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Simulation in surgery

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https://www.readbyqxmd.com/read/28092136/computational-fluid-dynamic-modeling-of-nose-to-ceiling-head-positioning-for-sphenoid-sinus-irrigation
#1
John R Craig, James N Palmer, Kai Zhao
BACKGROUND: After sinus surgery, patients are commonly instructed to irrigate with saline irrigations with their heads over a sink and noses directed inferiorly (nose-to-floor). Although irrigations can penetrate the sinuses in this head position, no study has assessed whether sphenoid sinus penetration can be improved by irrigating with the nose directed superiorly (nose-to-ceiling). The purpose of this study was to use a validated computational fluid dynamics (CFD) model of sinus irrigations to assess the difference in sphenoid sinus delivery of irrigations after irrigating in a nose-to-floor vs nose-to-ceiling head position...
January 16, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28090509/innovations-in-surgery-simulation-a-review-of-past-current-and-future-techniques
#2
REVIEW
Ido Badash, Karen Burtt, Carlos A Solorzano, Joseph N Carey
As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28090442/can-mri-accurately-detect-pilon-articular-malreduction-a-quantitative-comparison-between-ct-and-3t-mri-bone-models
#3
Shairah Radzi, Constantin Edmond Dlaska, Gary Cowin, Mark Robinson, Jit Pratap, Michael Andreas Schuetz, Sanjay Mishra, Beat Schmutz
BACKGROUND: Pilon fracture reduction is a challenging surgery. Radiographs are commonly used to assess the quality of reduction, but are limited in revealing the remaining bone incongruities. The study aimed to develop a method in quantifying articular malreductions using 3D computed tomography (CT) and magnetic resonance imaging (MRI) models. METHODS: CT and MRI data were acquired using three pairs of human cadaveric ankle specimens. Common tibial pilon fractures were simulated by performing osteotomies to the ankle specimens...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28089607/estimates-of-nasal-airflow-at-the-nasal-cycle-mid-point-improve-the-correlation-between-objective-and-subjective-measures-of-nasal-patency
#4
Courtney Gaberino, John S Rhee, Guilherme J M Garcia
INTRODUCTION: The nasal cycle represents a significant challenge when comparing pre- and post-surgery objective measures of nasal airflow. METHODS: Computational fluid dynamics (CFD) simulations of nasal airflow were conducted in 12 nasal airway obstruction patients showing significant nasal cycling between pre- and post-surgery computed tomography scans. To correct for the nasal cycle, mid-cycle models were created virtually. Subjective scores of nasal patency were obtained via the Nasal Obstruction Symptom Evaluation (NOSE) and unilateral visual analog scale (VAS)...
January 9, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28089473/box-or-virtual-reality-trainer-which-tool-results-in-better-transfer-of-laparoscopic-basic-skills-a-prospective-randomized-trial
#5
Christian Brinkmann, Mathias Fritz, Ulrich Pankratius, Ralf Bahde, Philipp Neumann, Steffen Schlueter, Norbert Senninger, Emile Rijcken
OBJECTIVE: Simulation training improves laparoscopic performance. Laparoscopic basic skills can be learned in simulators as box- or virtual-reality (VR) trainers. However, there is no clear recommendation for either box or VR trainers as the most appropriate tool for the transfer of acquired laparoscopic basic skills into a surgical procedure. DESIGN: Both training tools were compared, using validated and well-established curricula in the acquirement of basic skills, in a prospective randomized trial in a 5-day structured laparoscopic training course...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28089362/clinical-pharmacokinetics-of-oral-levofloxacin-and-sitafloxacin-in%C3%A2-epididymal-tissue
#6
Takuya Sadahira, Koichiro Wada, Kazuro Ikawa, Norifumi Morikawa, Hiroaki Kurahashi, Takashi Yoshioka, Yuichi Ariyoshi, Yasuyuki Kobayashi, Motoo Araki, Ayano Ishii, Masami Watanabe, Shinya Uehara, Toyohiko Watanabe, Yasutomo Nasu
OBJECTIVES: This study aimed to investigate the penetration of fluoroquinolones into human epididymal tissue. METHODS: The penetration of levofloxacin (LVFX) 500 mg or sitafloxacin (STFX) 100 mg into epididymal tissue was examined. Patients with prostate cancer who were referred for orchiectomy were included. LVFX 500 mg (n = 9) or STFX 100 mg (n = 9) was administered orally 1 h before orchiectomy, and 0.5 g of epididymal tissue and blood samples were collected simultaneously during surgery...
