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Simulation in surgery

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https://www.readbyqxmd.com/read/28634632/can-a-virtual-reality-surgical-simulation-training-provide-a-self-driven-and-mentor-free-skills-learning-investigation-of-the-practical-influence-of-the-performance-metrics-from-the-virtual-reality-robotic-surgery-simulator-on-the-skill-learning-and-associated
#1
Gyusung I Lee, Mija R Lee
BACKGROUND: While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system's performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634630/development-and-validation-of-a-tool-for-non-technical-skills-evaluation-in-robotic-surgery-the-icars-system
#2
Nicholas Raison, Thomas Wood, Oliver Brunckhorst, Takashige Abe, Talisa Ross, Ben Challacombe, Mohammed Shamim Khan, Giacomo Novara, Nicolo Buffi, Henk Van Der Poel, Craig McIlhenny, Prokar Dasgupta, Kamran Ahmed
BACKGROUND: Non-technical skills (NTS) are being increasingly recognised as vital for safe surgical practice. Numerous NTS rating systems have been developed to support effective training and assessment. Yet despite the additional challenges posed by robotic surgery, no NTS rating systems have been developed for this unique surgical environment. This study reports the development and validation of the first NTS behavioural rating system for robotic surgery. METHODS: A comprehensive index of all relevant NTS behaviours in robotic surgery was developed through observation of robotic theatre and interviews with robotic surgeons...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28633637/seroma-change-during-magnetic-resonance-imaging-guided-partial-breast-irradiation-and-its-clinical-implications
#3
Seung Hyuck Jeon, Kyung Hwan Shin, So-Yeon Park, Jung-In Kim, Jong Min Park, Jin Ho Kim, Eui Kyu Chie, Hong-Gyun Wu
BACKGROUND: To investigate the patterns of post-lumpectomy seroma volume (SV) change and related clinical factors to determine the benefits of adaptive planning in magnetic resonance imaging (MRI)-guided partial breast irradiation (PBI). METHODS: MRI data obtained from 37 women with early breast cancer acquired at simulation and at the 1st, 6th, and 10th fractions were analyzed. The planning target volume (PTV) was defined as unequal margins of 10-15 mm added according to the directional surgical margin status of each seroma...
June 20, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28630221/retrorectal-tumour-simulating-vaginal-birth-an-exceptional-case-of-emergency-surgery-indication
#4
Eduardo Alvarez-Sarrado, Salvador Pous-Serrano, Omar Carreño Saenz, Jose Pamies-Gilabert
Cystic retrorectal tumours are a very rare entity that pose a problem in differential diagnosis between congenital cyst and other lesions. We present a 49-year-old female patient presenting a perineal bulge which was discovered simulating a vaginal birth associated with prolapsed haemorrhoids grade IV. The interest of this case resides in the surgical indication of a big presacral cyst demonstrated via CT causing acute intense pain due to pelvic organ compression, as no emergent surgery management has been reported up to date...
June 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#5
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28628601/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-telementoring-telediagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#6
Andrew W Kirkpatrick, Jessica L McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather E Wright Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of posttraumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or resuscitative surgery in austere environments. Revolutions in technology for remote mentoring of ultrasound and surgery may enhance capabilities to utilize the skill sets of non-physicians. Thus, our research collaborative explored remote mentoring to empower non-physicians to address junctional and torso hemorrhage control in austere environments...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28623681/soft-tissue-changes-measured-with-three-dimensional-software-provides-new-insights-for-surgical-predictions
#7
Yu-Jen Chang, Antônio C O Ruellas, Marilia S Yatabe, Philip M Westgate, Lucia H S Cevidanes, Sarandeep S Huja
PURPOSE: Although computer-aided craniofacial reconstructions allows for simulation of hard tissue changes, the prediction of the final soft tissue facial changes remains a challenge. The purpose of the present study was to evaluate the 3-dimensional (3D) soft tissue changes in patients undergoing 2-jaw orthognathic surgery. PATIENTS AND METHODS: For the present retrospective cohort study, 40 consecutive patients (11 men and 29 women; mean age 23.5 ± 4.9 years) who had undergone 2-jaw orthognathic surgery were selected...
May 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28623479/fast-calibration-of-electromagnetically-tracked-oblique-viewing-rigid-endoscopes
#8
Xinyang Liu, Christina E Rice, Raj Shekhar
PURPOSE: The oblique-viewing (i.e., angled) rigid endoscope is a commonly used tool in conventional endoscopic surgeries. The relative rotation between its two moveable parts, the telescope and the camera head, creates a rotation offset between the actual and the projection of an object in the camera image. A calibration method tailored to compensate such offset is needed. METHODS: We developed a fast calibration method for oblique-viewing rigid endoscopes suitable for clinical use...
