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Simulation in surgery

Cecilia Nilsson, Jette Led Sorensen, Lars Konge, Mikkel Westen, Morten Stadeager, Bent Ottesen, Flemming Bjerrum
BACKGROUND: Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. MATERIALS AND METHODS: A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group)...
October 21, 2016: Surgical Endoscopy
Ahmed Almashrafi, Laura Vanderbloemen
BACKGROUND: Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. METHODS: This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department...
October 21, 2016: BMC Medical Informatics and Decision Making
Emmanuel Mandonnet, Juan Martino, Silvio Sarubbo, Francesco Corrivetti, Schahraed Bouazza, Damien Bresson, Hugues Duffau, Sebastien Froelich
BACKGROUND: Advances in the oncological and functional results of insular surgery have been reported recently. Such successes have been made possible by the advent of the transopercular approach under awake monitoring and by the improved anatomical and functional knowledge of the white matter pathways surrounding the insula. Nonetheless, given the rarity of insular tumors, it is difficult to get familiar with the complex 3D anatomy of the different neuronal and vascular structures encountered during a transopercular insular resection...
October 17, 2016: World Neurosurgery
Hsueh-Yu Li, Yu-Lun Lo, Chao-Jan Wang, Li-Jen Hsin, Wan-Ni Lin, Tuan-Jen Fang, Li-Ang Lee
Surgical success for obstructive sleep apnea (OSA) depends on identifying sites of obstruction in the upper airway. In this study, we investigated sites of obstruction by evaluating dynamic changes in the upper airway using drug-induced sleep computed tomography (DI-SCT) in patients with OSA. Thirty-five adult patients with OSA were prospectively enrolled. Sleep was induced with propofol under light sedation (bispectral index 70-75), and low-dose 320-detector row CT was performed for 10 seconds over a span of 2-3 respiratory cycles with supporting a continuous positive airway pressure model...
October 20, 2016: Scientific Reports
Mark W Scerbo, Rebecca C Britt, Dimitrios Stefanidis
INTRO: The mental workload associated with laparoscopic suturing can be assessed with a secondary task that requires the same visual-spatial attentional resources. The purpose of this study was to use a secondary task to measure the incremental workload demands of single-incision laparoscopic surgery (SILS) procedures versus traditional laparoscopic procedures. METHOD: 12 surgery residents and surgical assistants who had met FLS criteria on an FLS and SILS simulator performed one trial each of peg transfer, cutting, and intracorporeal suturing tasks simultaneously with the secondary task and provided subjective workload ratings using the NASA-TLX...
October 8, 2016: American Journal of Surgery
Sergei Kurenov, Juan Cendan, Saleh Dindar, Kristopher Attwood, James Hassett, Ruth Nawotniak, Gregory Cherr, William G Cance, Jörg Peters
OBJECTIVE: The study assesses user acceptance and effectiveness of a surgeon-authored virtual reality (VR) training module authored by surgeons using the Toolkit for Illustration of Procedures in Surgery (TIPS). METHODS: Laparoscopic adrenalectomy was selected to test the TIPS framework on an unusual and complex procedure. No commercial simulation module exists to teach this procedure. A specialist surgeon authored the module, including force-feedback interactive simulation, and designed a quiz to test knowledge of the key procedural steps...
October 6, 2016: Surgical Innovation
Ben Horsburgh, Mike Higgins
Purpose - To quantify through environmental audit the radiation dose urologists receive during surgery in the lithotomy position, and quantify the dose reduction achieved by altering techniques. Materials and Methods - Simulated surgery in the lithotomy position using an anthropomorphic phantom as a patient and a SimMan mannequin as the surgeon. Pulsed fluoroscopy, focus to skin distance, collimation and lead shielding at the table end were individually and collectively introduced following a control study...
