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https://www.readbyqxmd.com/read/28448921/novel-bone-surrogates-for-cranial-surgery-training
#1
Marianne Hollensteiner, David Fürst, Benjamin Esterer, Peter Augat, Falk Schrödl, Stefan Hunger, Michael Malek, Daniel Stephan, Andreas Schrempf
Parietal graft lifts are trained on human or animal specimens or are directly performed on patients without extensive training. In order to prevent harm to the patient resulting from fast rotating machinery tools, the surgeon needs to apply appropriate forces. Realistic haptics are essential to identify the varying parietal bone layers and to avoid a penetration of the brain. This however, requires experience and training. Therefore, in this study, bone surrogate materials were evaluated with the aim to provide an anatomically correct artificial skull cap with realistic haptic feedback for graft lift training procedures...
April 19, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28446925/ethical-legal-and-clinical-aspects-of-live-surgery-in-urology-contemporary-issues-and-a-glimpse-of-the-future
#2
REVIEW
Alin Adrian Cumpanas, Ovidiu Catalin Ferician, Silviu Constantin Latcu, Catalin Pricop, Razvan Tiberiu Bardan
Beside dry and wet lab training, simulators, video tapes, fellowships and clinical visits, live surgery has gained popularity during the last years, being an attraction point at large scientific meetings and at postgraduate courses as well. This type of surgical training raises both ethical and legal issues. Thus, there are professional societies that have banned such meetings, mainly due to safety reasons for the patient. The current article aims to identify and to discuss ethical and legal issues related to the topic, advantages, disadvantages and weak points of this emerging challenge for modern medicine, trying to analyze the issues from all relevant points of view: those of the patient, the surgeon and the session attendant...
2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/28444495/establishing-meaningful-benchmarks-the-development-of-a-formative-feedback-tool-for-advanced-laparoscopic-suturing
#3
Katherine M McKendy, Yusuke Watanabe, Elif Bilgic, Ghada Enani, Amani Munshi, Lawrence Lee, Liane S Feldman, Gerald M Fried, Melina C Vassiliou
BACKGROUND: Time and accuracy are commonly used metrics to assess laparoscopic skills in a simulated environment. However, they do not provide trainees with meaningful information about how to improve their skills. The objective of this study was to provide preliminary validity evidence for the creation a formative feedback tool (FFT) for advanced laparoscopic suturing skills. METHODS: Videotapes of senior surgical residents (PGY3-5; SRs) and minimally invasive surgeons (MIS) performing 3 advanced laparoscopic suturing tasks were analyzed: needle handling (NH), suturing under tension (UT), and continuous suturing (CS)...
April 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28444331/improved-implementation-of-the-risk-adjusted-bernoulli-cusum-chart-to-monitor-surgical-outcome-quality
#4
Matthew J Keefe, Justin B Loda, Ahmad E Elhabashy, William H Woodall
Methodology issue: The traditional implementation of the risk-adjusted Bernoulli cumulative sum (CUSUM) chart for monitoring surgical outcome quality requires waiting a pre-specified period of time after surgery before incorporating patient outcome information. Proposed solution: We propose a simple but powerful implementation of the risk-adjusted Bernoulli CUSUM chart that incorporates outcome information as soon as it is available, rather than waiting a pre-specified period of time after surgery...
April 21, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28443161/surgical-morphometry-of-c1-and-c2-vertebrae-a-three-dimensional-computed-tomography-analysis-of-180-chinese-indian-and-malay-patients
#5
Chee Kean Lee, Tiam Siong Tan, Chris Yin Wei Chan, Mun Keong Kwan
STUDY DESIGN: Clinical imaging study. PURPOSE: To study the surgical morphometry of C1 and C2 vertebrae in Chinese, Indian, and Malay patients. OVERVIEW OF LITERATURE: C1 lateral mass and C2 pedicle screw fixation is gaining popularity. However, there is a lack of C1-C2 morphometric data for the Asian population. METHODS: Computed tomography analysis of 180 subjects (60 subjects each belonging to Chinese, Indian, and Malay populations) using simulation software was performed...
April 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28441310/a-dose-response-curve-for-a-gram-negative-spinal-implant-infection-model-in-rabbits
#6
Joseph L Laratta, Jamal N Shillingford, Nathan Hardy, Ronald A Lehman, Lawrence G Lenke, K Daniel Riew
STUDY DESIGN: Randomized complete block animal spinal implant infection model with internal control. OBJECTIVE: To develop a spinal implant animal infection model to simulate postoperative gram-negative wound infection. SUMMARY OF BACKGROUND DATA: Implant-associated surgical site infections (SSI) remain a dreaded complication of spinal surgery. Currently, over 30% of all spine SSIs are secondary to gram-negative bacteria. Traditional animal models have utilized gram-positive inoculums to simulate postoperative infection, but there exists no model in the literature for gram-negative infection in the setting of spinal instrumentation...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28439484/gastroschisis-simulation-model-pre-surgical-management-technical-report
#7
Orna Rosen, Robert M Angert
This technical report describes the creation of a gastroschisis model for a newborn. This is a simple, low-cost task trainer that provides the opportunity for Neonatology providers, including fellows, residents, nurse practitioners, physician assistants, and nurses, to practice the management of a baby with gastroschisis after birth and prior to surgery. Included is a suggested checklist with which the model can be employed. The details can be modified to suit different learning objectives.
