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neurosurgery simulation

J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
Donghyun Lee, Changho Lee, Sehui Kim, Qifa Zhou, Jeehyun Kim, Chulhong Kim
Since its first implementation in otolaryngological surgery nearly a century ago, the surgical microscope has improved the accuracy and the safety of microsurgeries. However, the microscope shows only a magnified surface view of the surgical region. To overcome this limitation, either optical coherence tomography (OCT) or photoacoustic microscopy (PAM) has been independently combined with conventional surgical microscope. Herein, we present a near-infrared virtual intraoperative photoacoustic optical coherence tomography (NIR-VISPAOCT) system that combines both PAM and OCT with a conventional surgical microscope...
October 12, 2016: Scientific Reports
Ryosuke Tomio, Takenori Akiyama, Masahiro Toda, Takayuki Ohira, Kazunari Yoshida
OBJECTIVE Transcranial motor evoked potential (tMEP) monitoring is popular in neurosurgery; however, the accuracy of tMEP can be impaired by craniotomy. Each craniotomy procedure and changes in the CSF levels affects the current spread. The aim of this study was to investigate the influence of several craniotomies on tMEP monitoring by using C3-4 transcranial electrical stimulation (TES). METHODS The authors used the finite element method to visualize the electric field in the brain, which was generated by TES, using realistic 3D head models developed from T1-weighted MR images...
October 7, 2016: Journal of Neurosurgery
Adam Smith, Filippo Gagliardi, Nicholas Robert Pelzer, Jacob Hampton, Anthony Minh Tien Chau, Fiona Stewart, Pietro Mortini, Cristian Gragnaniello
BACKGROUND: Increasing focus has been placed on the use of simulation in neurosurgical and spinal surgical training worldwide, with the establishment of many surgical laboratories dedicated to such purpose. So far, the opportunities for hands-on cadaveric training in the areas of neurosurgery and spine surgery remain limited in Australia, owing to various factors, including the abolition of dissection in many medical schools, high maintenance requirements and widespread geographical distribution of surgical trainees...
December 2015: J Spine Surg
Bernardo Drummond Braga, Sebastião Berquó Peleja, Guaracy Macedo, Carlos Roberto S A Drummond, Pollyana H V Costa, Marco T Garcia-Zapata, Marcelo Magaldi Oliveira
INTRODUCTION: Neurosurgery simulation has gained attention recently due to changes in the medical system. First-year neurosurgical residents in low-income countries usually perform their first craniotomy on a real subject. Development of high-fidelity, cheap, and largely available simulators is a challenge in residency training. An original model for the first steps of craniotomy with cerebrospinal fluid (CSF) leak avoidance practice using a coconut is described. MATERIAL AND METHODS: The coconut is a drupe from Cocos nucifera L...
September 6, 2016: World Neurosurgery
Cheng Lu, Yuyi Zhang, Mingyu Chen, Ping Zhong, Yuancheng Chen, Jicheng Yu, Xiaojie Wu, Jufang Wu, Jing Zhang
Meropenem is used to manage post-neurosurgical meningitis, but its population pharmacokinetics (PPK) in plasma and cerebrospinal fluid (CSF) in this patient group is not well known. Our aims were: (i) characterizing meropenem PPK in plasma and CSF; (ii) recommending favorable dosing regimens in post-neurosurgical meningitis patients. 82 patients were enrolled to receive 2g q8h, 1g q8h or 1g q6h meropenem infusion for at least 3 days. Serial blood and CSF samples were collected, with concentrations determined and analyzed via population modeling...
August 29, 2016: Antimicrobial Agents and Chemotherapy
Ramsey A Falconer, Sean L Rogers, Cristie M Brewer, Franco Piscitani, Mahesh B Shenai
Simulated surgical environments are rapidly gaining adoption in training students, residents, and members of specialized surgical teams. However, minimal attention has been given to the use of simulated surgical environments to educate patients on surgical processes, particularly procedures that require the active participation of the patient. "Awake" neurosurgery provides a unique situation in which patients openly participate in their operation. We describe a case report, in which a 62-year-old male was referred for "awake" deep brain stimulation implantation, in relation to medically refractory Parkinson's disease...