June 16, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28623113/does-robotic-surgical-simulator-performance-correlate-with-surgical-skill
#9
James T Mills, Helen Y Hougen, Daniel Bitner, Tracey L Krupski, Noah S Schenkman
OBJECTIVE: To assess the relationship between robotic surgical simulation performance and the real-life surgical skill of attending surgeons. We hypothesized that simulation performance would not correlate with real-life robotic surgical skill in attending surgeons. DESIGN: In 2013, Birkmeyer et al. demonstrated an association between laparoscopic surgical performance as determined by expert review of video clips and surgical outcomes. Using that model of expert review, we studied the relationship between robotic simulator performance and real-life surgical skill...
June 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28623061/comparison-of-extraosseous-talotarsal-stabilization-implants-in-a-stage-ii-adult-acquired-flatfoot-model-a-finite-element-analysis
#10
Jian Xu, Xin Ma, Daping Wang, Wei Lu, Weimin Zhu, Kan Ouyang, Haifeng Liu, Hao Li, Luoyong Jiang
Subtalar arthroereisis has been proved to be an efficient method for correcting flexible adult flatfoot. However, the optimal sinus tarsi implant is still debated and yet to be determined. In the present study, we compared the biomechanical effects of type I and II sinus tarsi implants in stage II adult-acquired flatfoot deformity (AAFD). First, a finite element model of stage II AAFD was established in which virtual surgery of subtalar arthroereisis was simulated. The indexes of plantar stress distribution, peak von Mises of the medial and lateral columns, strain of the medial ligaments and plantar fascia, arch height, talo-first metatarsal angle, calcaneus pitch angle, talonavicular coverage angle, and hindfoot valgus angle were all compared and analyzed...
June 13, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#11
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28619402/global-health-values-of-a-multidirectional-near-peer-training-program-in-surgery-pathology-anatomy-research-methodology-and-medical-education-for-haitian-rwandan-and-canadian-medical-students
#12
Malik Elharram, Trish Dinh, Annie Lalande, Susan Ge, Sophie Gao, Geoffroy Noël
BACKGROUND: As health care delivery increasingly requires providers to cross international borders, medical students at McGill University, Canada, developed a multidirectional exchange program with Haiti and Rwanda. The program integrates surgery, pathology, anatomy, research methodology, and medical education. OBJECTIVE: The aim of the present study was to explore the global health value of this international training program to improve medical education within the environment of developing countries, such as Haiti and Rwanda, while improving sociocultural learning of Canadian students...
March 2017: Annals of Global Health
https://www.readbyqxmd.com/read/28619021/treatment-of-thoracolumbar-burst-fractures-by-short-segment-pedicle-screw-fixation-using-a-combination-of-two-additional-pedicle-screws-and-vertebroplasty-at-the-level-of-the-fracture-a-finite-element-analysis
#13
Jen-Chung Liao, Weng-Pin Chen, Hao Wang
BACKGROUND: Traditional one-above and one-below four-screw posterior short-segment instrumentation is used for unstable thoracolumbar burst fractures. However, this method has a high rate of implant failure and early loss of reduction. The purpose of this study was to use finite element (FE) analysis to determine the effect of treating thoracolumbar burst fractures by short-segment pedicle screw fixation using a combination of two additional pedicle screws and vertebroplasty at the level of the fracture...
June 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28618097/accuracy-of-navigated-cam-resection-in-femoroacetabular-impingement-a-randomised-controlled-trial
#14
Jan Van Houcke, Vikas Khanduja, Naoki Nakano, Peter Krekel, Christophe Pattyn, Emmanuel Audenaert
BACKGROUND: The main cause for revision hip arthroscopy surgery is incomplete bony resection of femoroacetabular impingement (FAI). This study aimed to compare the cam resection accuracy via the conventional hip arthroscopy technique with the navigation technique. METHODS: Two prospectively randomized groups were recruited: navigated (n = 15) and conventional (n = 14). A pre-operative CT and post-operative MRI scan were obtained in all cases to compare alpha angle, range of motion simulation and determine a pre-operative 3D surgical resection plan...
