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Simulation in surgery

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https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#1
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28802148/inattentional-blindness-in-anesthesiology-a-simulation-study
#2
Anthony M-H Ho, Joseph Y C Leung, Glenio B Mizubuti, Leeanne H Contardi, Matthew T V Chan, Thomas S F Lo, Alex K T Lee
STUDY OBJECTIVES: Inattentional blindness is the psychological phenomenon of inability to see the unexpected even if it is in plain view. We hypothesized that anesthesiologists may overlook unexpected intraoperative events whereas medical students, lacking in intraoperative monitoring experience and knowledge, may be more likely to notice such events. DESIGN: A simulation study using a video of a simulated septic patient undergoing abdominal surgery. SETTING: A large academic center...
August 9, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28801924/foramen-epiploicum-mesh-closure-femc-through-a-ventral-midline-laparotomy
#3
T van Bergen, A Rötting, P Wiemer, S Schauvliege, K Vanderperren, F Ugahary, A Martens
BACKGROUND: Preventive laparoscopic closure of the epiploic foramen (EF) has previously been described, but methods for EF closure during laparotomy for treatment of colic are lacking. OBJECTIVES: To describe the Foramen Epiploicum Mesh Closure (FEMC) technique through a ventral midline laparotomy in horses under general anaesthesia and its outcome. STUDY DESIGN: Terminal surgical experiment and in vivo study. METHODS: In a pilot study a standard ventral midline laparotomy was performed under general anaesthesia in 10 experimental horses and a three-dimensional expandable diabolo-shaped mesh construct was manually introduced through the EF into the omental vestibule...
August 12, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28801298/-application-of-3d-visualization-technique-in-breast-cancer-surgery-with-immediate-breast-reconstruction-using-laparoscopically-harvested-pedicled-latissimus-dorsi-muscle-flap
#4
Pu-Sheng Zhang, Li-Kun Wang, Yun-Feng Luo, Fu-Jun Shi, Lin-Yun He, Cheng-Bing Zeng, Yu Zhang, Chi-Hua Fang
OBJECTIVE: To study the value of 3D visualization technique in breast-preserving surgery for breast cancer with immediate breast reconstruction using laparoscopically harvested pedicled latissimus dorsi muscle flap. METHODS: From January, 2015 to May, 2016, 30 patients with breast cancer underwent breast-preserving surgery with immediate breast reconstruction using pedicled latissimus dorsi muscle flap. The CT data of the arterial phase and venous phase were collected preoperatively and imported into the self-developed medical image 3D visualization system for image segmentation and 3D reconstruction...
August 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#5
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28797976/physiological-mechanisms-of-water-and-electrolyte-disturbances-following-transsphenoidal-pituitary-surgery
#6
Evan T Blair, John S Clemmer, H Louis Harkey, Robert L Hester, W Andrew Pruett
BACKGROUND: Disturbances in water and electrolyte homeostasis are common following transsphenoidal surgery. These disorders are variable and unpredictable, increasing patient risk and complicating postsurgical treatment. Clinically, it is generally accepted that damage to the pituitary is the etiology, but the mechanisms behind the response variability and underlying pathophysiology remains unknown. OBJECTIVE: To test the hypothesis that changing the degree of damage to the pituitary stalk produces a spectrum of water and electrolyte disturbance along which all presentations of postsurgical water and electrolyte disturbances can be identified...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28796072/one-visualization-simulation-operation-system-for-distal-femoral-fracture
#7
Dan Wang, Ning Li, Ming Luo, Yao-Kun Chen
A computer-aided 3-dimensional (3D) visualization operation simulation system based on computer-aided design (CAD) Unigraphics NX and Mimics software was established to provide orthopedic surgeons with an actual and reliable system in treating of distal femoral fracture.According to the preoperative CT data, 3D reconstruction of the distal femoral fracture could be achieved by the Mimics software. Then, the CAD Unigraphics NX software was used to measure the model function of all the related surgical instruments, including less invasive stabilization system (LISS) and retrograde intramedullary nail fixation...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28793829/methodological-shortcomings-in-the-literature-evaluating-the-role-and-applications-of-3d-training-for-surgical-trainees
#8
Milosz Kostusiak, Michael Hart, Damiano Giuseppe Barone, Riikka Hofmann, Ramez Kirollos, Thomas Santarius, Rikin Trivedi
AIM: There has been an increased interest in the use of three-dimensional (3D) technology in surgical training. We wish to appraise the methodological rigor applied to evaluating the role and applications of 3D technology in surgical training, in particular, on the validity of these models and assessment methods in simulated surgical training. METHODS: Literature search was performed using MEDLINE with the following terms: "3D"; "surgery"; and "training". Only studies evaluating the role of 3D technology in surgical training were eligible for inclusion and assessed for the level of evidence, validity of the simulation model, and assessment method used...