March 22, 2017: Curēus
https://www.readbyqxmd.com/read/28439352/preoperative-practice-paired-with-instructor-feedback-may-not-improve-obstetrics-gynecology-residents-operative-performance
#8
Jamie Kroft, Michael Ordon, Leslie Po, Nora Zwingerman, Katie Waters, Jason Y Lee, Richard Pittini
BACKGROUND: There is evidence that preoperative practice prior to surgery can improve trainee performance, but the optimal approach has not been studied. OBJECTIVE: We sought to determine if preoperative practice by surgical trainees paired with instructor feedback improved surgical technique, compared to preoperative practice or feedback alone. METHODS: We conducted a randomized controlled trial of obstetrics-gynecology trainees, stratified on a simulator-assessed surgical skill...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28438070/creation-of-a-novel-simulator-for-minimally-invasive-neurosurgery-fusion-of-3d-printing-and-special-effects
#9
Peter Weinstock, Roberta Rehder, Sanjay P Prabhu, Peter W Forbes, Christopher J Roussin, Alan R Cohen
OBJECTIVE Recent advances in optics and miniaturization have enabled the development of a growing number of minimally invasive procedures, yet innovative training methods for the use of these techniques remain lacking. Conventional teaching models, including cadavers and physical trainers as well as virtual reality platforms, are often expensive and ineffective. Newly developed 3D printing technologies can recreate patient-specific anatomy, but the stiffness of the materials limits fidelity to real-life surgical situations...
April 25, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28437441/fluorescence-imaging-topography-scanning-system-for-intraoperative-multimodal-imaging
#10
Tri T Quang, Hye-Yeong Kim, Forrest Sheng Bao, Francis A Papay, W Barry Edwards, Yang Liu
Fluorescence imaging is a powerful technique with diverse applications in intraoperative settings. Visualization of three dimensional (3D) structures and depth assessment of lesions, however, are oftentimes limited in planar fluorescence imaging systems. In this study, a novel Fluorescence Imaging Topography Scanning (FITS) system has been developed, which offers color reflectance imaging, fluorescence imaging and surface topography scanning capabilities. The system is compact and portable, and thus suitable for deployment in the operating room without disturbing the surgical flow...
2017: PloS One
https://www.readbyqxmd.com/read/28437333/correction-capability-in-the-3-anatomic-planes-of-different-pedicle-screw-designs-in-scoliosis-instrumentation
#11
Xiaoyu Wang, Carl-Eric Aubin, John Coleman, Jeremy Rawlinson
STUDY DESIGN: Computer simulations to compare the correction capabilities of different pedicle screws in adolescent idiopathic scoliosis (AIS) instrumentations. OBJECTIVE: To compare the correction and resulting bone-screw forces associated with different pedicle screws in scoliosis instrumentations. SUMMARY OF BACKGROUND DATA: Pedicle screw fixation is widely used in surgical instrumentation for spinal deformity treatment. Screw design, correction philosophies, and surgical techniques are constantly evolving to achieve better control of the vertebrae and correction of the spinal deformity...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28434885/early-performance-on-an-eye-surgery-simulator-predicts-subsequent-resident-surgical-performance
#12
Ramak Roohipoor, Mehdi Yaseri, Amir Teymourpour, Carolyn Kloek, John B Miller, John I Loewenstein
OBJECTIVE: To examine early performance on an eye surgery simulator and its relationship to subsequent live surgical performance in a single large residency program. DESIGN: Retrospective study. SETTING: Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology. METHODS: In a retrospective study, we compared performance of 30 first-year ophthalmology residents on an eye surgery simulator to their surgical skills as third-year residents...
April 20, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28432489/design-development-and-clinical-validation-of-computer-aided-surgical-simulation-system-for-streamlined-orthognathic-surgical-planning
#13
REVIEW
Peng Yuan, Huaming Mai, Jianfu Li, Dennis Chun-Yu Ho, Yingying Lai, Siting Liu, Daeseung Kim, Zixiang Xiong, David M Alfi, John F Teichgraeber, Jaime Gateno, James J Xia
PURPOSE: There are many proven problems associated with traditional surgical planning methods for orthognathic surgery. To address these problems, we developed a computer-aided surgical simulation (CASS) system, the AnatomicAligner, to plan orthognathic surgery following our streamlined clinical protocol. METHODS: The system includes six modules: image segmentation and three-dimensional (3D) reconstruction, registration and reorientation of models to neutral head posture, 3D cephalometric analysis, virtual osteotomy, surgical simulation, and surgical splint generation...
