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Neurosurgical Simulation

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https://www.readbyqxmd.com/read/29337170/virtual-cerebral-aneurysm-clipping-with-real-time-haptic-force-feedback-in-neurosurgical-education
#1
Matthias Gmeiner, Johannes Dirnberger, Wolfgang Fenz, Maria Gollwitzer, Gabriele Wurm, Johannes Trenkler, Andreas Gruber
OBJECTIVE: Realistic, safe and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education and should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force-feedback and real-time deformation of the aneurysm and vessels. METHODS: A prototype simulator was developed from 2012-2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software and the prototype was evaluated by 18 neurosurgeons...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325962/systematic-review-of-factors-influencing-surgical-performance-practical-recommendations-for-microsurgical-procedures-in-neurosurgery
#2
Evgenii Belykh, Naomi R Onaka, Iraklii T Abramov, Kaan Yağmurlu, Vadim A Byvaltsev, Robert F Spetzler, Peter Nakaji, Mark C Preul
BACKGROUND: Microneurosurgical techniques involve complex manual skills and hand-eye coordination that require substantial training. Many factors affect microneurosurgical skills. The goal of this study was to use a systematic evidence-based approach to analyze the quality of evidence for intrinsic and extrinsic factors that influence microneurosurgical performance and to make weighted practical recommendations. MATERIALS AND METHODS: A literature search of factors that may impact microsurgical performance was conducted using PubMed and Embase...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29249540/a-morphometric-and-analytical-cadaver-dissection-study-of-a-tumor-simulation-balloon-model
#3
Baran Bozkurt, Evgenii Belykh, Kaan Yağmurlu, Abhishek Agrawal, Steve W Chang, Michael S Staren, Robert F Spetzler, Joseph M Zabramski, Mark C Preul
We quantified the effects on anatomical cadaver dissection of a balloon-inflation tumor model positioned in the parasellar region and approached through an orbitozygomatic (OZ) craniotomy. A modified supraorbital OZ was performed bilaterally on 5 silicon-injected cadaver heads. Ten predetermined anatomical points assigned using a frameless stereotactic device were used to measure the working area of exposure, degree of surgical freedom, and horizontal and vertical angles of attack to specific target points before and after inflation of a balloon catheter mimicking a parasellar tumor...
December 14, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29241171/virtual-reality-surgical-simulation-implications-for-resection-of-intracranial-gliomas
#4
Ayoub Dakson, Murray Hong, David B Clarke
Surgical simulation has the potential to play important roles in surgical training and preoperative planning. The advent of virtual reality (VR) with tactile haptic feedback has revolutionized surgical simulation, creating a novel environment for residents to learn manual skills without compromising patient safety. This concept is particularly relevant in neurosurgical training where the acquired skill set demands performance of technically challenging tasks under pressure and where the consequences of error are significant...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29238645/the-effectiveness-of-bioskills-training-for-simulated-open-lumbar-laminectomy
#5
Barrett S Boody, Brett D Rosenthal, Tyler J Jenkins, Alpesh A Patel, Jason W Savage, Wellington K Hsu
Study Design: Randomized, prospective study within an orthopedic surgery resident program at a large urban academic medical center. Objectives: To develop an inexpensive, user-friendly, and reproducible lumbar laminectomy bioskills training module and evaluation protocol that can be readily implemented into residency training programs to augment the clinical education of orthopedic and neurosurgical physicians-in-training. Methods: Twenty participants comprising senior medical students and orthopedic surgical residents...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29198889/virtual-reality-based-simulators-for-cranial-tumor-surgery-a-systematic-review
#6
REVIEW
Travis Mazur, Tarek R Mansour, Luke Mugge, Azedine Medkour
BACKGROUND: Virtual reality (VR) simulators have become useful tools in various fields of medicine. Prominent uses of VR technologies include assessment of physician skills and for pre-surgical planning. VR has demonstrated effectiveness in multiple surgical specialties, yet its use in the field of neurosurgery remains limited to date. OBJECTIVES: To examine all current literature on VR based simulation for pre-surgical planning and training in cranial tumor surgeries and to assess the quality of these studies...
November 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29184655/editorial-challenges-for-the-usability-of-ar-and-vr-for-clinical-neurosurgical-procedures
#7
EDITORIAL
Sandrine de Ribaupierre, Roy Eagleson
There are a number of challenges that must be faced when trying to develop AR and VR-based Neurosurgical simulators, Surgical Navigation Platforms, and "Smart OR" systems. Trying to simulate an operating room environment and surgical tasks in Augmented and Virtual Reality is a challenge many are attempting to solve, in order to train surgeons or help them operate. What are some of the needs of the surgeon, and what are the challenges encountered (human computer interface, perception, workflow, etc). We discuss these tradeoffs and conclude with critical remarks...
