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Liver training surgery

Mohd Raashid Sheikh, Houssam Osman, Muhammad Umar Butt, Dhiresh Rohan Jeyarajah
BACKGROUND: Hepatopancreatobiliary (HPB) surgery experience during residency in the Americas is limited. Residents interested in HPB surgery have different options available for further training. This study evaluated training in HPB surgery received during general surgery (GS) residency, and sought to determine the perception of fellowship training in HPB surgery. METHODS: An anonymous survey was distributed to all 259 GS residency programs in the United States...
October 13, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
A L P Nunes, A Maciel, L T Cavazzola, M Walter
While improved visual realism is known to enhance training effectiveness in virtual surgery simulators, the advances on realistic rendering for these simulators is slower than similar simulations for man-made scenes. One of the main reasons for this is that in vivo data is hard to gather and process. In this paper, we propose the analysis of videolaparoscopy data to compute the Bidirectional Reflectance Distribution Function (BRDF) of living organs as an input to physically based rendering algorithms. From the interplay between light and organic matter recorded in video images, we propose the definition of a process capable of establishing the BRDF for inside-the-body organic surfaces...
September 29, 2016: Medical Image Analysis
Carlo Sposito, Stefano Di Sandro, Federica Brunero, Vincenzo Buscemi, Carlo Battiston, Andrea Lauterio, Marco Bongini, Luciano De Carlis, Vincenzo Mazzaferro
AIM: To develop a prognostic scoring system for overall survival (OS) of patients undergoing liver resection (LR) for hepatocellular carcinoma (HCC). METHODS: Consecutive patients who underwent curative LR for HCC between 2000 and 2013 were identified. The series was randomly divided into a training and a validation set. A multivariable Cox model for OS was fitted to the training set. The beta coefficients derived from the Cox model were used to define a prognostic scoring system for OS...
September 28, 2016: World Journal of Gastroenterology: WJG
Gen-Min Lin, Yi-Hwei Li, Chung-Jen Lee, Jeng-Chuan Shiang, Ko-Huan Lin, Kai-Wen Chen, Yu-Jung Chen, Ching-Fen Wu, Been-Sheng Lin, Yun-Shun Yu, Felicia Lin, Fung-Ying Su, Chih-Hung Wang
AIM: To investigate the association between cardiorespiratory fitness and hospitalization events in a cohort of large voluntary arm forces in Taiwan. METHODS: The cardiorespiratory fitness and hospitalization events in armed forces (CHIEF) is a retrospective cohort consisting of more than 4000 professional military members aged 18-50 years in Eastern Taiwan. All participants received history taking, physical examination, chest radiography, 12-lead electrocardiography, blood tests for cell counts and fasting glucose, lipid profiles, uric acid, renal function and liver function in the Hualien Armed Forces General Hospital during 2014...
August 26, 2016: World Journal of Cardiology
Yuki Nakamura, Hiroshi Aikata, Takayuki Fukuhara, Fumi Honda, Kei Morio, Reona Morio, Masahiro Hatooka, Tomoki Kobayashi, Yuko Nagaoki, Tomokazu Kawaoka, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Hidenori Ochi, Tsuyoshi Kobayashi, Hideki Ohdan, Noriyuki Shiroma, Koji Arihiro, Kazuaki Chayama
AIM: FibroScan is a tool for the non-invasive diagnosis of hepatic fibrosis. Previous studies have compared liver stiffness to percutaneous liver biopsy findings, but no study has compared liver stiffness to liver resection specimen findings. The aim of this study was to compare FibroScan measurements to resected liver specimen findings. METHODS: From April 2011 to November 2015, a total of 114 patients with liver tumor and hepatitis C were enrolled. We divided them into two groups, the training set and validation set...
September 3, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
H M Joshi, E Alabraba, A Tufo, A Zone, P Ghaneh, S W Fenwick, G J Poston, H Z Malik
INTRODUCTION: Indicative numbers for completion of training (CCT) in the UK requires 35 upper Gastrointestinal/Hepatobiliary resections and 110 (50 non HPB trainees) cholecystectomies. We aim to identify whether the training experience in our centre meets the CCT requirements for hepatobiliary surgery and compare training opportunities to those in international fellowships. METHODS: We retrospectively reviewed our hospital's operating theatre database for all patients undergoing a liver or gallbladder resection between January 2008 and July 2015 using corresponding procedural codes and consultant name...