2016: Frontiers in Surgery
Jayesh P Thawani, Ashwin G Ramayya, Kalil G Abdullah, Eric Hudgins, Kerry Vaughan, Matthew Piazza, Peter J Madsen, Vivek Buch, M Sean Grady
Simulated practice may improve resident performance in endoscopic endonasal surgery. Using the NeuroTouch haptic simulation platform, we evaluated resident performance and assessed the effect of simulation training on performance in the operating room. First- (N=3) and second- (N=3) year residents were assessed using six measures of proficiency. Using a visual analog scale, the senior author scored subjects. After the first session, subjects with lower scores were provided with simulation training. A second simulation served as a task-learning control...
July 26, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
C Michael Honey, Volker M Tronnier, Christopher R Honey
The treatment of neuropathic pain remains a public health concern. A growing cohort of patients is plagued by medically refractory, unrelenting severe neuropathic pain that ruins their quality of life and productivity. For this group, neurosurgery can offer two different kinds of neuromodulation that may help: deep brain simulation (DBS) and motor cortex stimulation (MCS). Unfortunately, there is no consensus on how to perform these procedures, which stimulation parameters to select, how to measure success, and which patients may benefit...
2016: Computational and Structural Biotechnology Journal
Anthony Beardsworth Costa, Joshua B Bederson
INTRODUCTION: The practice of pre- and intraoperative interactive visualization and modeling continues to grow as its value to clinical practice is augmented by new technologies, such as virtual and augmented reality, or 3D printing. Current tools that extract the necessary structural information from medical imaging modalities and allow virtual or other interrogation of the data are either difficult to use in a practical clinical setting, or sufficiently simple as to limit the knowledge available to the operator...
August 2016: Neurosurgery
Ping Li, Weiwei Wang, Chenxi Zhang, Yong An, Zhijian Song
Intraoperative brain retraction leads to a misalignment between the intraoperative positions of the brain structures and their previous positions, as determined from preoperative images. In vitro swine brain sample uniaxial tests showed that the mechanical response of brain tissue to compression and extension could be described by the hyper-viscoelasticity theory. The brain retraction caused by the mechanical process is a combination of brain tissue compression and extension. In this paper, we first constructed a hyper-viscoelastic framework based on the extended finite element method (XFEM) to simulate intraoperative brain retraction...
2016: Scientific Reports
V A Byvaltsev, E G Belykh, N A Konovalov
The article presents a literature review on the current state of simulation technologies in neurosurgery, a brief description of the basic technology and the classification of simulation models, and examples of simulation models and skills simulators used in neurosurgery. Basic models for the development of physical skills, the spectrum of available computer virtual simulators, and their main characteristics are described. It would be instructive to include microneurosurgical training and a cadaver course of neurosurgical approaches in neurosurgery training programs and to extend the use of three-dimensional imaging...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Daniel Teichmann, Lucas Rohe, Annegret Niesche, Meiko Mueller, Klaus Radermacher, Steffen Leonhardt
: Craniotomy is the removal of a bone flap from the skull and is a first step in many neurosurgical interventions. During craniotomy, an efficient cut of the bone without injuring adjoining soft tissues is very critical. The aim of this work is to investigate the feasibility of estimating the currently penetrated cranial bone layer by means of bioimpedance measurement. METHODS: A finite element model was developed and a simulation study conducted. Simulations were performed at different positions along an elliptical cutting path and at three different operation areas...
June 7, 2016: IEEE Transactions on Bio-medical Engineering
Vinícius Gabriel Barros Florentino, Diego Santiago de Mendonça, Ariel Valente Bezerra, Leonardo de Freitas Silva, Rafael Figueirêdo Pontes, Carlos Vinícius Mota de Melo, Manoel de Jesus Rodrigues Mello, Andréa Silvia Walter de Aguiar
Frontal bone fracture treatment is still an issue of research in craniofacial surgery and neurosurgery. The aims of the treatment are to reduce the complication risks and to keep the aesthetic of the face. Before the management of this fracture type, it is necessary to consider the permanence or not of the frontal sinus function. Rapid prototyping has been an aid tool on planning and simulation of the surgical procedure, improving the diagnostic quality and the implant manufacture, beyond reducing the operative time...