October 2017: Healthcare Technology Letters
https://www.readbyqxmd.com/read/29174238/association-of-hospital-teaching-status-with-neurosurgical-outcomes-an-instrumental-variable-analysis
#8
Kimon Bekelis, Symeon Missios, Shannon Coy, Todd A MacKenzie
BACKGROUND: The interpretation of the results of prior studies on the association of hospital teaching status with surgical outcomes is limited by selection bias. We investigated whether undergoing surgical operations in teaching hospitals is associated with improved outcomes. METHODS: We performed a cohort study of all patients undergoing spine and cranial operations who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2009-2013...
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29170740/tip-design-for-safety-of-steerable-needles-for-robot-controlled-brain-insertion
#9
Craig A Lehocky, Wendy Fellows-Mayle, Johnathan A Engh, Cameron N Riviere
Background: Current practice in neurosurgical needle insertion is limited by the straight trajectories inherent with rigid probes. One technique allowing curvilinear trajectories involves flexible bevel-tipped needles, which bend during insertion due to their asymmetry. In the brain, safety will require avoidance of the sharp tips often used in laboratory studies, in favor of a more rounded profile. Steering performance, on the other hand, requires maximal asymmetry. Design of safe bevel-tipped brain needles thus involves management of this tradeoff by adjusting needle gauge, bevel angle, and fillet (or tip) radius to arrive at a design that is suitably asymmetrical while producing strain, strain rate, and stress below the levels that would damage brain tissue...
2017: Robotic Surgery: Research and Reviews
https://www.readbyqxmd.com/read/29119039/osirix-software-as-a-preoperative-planning-tool-in-cranial-neurosurgery-a-step-by-step-guide-for-neurosurgical-residents
#10
REVIEW
Toma Spiriev, Vladimir Nakov, Lili Laleva, Christo Tzekov
Background: OsiriX (Pixmeo, Switzerland) is an open-source Digital Imaging and Communications in Medicine (DICOM) viewer that is gaining more and more attention in the neurosurgical community because of its user-friendly interface, powerful three-dimensional (3D) volumetric rendering capabilities, and various options for data integration. This paper presents in detail the use of OsiriX software as a preoperative planning tool in cranial neurosurgery. Methods: In January 2013, OsiriX software was introduced into our clinical practice as a preoperative planning tool...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#11
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29106668/usim-a-new-device-and-app-for-case-specific-intraoperative-ultrasound-simulation-and-rehearsal-in-neurosurgery-a-preliminary-study
#12
Alessandro Perin, Francesco Ugo Prada, Michela Moraldo, Andrea Schiappacasse, Tommaso Francesco Galbiati, Enrico Gambatesa, Piergiorgio d'Orio, Nicole Irene Riker, Curzio Basso, Matteo Santoro, Torstein Ragnar Meling, Karl Schaller, Francesco DiMeco
BACKGROUND: Intraoperative ultrasound (iUS) is an excellent aid for neurosurgeons to perform better and safer operations thanks to real time, continuous, and high-quality intraoperative visualization. OBJECTIVE: To develop an innovative training method to teach how to perform iUS in neurosurgery. METHODS: Patients undergoing surgery for different brain or spine lesions were iUS scanned (before opening the dura) in order to arrange a collection of 3-dimensional, US images; this set of data was matched and paired to preoperatively acquired magnetic resonance images in order to create a library of neurosurgical cases to be studied offline for training and rehearsal purposes...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29105281/semi-autonomous-image-guided-brain-tumour-resection-using-an-integrated-robotic-system-a-bench-top-study
#13
Danying Hu, Yuanzheng Gong, Eric J Seibel, Laligam N Sekhar, Blake Hannaford
BACKGROUND: Complete brain tumour resection is an extremely critical factor for patients' survival rate and long-term quality of life. This paper introduces a prototype medical robotic system that aims to automatically detect and clean up brain tumour residues after the removal of tumour bulk through conventional surgery. METHODS: We focus on the development of an integrated surgical robotic system for image-guided robotic brain surgery. The Behavior Tree framework is explored to coordinate cross-platform medical subtasks...
November 3, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29099299/perfusion-based-human-cadaveric-specimen-as-a-simulation-training-model-in-repairing-cerebrospinal-fluid-leaks-during-endoscopic-endonasal-skull-base-surgery
#14
Eisha A Christian, Joshua Bakhsheshian, Ben A Strickland, Vance L Fredrickson, Ian A Buchanan, Martin H Pham, Andrew Cervantes, Michael Minneti, Bozena B Wrobel, Steven Giannotta, Gabriel Zada
OBJECTIVE Competency in endoscopic endonasal approaches (EEAs) to repair high-flow cerebrospinal fluid (CSF) leaks is an essential component of the neurosurgical training process. The objective of this study was to demonstrate the feasibility of a simulation model for EEA repair of anterior skull base CSF leaks. METHODS Human cadaveric specimens were utilized with a perfusion system to simulate a high-flow CSF leak. Neurological surgery residents (postgraduate year 3 or greater) performed a standard EEA to repair a CSF leak using a combination of fat, fascia lata, and pedicled nasoseptal flaps...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28989263/modeling-and-characterization-of-shape-memory-alloy-springs-with-water-cooling-strategy-in-a-neurosurgical-robot
#15
Shing Shin Cheng, Yeongjin Kim, Jaydev P Desai
Since shape memory alloy (SMA) has high power density and is magnetic resonance imaging (MRI) compatible, it has been chosen as the actuator for the meso-scale minimally invasive neurosurgical intracranial robot (MINIR-II) that is envisioned to be operated under continuous MRI guidance. We have devised a water cooling strategy to improve its actuation frequency by threading a silicone tube through the spring coils to form a compact cooling module-integrated actuator. To create active bi-directional motion in each robot joint, we configured the SMA springs in an antagonistic way...