August 9, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28791080/three-dimensional-printing-model-as-a-tool-to-assist-in-surgery-for-large-mandibular-tumour-a-case-report
#9
Kazuyuki Yusa, Hideyuki Yamanochi, Akira Takagi, Mitsuyoshi Iino
OBJECTIVES: Recently, three-dimensional printing models based on preoperative computed tomography and magnetic resonance imaging images have been widely used in medical fields. This study presents an effective use of the three-dimensional printing model in exploring complex spatial relationship between the tumour and surrounding tissue and in simulation surgery based planning of the operative procedure. MATERIAL AND METHODS: The patient was a 7-year-old boy with ameloblastic fibro-odontoma...
April 2017: Journal of Oral & Maxillofacial Research
https://www.readbyqxmd.com/read/28790474/possible-vascular-injury-due-to-screw-eccentricity-in-minimally-invasive-total-hip-arthroplasty
#10
Nishant Kumar Singh, Sanjay Kumar Rai, Amit Rastogi
BACKGROUND: Vascular injury during minimally invasive total hip arthroplasty (THA) is uncommon, yet a well-recognized and serious issue. It emerges because of non-visibility of vascular structures proximal to the pelvic bone during reaming, drilling holes, and fixing of screws. Numerous studies have found that screw fixation during cementless THA is beneficial for the initial stability of cup; yet, no anatomical guidelines support angular eccentric screw fixation. MATERIALS AND METHODS: In this study, we obtained the pelvic arterial-phase computed tomographic data of thirty eight humans and reconstructed the three-dimensional models of osseous and vessel structures...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28782700/effects-of-intertrochanteric-osteotomy-plane-and-pre-operative-femoral-anteversion-on-the-post-operative-morphology-of-the-proximal-femur-in-transtrochanteric-anterior-rotational-osteotomy-3d-ct-based-simulation-study
#11
Kazuhiko Sonoda, Goro Motomura, Satoshi Ikemura, Yusuke Kubo, Takuaki Yamamoto, Yasuharu Nakashima
BACKGROUND: Transtrochanteric anterior rotational osteotomy (ARO) is joint-preserving surgery for patients with osteonecrosis of the femoral head (ONFH).During ARO, femoral neck-shaft varus angulation by changing intertrochanteric osteotomy plane is often designed to obtain a sufficient post-operative intact ratio. However, the effect of intertrochanteric osteotomy plane on post-operative femoral anteversion has not been well examined.Therefore we performed a simulation study of ARO to determinehow intertrochanteric osteotomy plane and pre-operative femoral anteversionaffect both femoral neck-shaft varus angle and post-operative femoral anteversion...
August 3, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28782115/optical-coherence-tomography-image-guided-smart-laser-knife-for-surgery
#12
Nitesh Katta, Austin B McElroy, Arnold D Estrada, Thomas E Milner
BACKGROUND AND OBJECTIVE: Surgical oncology can benefit from specialized tools that enhance imaging and enable precise cutting and removal of tissue without damage to adjacent structures. The combination of high-resolution, fast optical coherence tomography (OCT) co-aligned with a nanosecond pulsed thulium (Tm) laser offers advantages over conventional surgical laser systems. Tm lasers provide superior beam quality, high volumetric tissue removal rates with minimal residual thermal footprint in tissue, enabling a reduction in unwanted damage to delicate adjacent sub-surface structures such as nerves or micro-vessels...
August 7, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28781867/three-dimensional-full-scale-bone-modeling-for-preoperative-simulation-of-surgery-in-patients-with-elbow-contractures-due-to-bone-deformities
#13
Naoshige Nagura, Tomonori Kenmoku, Kenji Onuma, Kensuke Fukushima, Hisako Fujimaki, Naonobu Takahira, Masashi Takaso
It is often difficult to treat for elbow contractures by malformation of bones. We planned a mobilization of elbow with using three-dimensional full-scale bone modeling. We found it was effective to use it in preoperative planning because we could recognize the elements of contractures in every deformity.