April 21, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28431561/the-evaluation-of-the-role-of-medial-collateral-ligament-maintaining-knee-stability-by-a-finite-element-analysis
#14
Dong Ren, Yueju Liu, Xianchao Zhang, Zhaohui Song, Jian Lu, Pengcheng Wang
BACKGROUND: A three-dimensional finite element model (FEM) of the knee joint was established to analyze the biomechanical functions of the superficial and deep medial collateral ligaments (MCLs) of knee joints and to investigate the treatment of the knee medial collateral ligament injury. METHODS: The right knee joint of a healthy male volunteer was subjected to CT and MRI scans in the extended position. The scanned data were imported into MIMICS, Geomagic, and ANSYS software to establish a three-dimensional FEM of the human knee joint...
April 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28430115/a-systematic-review-of-3-d-printing-in-cardiovascular-and-cerebrovascular-diseases
#15
Zhonghua Sun, Shen Yuan Lee
OBJECTIVE: The application of 3-D printing has been increasingly used in medicine, with research showing many applications in cardiovascular disease. This systematic review analyzes those studies published about the applications of 3-D printed, patient-specific models in cardiovascular and cerebrovascular diseases. METHODS: A search of PubMed/Medline and Scopus databases was performed to identify studies investigating the 3-D printing in cardiovascular and cerebrovascular diseases...
April 10, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28429161/on-the-in-vivo-function-of-the-mitral-heart-valve-leaflet-insights-into-tissue-interstitial-cell-biomechanical-coupling
#16
Chung-Hao Lee, Will Zhang, Kristen Feaver, Robert C Gorman, Joseph H Gorman, Michael S Sacks
There continues to be a critical need for developing data-informed computational modeling techniques that enable systematic evaluations of mitral valve (MV) function. This is important for a better understanding of MV organ-level biomechanical performance, in vivo functional tissue stresses, and the biosynthetic responses of MV interstitial cells (MVICs) in the normal, pathophysiological, and surgically repaired states. In the present study, we utilized extant ovine MV population-averaged 3D fiducial marker data to quantify the MV anterior leaflet (MVAL) deformations in various kinematic states...
April 20, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28425116/dynamic-probability-control-limits-for-risk-adjusted-cusum-charts-based-on-multiresponses
#17
Xiang Zhang, Justin B Loda, William H Woodall
For a patient who has survived a surgery, there could be several levels of recovery. Thus, it is reasonable to consider more than two outcomes when monitoring surgical outcome quality. The risk-adjusted cumulative sum (CUSUM) chart based on multiresponses has been developed for monitoring a surgical process with three or more outcomes. However, there is a significant effect of varying risk distributions on the in-control performance of the chart when constant control limits are applied. To overcome this disadvantage, we apply the dynamic probability control limits to the risk-adjusted CUSUM charts for multiresponses...
April 19, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28421140/comparison-of-corneal-power-and-astigmatism-between-simulated-keratometry-true-net-power-and-total-corneal-refractive-power-before-and-after-smile-surgery
#18
Yishan Qian, Yan Liu, Xingtao Zhou, Rajeev Krishnan Naidu
Purpose. To compare the mean corneal power (Km) and total astigmatism (Ka) estimated by three methods: simulated keratometry (simK), true net power (TNP), and total corneal refractive power (TCRP) before and after femtosecond laser small incision lenticule extraction (SMILE) surgery. Methods. A retrospective, cross-sectional study. SimK, TNP, and TCRP from a Scheimpflug analyzer were obtained from 144 patients before and 6 months after SMILE surgery. Km and Ka were recorded as the mean of individual paracentral rings of 1...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28420248/creating-an-optimal-3d-printed-model-for-temporal-bone-dissection-training
#19
Kuniyuki Takahashi, Yuka Morita, Shinsuke Ohshima, Shuji Izumi, Yamato Kubota, Yutaka Yamamoto, Sugata Takahashi, Arata Horii
OBJECTIVE: Making a 3-dimensional (3D) temporal bone model is simple using a plaster powder bed and an inkjet printer. However, it is difficult to reproduce air-containing spaces and precise middle ear structures. The objective of this study was to overcome these problems and create a temporal bone model that would be useful both as a training tool and for preoperative simulation. METHODS: Drainage holes were made to remove excess materials from air-containing spaces, ossicle ligaments were manually changed to bony structures, and small and/or soft tissue structures were colored differently while designing the 3D models...
April 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28419189/propensity-scores-with-misclassified-treatment-assignment-a-likelihood-based-adjustment
#20
Danielle Braun, Malka Gorfine, Giovanni Parmigiani, Nils D Arvold, Francesca Dominici, Corwin Zigler
Propensity score methods are widely used in comparative effectiveness research using claims data. In this context, the inaccuracy of procedural or billing codes in claims data frequently misclassifies patients into treatment groups, that is, the treatment assignment ($T$) is often measured with error. In the context of a validation data where treatment assignment is accurate, we show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis: (i) propensity score estimation; (ii) propensity score implementation; and (iii) outcome analysis conducted conditional on the estimated propensity score and its implementation...
April 17, 2017: Biostatistics
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