morimoto, Makiko Tahara, Alan K Lefor, Naohiro Sata, Takahiro Sasaki, Hideharu Sugimoto
INTRODUCTION: Laparoscopic lateral pelvic lymph node dissection (LPLD) is technically challenging because of the complicated anatomy of the pelvic wall. To overcome this difficulty, we introduced preoperative 3-D simulation. The aim of the study is to investigate the usefulness of preoperative 3-D simulation for the safe conduct of laparoscopic LPLD for rectal cancer. METHODS: After undergoing colonoscopy, patients were brought to the radiology suite where multi-detector row CT was performed...
March 12, 2018: Asian Journal of Endoscopic Surgery
Patrick G Chan, Lara W Schaheen, Ernest G Chan, Chris C Cook, James D Luketich, Jonathan D'Cunha
OBJECTIVE: Transitioning from medical school and general surgery training to cardiothoracic (CT) surgical training poses unique challenges for trainees and patient care. We hypothesized that participation in technology-enhanced simulation modules that provided early exposure to urgent/emergent CT patient problems would improve cognitive skills and readiness to manage common urgencies/emergencies. DESIGN: Traditional and integrated cardiothoracic residents at our institution participated in a technology-enhanced simulation curriculum...
March 9, 2018: Journal of Surgical Education
Mohammad Kia, Timothy M Wright, Michael B Cross, David J Mayman, Andrew D Pearle, Peter K Sculco, Geoffrey H Westrich, Carl W Imhauser
BACKGROUND: The correct amount of external rotation of the femoral component during TKA is controversial because the resulting changes in biomechanical knee function associated with varying degrees of femoral component rotation are not well understood. We addressed this question using a computational model, which allowed us to isolate the biomechanical impact of geometric factors including bony shapes, location of ligament insertions, and implant size across three different knees after posterior-stabilized (PS) TKA...
January 2018: Clinical Orthopaedics and related Research
A Walkden, J Huxtable, M Senior, H Lee, S Naylor, S Turner, K Ivanova, J Koppens, B Todd, A Macleod, F Sii, N Anand, P Shah, A King, D C Broadway, J F Kirwan, A McNaught, A Bhan-Bhargava
OBJECTIVES: To define the safety profile of trainee trabeculectomy surgery in the United Kingdom. Surgical exposure for trainees in England is limited due to service requirements, the European working time directive constraints and increasing sub-specialisation of glaucoma surgery. Limited knowledge exists on the outcomes of supervised glaucoma surgery. The aim is to determine the safety of supervised trabeculectomy surgery performed by trainee ophthalmologists. METHODS: Retrospective case note review of all patients that had trabeculectomy surgery with MMC by consultant and trainee surgeons across multiple UK centres...
March 12, 2018: Eye
Fereshteh Aein
BACKGROUND: Interprofessional learning is identified as one of the most innovative ways to encourage students of different disciplines to communicate with each other in interprofessional teams. A review of existing studies identified that inter-professional learning with nursing and midwifery students learning together had not previously been reported. AIM: This qualitative study sought to explore perceptions and experiences of midwifery students from interprofessional learning with nursing students...
March 8, 2018: Women and Birth: Journal of the Australian College of Midwives
Sasan Sadrizadeh, Jovan Pantelic, Max Sherman, Jordan Clark, Omid Abouali
BACKGROUND: Operating rooms (ORs) are usually over-pressurized in order to prevent the penetration of contaminated air and the consequent risk of surgical site infection. However, a door-opening can result in the rapid disappearance of pressure and contaminants can then easily penetrate into the surgical zone. Therefore, a broad knowledge and understanding of OR ventilation systems and their protective potential is essential for optimizing the surgical environment. OBJECTIVES: This study investigated the air quality and level of airborne particles during a single and multiple door-opening cycles in an operating room supplied by a turbulent-mixing ventilation system...
March 8, 2018: Journal of Infection and Public Health
Monique H Vaughan, Shunaha Kim-Fine, Kathie L Hullfish, Tovia M Smith, Nazema Y Siddiqui, Elisa R Trowbridge
STUDY OBJECTIVE: To establish construct validity of the simulated vaginal hysterectomy trainer (SimVaHT). DESIGN: Cross-sectional validation study (Canadian Task Force classification II-2). SETTING: Single academic medical center in the United States. SUBJECTS: Fourteen residents in Obstetrics and Gynecology (four PGY-1, four PGY-2, three PGY-3 and three PGY-4). PGY-1 and PGY-2 residents were grouped to form the "junior level" cohort, while PGY-3 and PGY-4 residents comprised the "senior level" cohort...
March 7, 2018: Journal of Minimally Invasive Gynecology
George Melich, Ajit Pai, Ramy Shoela, Kunal Kochar, Supriya Patel, John Park, Leela Prasad, Slawomir Marecik
BACKGROUND: Apprenticeship in training new surgical skills is problematic, because it involves human subjects. To date there are limited inanimate trainers for rectal surgery. OBJECTIVE: The purpose of this article is to present manufacturing details accompanied by evidence of construct, face, and content validity for a robotic rectal dissection simulation. DESIGN: Residents versus experts were recruited and tested on performing simulated total mesorectal excision...
April 2018: Diseases of the Colon and Rectum
Richard W Helms, Xiaowei Zhao, Rony R Sayegh
PURPOSE: To study the effect of decentration and tilt of the type I Boston keratoprosthesis (KPro) on image quality in both aphakic and pseudophakic eyes. METHODS: An optical ray-tracing program was used to simulate the image projected onto the retina in an eye with a perfectly centered KPro, and in eyes with varying degrees of KPro decentration and tilt. Decentration was modeled along a typical white-to-white distance of 12.0 mm, and the corresponding tilt was calculated assuming a radius of curvature of 8...
March 6, 2018: Cornea
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