October 2016: European Journal of Surgical Oncology
Federico Tomassini, Vincenzo Scuderi, Giammauro Berardi, Alexandra Dili, Mathieu D'Hondt, Gregory Sergeant, Catherine Hubert, Frederik Huysentruyt, Frederik Berrevoet, Valerio Lucidi, Roberto Ivan Troisi
BACKGROUND: Laparoscopic liver surgery (LLS) gained popularity bringing several advantages including decreased morbidity and reduction of length of hospital stay compared to open. METHODS: To understand practice and evolution of LLS in Belgium, a 20-questions survey was sent to all members of the Royal Belgian Society for Surgery, the Belgian Section of Hepato-Pancreatic and Biliary Surgery and the Belgian Group for Endoscopic Surgery. RESULTS: Thirty-seven surgical units representing 61 surgeons performing LLS in Belgium responded: 50% from regional hospitals, 28% from university and 22% from peripheral hospitals...
August 19, 2016: Acta Chirurgica Belgica
Jana Billson, F Haynes van der Merwe, Robbert P Soeters
INTRODUCTION: The aim of this study was to assess practice patterns and rationale with regard to debulking surgery for advanced epithelial ovarian carcinoma among South African Gynaecological oncologists. METHODS: A survey was distributed to all practicing gynecological oncologists in South Africa. It was structured to assess definitions of optimal debulking, procedures used to achieve optimal debulking, and reasons for not performing specific procedures. Respondents were also asked to report on experience and additional surgical training to improve skill in performing ultra-radical debulking surgery...
October 2016: International Journal of Gynecological Cancer
Vanessa A Fravel, Linda J Lowenstine, Amanda Koehne
A wild-born, captive-reared, 14 yr old, primiparous female California sea lion Zalophus californianus presented for anorexia of 14 d duration and abdominal distention. Routine complete blood cell count revealed leukocytosis with a neutrophilia, and serum chemistry revealed hypoalbumenemia and hyponatremia. Treatment with broad spectrum antibiotics and non-steroidal anti-inflammatories were started, but the animal continued to decline. Abdominal radiographs revealed a mature mineralized fetal skull and spine in the caudal abdomen and abdominal ultrasound revealed ascites but could not confirm the fetus...
July 7, 2016: Diseases of Aquatic Organisms
Marcel J van der Poel, Marc G Besselink, Federica Cipriani, Thomas Armstrong, Arjun S Takhar, Susan van Dieren, John N Primrose, Neil W Pearce, Mohammad Abu Hilal
Importance: Widespread implementation of laparoscopic hemihepatectomy is currently limited by its technical difficulty, paucity of training opportunities, and perceived long and harmful learning curve. Studies confirming the possibility of a short and safe learning curve for laparoscopic hemihepatectomy could potentially benefit the further implementation of the technique. Objective: To evaluate the extent and safety of the learning curve for laparoscopic hemihepatectomy...
July 6, 2016: JAMA Surgery
Albert Fung, Paul Kelly, Gordon Tait, Paul D Greig, Ian D McGilvray
The potential for integrating real-time surgical video and state-of-the art animation techniques has not been widely applied to surgical education. This paper describes the use of new technology for creating videos of liver, pancreas and transplant surgery, annotating them with 3D animations, resulting in a freely-accessible online resource: The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery ( ). The atlas complements the teaching provided to trainees in the operating room, and the techniques described in this study can be readily adapted by other surgical training programmes...
January 2016: Journal of Visual Communication in Medicine
Karin Valkenet, Jaap C A Trappenburg, Carlo C Schippers, Lisa Wanders, Lidwien Lemmens, Frank J G Backx, Richard van Hillegersberg
BACKGROUND/AIMS: This study examines the feasibility of a preoperative exercise program to improve the physical fitness of a patient before gastrointestinal surgery. METHODS: An outpatient exercise program was developed to increase preoperative aerobic capacity, peripheral muscle endurance and respiratory muscle function in patients with pancreatic, liver, intestinal, gastric or esophageal cancer. During a consult at the outpatient clinic, patients were invited to participate in the exercise program when their surgery was not scheduled within 2 weeks...
2016: Digestive Surgery
Sonia Radunz, Dieter P Hoyer, Gernot M Kaiser, Andreas Paul, Maren Schulze
PURPOSE: Women represent up to 60 % of students entering the medical profession in many countries in the world. However, the proportion of women to men is not accordingly balanced among surgical residents and especially in leadership positions in surgery. Therefore, we investigated the career goals as well as family and lifestyle priorities of female surgeons in German liver transplant centers. METHODS: A standardized questionnaire was developed using the web-based survey tool SurveyMonkey®...
