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Neurosurgical Simulation

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https://www.readbyqxmd.com/read/29119039/osirix-software-as-a-preoperative-planning-tool-in-cranial-neurosurgery-a-step-by-step-guide-for-neurosurgical-residents
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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.)
https://www.readbyqxmd.com/read/28931258/simulation-based-education-for-endoscopic-third-ventriculostomy-a-comparison-between-virtual-and-physical-training-models
#12
Gerben E Breimer, Faizal A Haji, Vivek Bodani, Melissa S Cunningham, Adriana-Lucia Lopez-Rios, Allan Okrainec, James M Drake
BACKGROUND: The relative educational benefits of virtual reality (VR) and physical simulation models for endoscopic third ventriculostomy (ETV) have not been evaluated "head to head." OBJECTIVE: To compare and identify the relative utility of a physical and VR ETV simulation model for use in neurosurgical training. METHODS: Twenty-three neurosurgical residents and 3 fellows performed an ETV on both a physical and VR simulation model. Trainees rated the models using 5-point Likert scales evaluating the domains of anatomy, instrument handling, procedural content, and the overall fidelity of the simulation...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28927207/surgical-approaches-to-the-temporal-horn-an-anatomic-analysis-of-white-matter-tract-interruption
#13
Paulo A S Kadri, Jean G de Oliveira, Niklaus Krayenbühl, Ugur Türe, Evandro P L de Oliveira, Ossama Al-Mefty, Guilherme C Ribas
BACKGROUND: Surgical access to the temporal horn is necessary to treat tumors and vascular lesions, but is used mainly in patients with mediobasal temporal epilepsy. The surgical approaches to this cavity fall into 3 primary categories: lateral, inferior, and transsylvian. The current neurosurgical literature has underestimated the interruption of involved fiber bundles and the correlated clinical manifestations. OBJECTIVE: To delineate the interruption of fiber bundles during the different approaches to the temporal horn...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28879577/models-and-tissue-mimics-for-brain-shift-simulations
#14
Antonio E Forte, Stefano Galvan, Daniele Dini
Capturing the deformation of human brain during neurosurgical operations is an extremely important task to improve the accuracy or surgical procedure and minimize permanent damage in patients. This study focuses on the development of an accurate numerical model for the prediction of brain shift during surgical procedures and employs a tissue mimic recently developed to capture the complexity of the human tissue. The phantom, made of a composite hydrogel, was designed to reproduce the dynamic mechanical behaviour of the brain tissue in a range of strain rates suitable for surgical procedures...
September 6, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28864400/effects-of-transcranial-direct-current-stimulation-on-neurosurgical-skill-acquisition-a-randomized-controlled-trial
#15
Patrick Ciechanski, Adam Cheng, Steven Lopushinsky, Kent Hecker, Liu Shi Gan, Stefan Lang, Kourosh Zareinia, Adam Kirton
BACKGROUND: Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery required extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure skill proficiency is met. Transcranial direct-current stimulation (tDCS) can enhance motor skill learning but is untested in surgical procedural training. We aimed to determine the effects of tDCS on simulation-based neurosurgical skill acquisition...
August 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28811078/mentoring-models-in-neurosurgical-training-review-of-literature
#16
REVIEW
Taiwo Akhigbe, Ardalan Zolnourian, Diederik Bulters
BACKGROUND: Effective mentoring is an invaluable element in the development of next generation of neurosurgeons. A mentor helps to develop professional core values, technical and non-technical skills, attitudes and disposition required to be qualified and competent neurosurgeon. Giving the invaluable significance of mentoring in neurosurgery, we undertook this literature review to identify mentoring models evaluating its success and relative benefit. METHODS: Literature search identified using MeSH word 'mentor', mentoring, mentorship, mentoring model, neurosurgery' in MEDLINE, EMBASE and Scopus databases from 1990 to 2016...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28765716/simulation-training-in-neurosurgery-advances-in-education-and-practice
#17
REVIEW
Sanjay Konakondla, Reginald Fong, Clemens M Schirmer
The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the "real-life" feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28754068/a-new-head-mounted-display-based-augmented-reality-system-in-neurosurgical-oncology-a-study-on-phantom
#18
Fabrizio Cutolo, Antonio Meola, Marina Carbone, Sara Sinceri, Federico Cagnazzo, Ennio Denaro, Nicola Esposito, Mauro Ferrari, Vincenzo Ferrari
PURPOSE: Benefits of minimally invasive neurosurgery mandate the development of ergonomic paradigms for neuronavigation. Augmented Reality (AR) systems can overcome the shortcomings of commercial neuronavigators. The aim of this work is to apply a novel AR system, based on a head-mounted stereoscopic video see-through display, as an aid in complex neurological lesion targeting. Effectiveness was investigated on a newly designed patient-specific head mannequin featuring an anatomically realistic brain phantom with embedded synthetically created tumors and eloquent areas...
December 2017: Computer Assisted Surgery (Abingdon, England)
https://www.readbyqxmd.com/read/28725549/performance-of-unscented-kalman-filter-tractography-in-edema-analysis-of-the-two-tensor-model
#19
Ruizhi Liao, Lipeng Ning, Zhenrui Chen, Laura Rigolo, Shun Gong, Ofer Pasternak, Alexandra J Golby, Yogesh Rathi, Lauren J O'Donnell
Diffusion MRI tractography is increasingly used in pre-operative neurosurgical planning to visualize critical fiber tracts. However, a major challenge for conventional tractography, especially in patients with brain tumors, is tracing fiber tracts that are affected by vasogenic edema, which increases water content in the tissue and lowers diffusion anisotropy. One strategy for improving fiber tracking is to use a tractography method that is more sensitive than the traditional single-tensor streamline tractography...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28684100/automaticity-of-force-application-during-simulated-brain-tumor-resection-testing-the-fitts-and-posner-model
#20
Abdulgadir Bugdadi, Robin Sawaya, Duaa Olwi, Gmaan Al-Zhrani, Hamed Azarnoush, Abdulrahman Jafar Sabbagh, Ghusn Alsideiri, Khalid Bajunaid, Fahad E Alotaibi, Alexander Winkler-Schwartz, Rolando Del Maestro
OBJECTIVE: The Fitts and Posner model of motor learning hypothesized that with deliberate practice, learners progress through stages to an autonomous phase of motor ability. To test this model, we assessed the automaticity of neurosurgeons, senior residents, and junior residents when operating on 2 identical tumors using the NeuroVR virtual reality simulation platform. DESIGN: Participants resected 9 identical simulated tumors on 2 occasions (total = 18 resections)...
July 3, 2017: Journal of Surgical Education
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