January 11, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28089342/a-simulation-based-cognitive-assessment-of-resident-decision-making-during-complex-urinary-catheterization-scenarios
#7
Jay N Nathwani, Katherine E Law, Anna K Witt, R D Ray, S M DiMarco, C M Pugh
BACKGROUND: This study explores general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios. METHODS: 40 residents were presented with two scenarios. Scenario A was a male with traumatic urethral injury and scenario B was a male with complete urinary blockage. Residents verbalized whether they would catheterize the patient and described the workup and management of suspected pathologies. Residents' decision paths were documented and analyzed...
January 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28087244/practice-makes-perfect-correlations-between-prior-experience-in-high-level-athletics-and-robotic-surgical-performance-do-not-persist-after-task-repetition
#8
Kevin Shee, Fady M Ghali, Elias S Hyams
OBJECTIVE: Robotic surgical skill development is central to training in urology as well as in other surgical disciplines. Here, we describe a pilot study assessing the relationships between robotic surgery simulator performance and 3 categories of activities, namely, videogames, musical instruments, and athletics. DESIGN: A questionnaire was administered to preclinical medical students for general demographic information and prior experiences in surgery, videogames, musical instruments, and athletics...
January 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28079687/periocular-amyloidosis-manifesting-as-pseudopemphigoid-treated-with-mitomycin-c
#9
Kaveh Vahdani, Vladimir T Thaller, Giorgio Albanese, Andrew F Dean
PURPOSE: To describe an unusual cicatrizing manifestation of periocular amyloid and the utility of adjuvant antimetabolite therapy. METHODS: This is a case report of a 49-year old woman with progressive bilateral upper lid ptosis, who was found to have bilateral inferior forniceal masses with thickening of the conjunctiva. Conjunctival and eyelid biopsies showed evidence of amyloid deposition. Systemic evaluation did not reveal any evidence of systemic amyloidosis...
January 11, 2017: Cornea
https://www.readbyqxmd.com/read/28079566/retesting-the-hypothesis-of-a-clinical-randomized-controlled-trial-in-a-simulation-environment-to-validate-anesthesia-simulation-in-error-research-the-vaser-study
#10
Alan F Merry, Jacqueline A Hannam, Craig S Webster, Kylie-Ellen Edwards, Jane Torrie, Chris Frampton, Daniel W Wheeler, Arun K Gupta, Ravi P Mahajan, Rachel Evley, Jennifer M Weller
BACKGROUND: Simulation has been used to investigate clinical questions in anesthesia, surgery, and related disciplines, but there are few data demonstrating that results apply to clinical settings. We asked "would results of a simulation-based study justify the same principal conclusions as those of a larger clinical study?" METHODS: We compared results from a randomized controlled trial in a simulated environment involving 80 cases at three centers with those from a randomized controlled trial in a clinical environment involving 1,075 cases...
January 12, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28078822/development-and-testing-of-a-grasper-for-notes-powered-by-variable-stiffness-pneumatic-actuation
#11
Michele Gabrio Antonelli, Pierluigi Beomonte Zobel, Francesco Durante, Fabio Gaj
BACKGROUND: In natural orifice transluminal endoscopic surgery (NOTES) the peritoneal cavity is reached through natural orifices (mouth, rectus and transvaginal duct), by means of little cuttings in the walls of hollow organs. Due to narrow spaces, NOTES needs robotic systems to assure operation/movement precision and patient safety. Variable stiffness actuation (VSA) assures both requirements. METHODS: The authors developed a grasper for NOTES, provided with VSA, to use as an end-effector for snail robot devices...
January 12, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28078461/cost-effectiveness-of-prophylactic-appendectomy-a-markov-model
#12
Karina Newhall, Benjamin Albright, Anna Tosteson, Elissa Ozanne, Thadeus Trus, Philip P Goodney
BACKGROUND: Appendectomy is the most common emergency surgery performed in the USA. Removal of a non-inflamed appendix during unrelated abdominal surgery (prophylactic or incidental appendectomy) can prevent the downstream risks and costs of appendicitis. It is unknown whether such a strategy could be cost saving for the health system. METHODS: We considered hypothetical patient cohorts of varying ages from 18 to 80, undergoing elective laparoscopic abdominal and pelvic procedures...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078455/retention-of-laparoscopic-and-robotic-skills-among-medical-students-a-randomized-controlled-trial
#13
Megan S Orlando, Lauren Thomaier, Melinda G Abernethy, Chi Chiung Grace Chen
BACKGROUND: Although simulation training beneficially contributes to traditional surgical training, there are less objective data on simulation skills retention. OBJECTIVE: To investigate the retention of laparoscopic and robotic skills after simulation training. METHODS: We present the second stage of a randomized single-blinded controlled trial in which 40 simulation-naïve medical students were randomly assigned to practice peg transfer tasks on either laparoscopic (N = 20, Fundamentals of Laparoscopic Surgery, Venture Technologies Inc...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28076623/low-cost-simulator-for-heart-surgery-training
#14
Roberto Rocha E Silva, Artur Lourenção, Maxim Goncharov, Fabio B Jatene
Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28074152/optimal-dosage-of-cefmetazole-for-intraoperative-antimicrobial-prophylaxis-in-patients-undergoing-surgery-for-colorectal-cancer
#15
Atsushi Tomizawa, Takatoshi Nakamura, Toshiaki Komatsu, Hiroshi Inano, Rumiko Kondo, Masahiko Watanabe, Koichiro Atsuda
BACKGROUND: Few studies have reported the dosage of cefmetazole (CMZ) for intraoperative antimicrobial prophylaxis in patients underwent surgery for colorectal cancer. We therefore examined the optimal intraoperative dosage of CMZ according to pharmacokinetic/pharmacodynamic (PK/PD) theory in patients who undergoing surgery for colorectal cancer. METHODS: The study group comprised 23 patients with colorectal cancer who underwent surgery, using CMZ as antimicrobial treatment to prevent postoperative infection...