April 21, 2016: Langenbeck's Archives of Surgery
Oliver C Burdall, Erica Makin, Mark Davenport, Niyi Ade-Ajayi
AIMS OF THE STUDY: Laparoscopic simulation has transformed skills acquisition for many procedures. However, realistic nonbiological simulators for complex reconstructive surgery are rare. Life-like tactile feedback is particularly difficult to reproduce. Technological innovations may contribute novel solutions to these shortages. We describe a hybrid model, harnessing 3D technology to simulate laparoscopic choledochal surgery for the first time. METHODS: Digital hepatic anatomy images and standard laparoscopic trainer dimensions were employed to create an entry level laparoscopic choledochal surgery model...
May 2016: Journal of Pediatric Surgery
R Croner, A Perrakis, R Grützmann, W Hohenberger, M Brunner
BACKGROUND: The advantages of minimally invasive liver resections for selected patients are evident. Robots provide new innovations that will influence minimally invasive liver surgery in the future. This article presents our initial experience with this technology in our patient population. Material und Methods: In 14 patients with benign or malignant liver tumours, robotic-assisted liver surgery was performed. Selection criteria were compensated liver function and resection of ≤ 3 liver segments...
April 2016: Zentralblatt Für Chirurgie
Masaya Sato, Ryosuke Tateishi, Hideo Yasunaga, Hiromasa Horiguchi, Hiroki Matsui, Haruhiko Yoshida, Kiyohide Fushimi, Kazuhiko Koike
BACKGROUND: The majority of previous studies that evaluated risk factors for in-hospital mortality of cirrhotic patients following surgical procedures were limited by a small sample size. METHODS: Using a Japanese nationwide administrative database, we enrolled 2197 cirrhotic patients who underwent elective (n = 1973) or emergency (n = 224) surgery. We analyzed the risk factors for postoperative mortality and established a scoring system for predicting postoperative mortality in cirrhotic patients using a split-sample method...
April 7, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Andre Mastmeyer, Matthias Wilms, Dirk Fortmeier, Julian Schröder, Heinz Handels
One draw-back of most existing VR ultrasound training simulators is the use of static 3D patient models neglecting physiological changes induced e.g. by respiration or heart motion. In this paper to the aim of more realistic Ultrasound simulation, breathing motion extracted from 4D CT image data is integrated into our visuo-haptic simulation framework. The simulated ultrasound images are used for the training of US-guided needle insertion procedures in liver surgery. The methodology developed enables US simulation, 3D visualization and haptic steering of the ultrasound probe and the needle in real-time in breathing virtual bodies...
2016: Studies in Health Technology and Informatics
Florian Heitz, Philipp Harter, Piero F Alesina, Martin K Walz, Dietmar Lorenz, Harald Groeben, Sebastian Heikaus, Anette Fisseler-Eckhoff, Stephanie Schneider, Beyhan Ataseven, Christian Kurzeder, Sonia Prader, Bianca Beutel, Alexander Traut, Andreas du Bois
OBJECTIVE: Describing the pattern of and reasons for post-operative tumor residuals in patients with advanced epithelial ovarian cancer (AOC) operated in a specialized gynecologic cancer center following a strategy of maximum upfront debulking followed by systemic chemotherapy. METHODS: All consecutive AOC-patients treated between 2005 and 2015 due to stages FIGO IIIB/IV were included in this single-center analysis. RESULTS: 739 patients were included in this analysis...
May 2016: Gynecologic Oncology
D F J Dunne, S Jack, R P Jones, L Jones, D T Lythgoe, H Z Malik, G J Poston, D H Palmer, S W Fenwick
BACKGROUND: Patients with low fitness as assessed by cardiopulmonary exercise testing (CPET) have higher mortality and morbidity after surgery. Preoperative exercise intervention, or prehabilitation, has been suggested as a method to improve CPET values and outcomes. This trial sought to assess the capacity of a 4-week supervised exercise programme to improve fitness before liver resection for colorectal liver metastasis. METHODS: This was a randomized clinical trial assessing the effect of a 4-week (12 sessions) high-intensity cycle, interval training programme in patients undergoing elective liver resection for colorectal liver metastases...
April 2016: British Journal of Surgery
Fabricio Ferreira Coelho, Jaime Arthur Pirola Kruger, Gilton Marques Fonseca, Raphael Leonardo Cunha Araújo, Vagner Birk Jeismann, Marcos Vinícius Perini, Renato Micelli Lupinacci, Ivan Cecconello, Paulo Herman
Laparoscopic liver resection (LLR) has been progressively developed along the past two decades. Despite initial skepticism, improved operative results made laparoscopic approach incorporated to surgical practice and operations increased in frequency and complexity. Evidence supporting LLR comes from case-series, comparative studies and meta-analysis. Despite lack of level 1 evidence, the body of literature is stronger and existing data confirms the safety, feasibility and benefits of laparoscopic approach when compared to open resection...
January 27, 2016: World Journal of Gastrointestinal Surgery
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