June 2016: Journal of Craniofacial Surgery
Daniel J Meara, Susan Coffey Zern
PURPOSE OF REVIEW: Simulation in healthcare is no longer a novel idea. Simulation continues to rapidly permeate and transform both clinical practice and medical education. Craniomaxillofacial surgery is comprised of multiple surgical disciplines, including neurosurgery, plastic surgery, otolaryngology, ophthalmology, and oral and maxillofacial surgery. All of these specialties are performing surgery in an era of evolving technology, cost containment, reduced resident work hours, and a focus on patient safety...
August 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Deborah M Rooney, Bruce L Tai, Oren Sagher, Albert J Shih, David Andrew Wilkinson, Luis E Savastano
BACKGROUND: Ventriculostomy is a common neurosurgical procedure with a relatively steep learning curve. A low-cost, high-fidelity simulator paired with procedure-specific performance measures would provide a safe environment to teach ventriculostomy procedural skills. The same validated simulation model could also allow for assessment of trainees' proficiencies with measures that align with Accreditation Council for Graduate Medical Education milestones. This study extends previous work to evaluate validity evidence from the simulator, its newly developed performance assessment, the Ventricolostomy Procedural Assessment Tool, and the Objective Structured Assessment for Technical Skills...
September 2016: Surgery
David B Clarke, Nelofar Kureshi, Murray Hong, Maryam Sadeghi, Ryan C N D'Arcy
BACKGROUND: The use of simulation training in postgraduate medical education is an area of rapidly growing popularity and research. This study was designed to assess the impact of simulation training for instrument knowledge and recognition among neurosurgery residents. METHODS: This was a randomized control trial of first year residents from neurosurgery residency training programs across Canada. Eighteen neurosurgery trainees were recruited to test two simulation-based applications: PeriopSim™ Instrument Trainer and PeriopSim™ for Burr Hole Surgery...
2016: BMC Medical Education
P Mazzone, P Arena, L Cantelli, G Spampinato, S Sposato, S Cozzolino, P Demarinis, G Muscato
The use of robotics in neurosurgery and, particularly, in stereotactic neurosurgery, is becoming more and more adopted because of the great advantages that it offers. Robotic manipulators easily allow to achieve great precision, reliability, and rapidity in the positioning of surgical instruments or devices in the brain. The aim of this work was to experimentally verify a fully automatic "no hands" surgical procedure. The integration of neuroimaging to data for planning the surgery, followed by application of new specific surgical tools, permitted the realization of a fully automated robotic implantation of leads in brain targets...
July 2016: Journal of Neural Transmission
Yanni Zou, Peter X Liu, Qiangqiang Cheng, Pinhua Lai, Chunquan Li
A novel meshless deformation model of biological soft tissue, which is mainly based on the radial basis function point interpolation, is presented for interactive simulation applications such as virtual surgery simulators. Compared with conventional mesh models, the proposed model is particularly suitable for simulating large deformation, sucking and cutting tasks since there is no need to maintain grid information. Kelvin viscoelasticity, which represents relaxation, creep, and hysteresis of soft tissue, is integrated into the proposed model, making the simulation much more realistic than many existing meshless models...
May 12, 2016: IEEE Transactions on Cybernetics
A Jessey Chugh, Jonathan R Pace, Justin Singer, Curtis Tatsuoka, Alan Hoffer, Warren R Selman, Nicholas C Bambakidis
OBJECTIVE The field of neurosurgery is constantly undergoing improvements and advances, both in technique and technology. Cerebrovascular neurosurgery is no exception, with endovascular treatments changing the treatment paradigm. Clipping of aneurysms is still necessary, however, and advances are still being made to improve patient outcomes within the microsurgical treatment of aneurysms. Surgical rehearsal platforms are surgical simulators that offer the opportunity to rehearse a procedure prior to entering the operative suite...
May 13, 2016: Journal of Neurosurgery
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