September 2017: Journal of Intelligent Material Systems and Structures
https://www.readbyqxmd.com/read/28985669/establishment-of-next-generation-neurosurgery-research-and-training-laboratory-with-integrated-human-performance-monitoring
#16
Antonio Bernardo
Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28985656/virtual-reality-and-simulation-in-neurosurgical-training
#17
Antonio Bernardo
Recent biotechnological advances, including three-dimensional microscopy and endoscopy, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging, have continued to mold the surgeon-computer relationship. For developing neurosurgeons, such tools can reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills. We explore the current and future roles and application of virtual reality and simulation in neurosurgical training.
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28962033/virtual-reality-tumor-resection-the-force-pyramid-approach
#18
Robin Sawaya, Abdulgadir Bugdadi, Hamed Azarnoush, Alexander Winkler-Schwartz, Fahad E Alotaibi, Khalid Bajunaid, Gmaan A AlZhrani, Ghusn Alsideiri, Abdulrahman J Sabbagh, Rolando F Del Maestro
BACKGROUND: The force pyramid is a novel visual representation allowing spatial delineation of instrument force application during surgical procedures. In this study, the force pyramid concept is employed to create and quantify dominant hand, nondominant hand, and bimanual force pyramids during resection of virtual reality brain tumors. OBJECTIVE: To address 4 questions: Do ergonomics and handedness influence force pyramid structure? What are the differences between dominant and nondominant force pyramids? What is the spatial distribution of forces applied in specific tumor quadrants? What differentiates "expert" and "novice" groups regarding their force pyramids? METHODS: Using a simulated aspirator in the dominant hand and a simulated sucker in the nondominant hand, 6 neurosurgeons and 14 residents resected 8 different tumors using the CAE NeuroVR virtual reality neurosurgical simulation platform (CAE Healthcare, Montréal, Québec and the National Research Council Canada, Boucherville, Québec)...
September 5, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28955599/rapid-intraoperative-histology-of-unprocessed-surgical-specimens-via-fibre-laser-based-stimulated-raman-scattering-microscopy
#19
Daniel A Orringer, Balaji Pandian, Yashar S Niknafs, Todd C Hollon, Julianne Boyle, Spencer Lewis, Mia Garrard, Shawn L Hervey-Jumper, Hugh J L Garton, Cormac O Maher, Jason A Heth, Oren Sagher, D Andrew Wilkinson, Matija Snuderl, Sriram Venneti, Shakti H Ramkissoon, Kathryn A McFadden, Amanda Fisher-Hubbard, Andrew P Lieberman, Timothy D Johnson, X Sunney Xie, Jay K Trautman, Christian W Freudiger, Sandra Camelo-Piragua
Conventional methods for intraoperative histopathologic diagnosis are labour- and time-intensive, and may delay decision-making during brain-tumour surgery. Stimulated Raman scattering (SRS) microscopy, a label-free optical process, has been shown to rapidly detect brain-tumour infiltration in fresh, unprocessed human tissues. Here, we demonstrate the first application of SRS microscopy in the operating room by using a portable fibre-laser-based microscope and unprocessed specimens from 101 neurosurgical patients...
2017: Nature Biomedical Engineering
https://www.readbyqxmd.com/read/28931262/assessment-of-the-interrater-reliability-of-the-congress-of-neurological-surgeons-microanastomosis-assessment-scale
#20
Andrew R Pines, Mohammed S Alghoul, Youssef J Hamade, Mithun G Sattur, Rami James N Aoun, Tariq K Halasa, Chandan Krishna, Samer G Zammar, Najib E El Tecle, Tarek Y El Ahmadieh, Salah G Aoun, Richard W Byrne, James S Harrop, Brian T Ragel, Daniel K Resnick, Russell R Lonser, Nathan R Selden, Bernard R Bendok
BACKGROUND: The potential for simulation-based learning in neurosurgical training has led the Congress of Neurosurgical Surgeons to develop a series of simulation modules. The Northwestern Objective Microanastomosis Assessment Tool (NOMAT) was created as the corresponding assessment tool for the Congress of Neurosurgical Surgeons Microanastomosis Module. The face and construct validity of the NOMAT have been previously established. OBJECTIVE: To further validate the NOMAT by determining its interrater reliability (IRR) between raters of varying levels of microsurgical expertise...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
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