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28776686/contralateral-r1-and-r2-components-of-the-laryngeal-adductor-reflex-in-humans-under-general-anesthesia
#14
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan
OBJECTIVES: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc. STUDY DESIGN: Case series. METHODS: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28776178/protocols-for-rat-uterus-isolation-and-decellularization-applications-for-uterus-tissue-engineering-and-3d-cell-culturing
#15
Arvind Manikantan Padma, Tom Tristan Tiemann, Ahmed Baker Alshaikh, Randa Akouri, Min Jong Song, Mats Hellström
Sophisticated culturing conditions are required to grow cells in a three-dimensional (3D) environment. Cells then require a type of scaffold rich in proteins, growth factors, and signaling molecules that simulates their natural environment. Tissues from all species of animals have an organ-specific extracellular matrix (ECM) structure that plays a key role in cell proliferation and migration. Hence, the scaffold composition plays a significant role for any successful 3D cell culturing system. We developed a whole rat uterus ECM scaffold by the perfusion of detergents and ionic solutions through the vascular system of an isolated normal rat uterus in a process termed "decellularization...
August 4, 2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28775383/high-resolution-3-dimensional-imaging-of-the-human-cardiac-conduction-system-from-microanatomy-to-mathematical-modeling
#16
Robert S Stephenson, Andrew Atkinson, Petros Kottas, Filip Perde, Fatemeh Jafarzadeh, Mike Bateman, Paul A Iaizzo, Jichao Zhao, Henggui Zhang, Robert H Anderson, Jonathan C Jarvis, Halina Dobrzynski
Cardiac arrhythmias and conduction disturbances are accompanied by structural remodelling of the specialised cardiomyocytes known collectively as the cardiac conduction system. Here, using contrast enhanced micro-computed tomography, we present, in attitudinally appropriate fashion, the first 3-dimensional representations of the cardiac conduction system within the intact human heart. We show that cardiomyocyte orientation can be extracted from these datasets at spatial resolutions approaching the single cell...
August 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28774433/a-high-resolution-model-for-soft-tissue-deformation-based-on-point-primitives
#17
Yanni Zou, Peter X Liu
BACKGROUND AND OBJECTIVES: In order to achieve a high degree of visual realism in surgery simulation, we propose a new model, which is based on point primitives and continuous elastic mechanics theory, for soft tissue deformation, tearing and/or cutting. METHODS: The model can be described as a two-step local high-resolution strategy. First, appropriate volumetric data are sampled and assigned with proper physical properties. Second, sparsely sampled points in non-deformed regions and densely-sampled points in the deformed zone are selected and evaluated...
September 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28770313/eleven-year-retrospective-report-of-super-selective-venous-sampling-for-the-evaluation-of-recurrent-or-persistent-hyperparathyroidism-in-32-patients
#18
Peiman Habibollahi, Benjamin Shin, Sara P Shamchi, Heather Wachtel, Douglas L Fraker, Scott O Trerotola
PURPOSE: Parathyroid venous sampling (PAVS) is usually reserved for patients with persistent or recurrent hyperparathyroidism after parathyroidectomy with inconclusive noninvasive imaging studies. A retrospective study was performed to evaluate the diagnostic efficacy of super-selective PAVS (SSVS) in patients needing revision neck surgery with inconclusive imaging. MATERIALS AND METHODS: Patients undergoing PAVS between 2005 and 2016 due to persistent or recurrent hyperparathyroidism following surgery were reviewed...
August 2, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28769832/supporting-third-year-medical-students-skill-acquisition-and-self-efficacy-with-coping-models-and-process-feedback-during-laparoscopic-knot-tying-simulation
#19
Michael S Dempsey, Douglas F Kauffman
Background: During the third year general surgery clerkship, medical students are required to develop laparoscopic knot-tying skills. Knot-tying skills studies often rely on objective variables (e.g., time, materials used, number of iterations) that lend themselves to correlational analysis of pre- and post-intervention skill level. This study differs by examining how instructional interventions-role modeling and feedback-affect medical students' skill acquisition and self-efficacy during a laparoscopic surgical simulation training session...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28768919/pediatric-craniovertebral-junction-surgery
#20
Nobuhito Morota
The craniovertebral junction (CVJ) has attracted more attention in pediatric medicine in recent years due to the progress in surgical technologies allowing a direct approach to the CVJ in children. The CVJ is the site of numerous pathologies, most originating in bone anomalies resulting from abnormal CVJ development. Before discussing the surgical approaches to CVJ, three points should be borne in mind: first, that developmental anatomy demonstrates age-dependent mechanisms and the pathophysiology of pediatric CVJ anomalies; second, that CT-based dynamic simulations have improved our knowledge of functional anatomy, enabling us to locate CVJ lesions with greater certainty; and third, understanding the complex structure of the pediatric CVJ also clarifies the surgical anatomy...
August 1, 2017: Neurologia Medico-chirurgica
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