2017: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/28071714/three-dimensional-surgical-simulation-improves-the-planning-for-correction-of-facial-prognathism-and-asymmetry-a-qualitative-and-quantitative-study
#16
Cheng-Ting Ho, Hsiu-Hsia Lin, Eric J W Liou, Lun-Jou Lo
Traditional planning method for orthognathic surgery has limitations of cephalometric analysis, especially for patients with asymmetry. The aim of this study was to assess surgical plan modification after 3-demensional (3D) simulation. The procedures were to perform traditional surgical planning, construction of 3D model for the initial surgical plan (P1), 3D model of altered surgical plan after simulation (P2), comparison between P1 and P2 models, surgical execution, and postoperative validation using superimposition and root-mean-square difference (RMSD) between postoperative 3D image and P2 simulation model...
January 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28066674/three-dimensional-computed-tomography-bronchography-and-angiography-in-the-preoperative-evaluation-of-thoracoscopic-segmentectomy-and-subsegmentectomy
#17
REVIEW
Wei-Bing Wu, Xin-Feng Xu, Wei Wen, Jing Xu, Quan Zhu, Xiang-Long Pan, Yang Xia, Liang Chen
Thoracoscopic pulmonary segmentectomy is technically meticulous due to the complicated anatomical variations of segmental bronchus and vessels. Currently three dimensional-computed tomography angiography (3D-CTA) could only meet the simple requirements of segmentectomy. Our center developed a software for reconstruction, "deepinsight", which could effectively solve some key technical problems. Preoperative three-dimensional computed tomography bronchography and angiography (3D-CTBA) could reveal the anatomical structures and improve the accuracy of operation...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28064203/predictive-factors-of-gastroduodenal-bleeding-after-postoperative-radiotherapy-in-biliary-tract-cancer
#18
Jieun Lee, Do Hoon Lim, Hee Chul Park, Jeong Il Yu, Dong Wook Choi, Seong Ho Choi, Jin Seok Heo
OBJECTIVE: To identify predictive factors for gastroduodenal bleeding after postoperative radiation therapy in patients with biliary tract cancer. METHODS: We identified 186 patients with biliary tract cancer who completed scheduled postoperative radiation therapy from March 2000 to August 2013. To isolate the effects of radiation on gastroduodenal bleeding, patients with pylorus-preserving pancreaticoduodenectomy, pylorus-resecting pancreaticoduodenectomy or Whipple surgery (n = 67) were excluded from this analysis...
January 6, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28063607/do-great-teams-think-alike-an-examination-of-team-mental-models-and-their-impact-on%C3%A2-team%C3%A2-performance
#19
Aimee K Gardner, Daniel J Scott, Kareem R AbdelFattah
BACKGROUND: Team mental models represent the shared understanding of team members within their relevant environment. Thus, team mental models should have a substantial impact on a team's ability to engage in purposeful and coordinated action. We sought to examine the impact of shared team mental models on team performance and to investigate if team mental models increase over time as teams continue to work together. METHODS: New surgery interns were assigned randomly to 1 of 10 teams...
January 4, 2017: Surgery
https://www.readbyqxmd.com/read/28061038/laparoscopic-partial-nephrectomy-supported-by-training-involving-personalized-silicone-replica-poured-in-three-dimensional-printed-casting-mold
#20
Adam Golab, Tomasz Smektala, Krystian Kaczmarek, Remigiusz Stamirowski, Michal Hrab, Marcin Slojewski
BACKGROUND: Most kidney neoplasms are found incidentally and qualify for nephron-sparing surgery. Laparoscopic approach is beneficial to these patients because of its minimally invasive approach. However, these operations are both difficult and require plenty of experience and extended training. Some stages of the operation are limited by permissible time of transient ischemia. We applied three-dimensional (3D) printing technology to create individual silicone models of kidney to be used for training in laparoscopic procedures before the actual surgeries...
January 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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