June 15, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28616609/three-dimensional-computed-tomography-simulation-for-laparoscopic-lymph-node-dissection-in-the-treatment-of-proximal-gastric-cancer
#15
REVIEW
Hideki Sunagawa, Takahiro Kinoshita
Application of laparoscopic surgery (LS) has expanded worldwide in the various fields due to the potential advantage of being less invasive than open surgery; however difficulty in recognizing positional relationship of the organs is one of the disadvantages of this kind of surgery. In order to compensate this drawback, preoperative three-dimensional computed tomography (3D-CT) simulation is regarded as promising. In gastric cancer surgery, 3D-CT simulation seems particularly effective in the splenic hilar dissection, because this region is associated with remarkable anatomical variation with complexity...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28616108/advances-in-basic-science-methodologies-for-clinical-diagnosis-in-female-stress-urinary-incontinence
#16
REVIEW
Marwa Abdulaziz, Emily G Deegan, Alex Kavanagh, Lynn Stothers, Denise Pugash, Andrew Macnab
We provide an overview of advanced imaging techniques currently being explored to gain greater understanding of the complexity of stress urinary incontinence (SUI) through better definition of structural anatomic data. Two methods of imaging and analysis are detailed for SUI with or without prolapse: 1) open magnetic resonance imaging (MRI) with or without the use of reference lines; and 2) 3D reconstruction of the pelvis using MRI. An additional innovative method of assessment includes the use of near infrared spectroscopy (NIRS), which uses non-invasive photonics in a vaginal speculum to objectively evaluate pelvic floor muscle (PFM) function as it relates to SUI pathology...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28615807/soft-embalming-of-cadavers-for-training-purposes-optimising-for-long-term-use-in-tropical-weather
#17
Raghuveer Reddy, Subramania Iyer, Minnie Pillay, Krishnakumar Thankappan, Janarthanan Ramu
BACKGROUND: Surgical and anatomical training has been found to be most optimally simulated in a cadaver than any other available methods. Soft embalming methods have made the bodies more 'lifelike' and better suited for training. The widely accepted soft embalming techniques, including Thiel embalming, are designed for temperate climates. Their use in tropical locations has been found to be associated with poor short-term and long-term preservation of the bodies. In fact, adequate reports from tropical countries on effective methods for soft embalming are lacking...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28615615/stat6-upregulation-promotes-m2-macrophage-polarization-to-suppress-atherosclerosis
#18
Min Gong, Xiaozhen Zhuo, Aiqun Ma
BACKGROUND Macrophages are highly heterogeneous and plastic cells that are involved in all stages of atherogenesis. They can undergo polarization by shifting between M1 and M2 functional phenotypes. However, the role of macrophage polarization and the molecular mechanism in modulating atherosclerotic plaque stability remain incompletely understood. Our study investigated the role of STAT6 in regulating macrophage phenotypes to affect atherosclerotic plaque stability. MATERIAL AND METHODS A murine atherosclerosis model with vulnerable plaques was induced with high-cholesterol diet and PCCP surgeries in ApoE-/- mice...
June 15, 2017: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/28614968/putty-like-bone-fillers-based-on-cap-ceramics-or-biosilicate%C3%A2-combined-with-carboxymethylcellulose-characterization-optimization-and-evaluation
#19
Paulo R Gabbai-Armelin, Ana Cm Renno, Murilo C Crovace, Angela Mp Magri, Edgar D Zanotto, Oscar Peitl, Sander Cg Leeuwenburgh, John A Jansen, Jeroen Jjp van den Beucken
Calcium phosphates and bioactive glass ceramics have been considered promising biomaterials for use in surgeries. However, their moldability should be further enhanced. We here thereby report the handling, physicochemical features, and morphological characteristics of formulations consisting of carboxymethylcellulose-glycerol and hydroxyapatite-tricalcium phosphate or Biosilicate® particles. We hypothesized that combining either material with carboxymethylcellulose-glycerol would improve handling properties, retaining their bioactivity...
January 1, 2017: Journal of Biomaterials Applications
https://www.readbyqxmd.com/read/28614152/superficial-automated-keratopigmentation-for-iris-and-pupil-simulation-using-micronized-mineral-pigments-and-a-new-puncturing-device-experimental-study
#20
Alejandra E Rodriguez, Maria A Amesty, Mohammed El Bahrawy, Severino Rey, Jorge Alio Del Barrio, Jorge L Alio
PURPOSE: To study the outcomes and tolerance of micronized mineral pigments for corneal tattooing, using a superficial automated keratopigmentation (SAK) technique in an experimental animal model and a new puncture device to inject the pigments into the corneal stroma. METHODS: Forty eyes of 40 New Zealand rabbits were included in this study. The animals were divided into groups A and B. Both groups underwent SAK using a new automated keratopigmentation device. Micronized mineral pigments were injected through the epithelium into the corneal stroma to replicate the iris color in 25 eyes (group A), and black color was used to replicate the pupil in 15 eyes (group B)...
June 13, 2017: Cornea
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