October 19, 2016: Journal of Endourology
Narges Shayesteh Moghaddam, Ahmadreza Jahadakbar, Amirhesam Amerinatanzi, Mohammad Elahinia, Michael Miller, David Dean
: The aim of this study is to investigate the behavior of the healthy mandible under maximum molar bite force to demonstrate the problems associated with the current standard of care procedures for mandibular segmental defect reconstruction (ie, use of Ti-6Al-4V hardware and either a single- or double-barrel fibular graft). With current Ti-6Al-4V mandibular reconstruction hardware, there is a significant stiffness mismatch among the hardware, graft, and the remaining host anatomy. How the distribution of mechanical forces through the mandible is altered after a segmental bone loss and reconstruction is incompletely understood...
September 2016: Plastic and Reconstructive Surgery. Global Open
Yuki Mawatari, Mikiko Fukushima
PURPOSE: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection. METHODS: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller's muscle complex (levator resection). Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop(®)). Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery...
2016: Clinical Ophthalmology
Wei Yu, Wei Hu, Yongjie Shui, Xiaoyang Zhu, Chao Li, Xiaoqiu Ren, Xueli Bai, Risheng Yu, Li Shen, Tingbo Liang, Lei Zheng, Qichun Wei
OBJECTIVES: To explore the areas at highest risk for postoperative pancreatic cancer local recurrence according to the spatial location of local failures, with the aim to provide a precise target volume for pancreatic cancer adjuvant radiotherapy. METHODS: Patients with pancreatic cancer who had undergone surgery for the primary tumor in pancreas at our institution from January 2010 to August 2015 were retrospectively analyzed. All local recurrences were plotted on the computed tomography (CT) image of a representative patient according to their relative coordinates to superior mesenteric artery (SMA) or celiac axis (CA)...
October 19, 2016: Radiation Oncology
Christopher M Runyan, Vishal Sharma, David A Staffenberg, Jamie P Levine, Lawrence E Brecht, Leonard H Wexler, David L Hirsch
BACKGROUND: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. METHODS: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality...
October 14, 2016: Journal of Craniofacial Surgery
Harsh Pipalia, Praveen Ganesh, Samarth Shetty, Paul C Salins, Rohan Raut, Kiran Kumar Boyina
Three-dimensional virtual surgery programs are widely available for orthognathic surgery. The advent of imaging software programs has proved to be useful for diagnosis, treatment planning, outcome measurement, and three-dimensional surgical simulation. Complex maxillofacial malformations continue to present challenges in analysis and correction beyond modern technology. Orthomorphic correction for mandibular dysmorphology refers to basal bone movement without any change in dental component. The purpose of this paper is to present a virtual surgery planning for surgeons to perform the orthomorphic surgery with precision and quantification...
October 14, 2016: Journal of Craniofacial Surgery
Viktor Feldman, Meir Nyska, Niv Marom, Omer Slavin, Yaron S Brin, Uri Farkash, Ezequiel Palmanovich
BACKGROUND: This study was designed to measure transverse forces between the 1st and 2nd metatarsals after reducing the intermetatarsal angle (IMA) in normal and hallux valgus (HV) feet, during non weight-bearing and weight-bearing phases of gait. METHODS: Four cadaver feet, three normal and one with hallux valgus, were used. A new suture button device (CyclaPlex™) composed of screw-type buttons connected with a wire was implanted at the mid-shaft of the 1st and 2nd metatarsals of all the feet...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Hideyuki Suenaga, Asako Taniguchi, Kazumichi Yonenaga, Kazuto Hoshi, Tsuyoshi Takato
INTRODUCTION: Computer-assisted preoperative simulation surgery is employed to plan and interact with the 3D images during the orthognathic procedure. It is useful for positioning and fixation of maxilla by a plate. We report a case of maxillary retrusion by a bilateral cleft lip and palate, in which a 2-stage orthognathic procedure (maxillary advancement by distraction technique and mandibular setback surgery) was performed following a computer-assisted preoperative simulation planning to achieve the positioning and fixation of the plate...
October 4, 2016: International Journal of Surgery Case Reports
Wendong Huang, Yongfei Yang, Zhi Zeng, Meiling Su, Qi Gao, Banghao Zhu
Salvia miltiorrhiza and ligustrazine are traditional Chinese medicines that have been used in combination for treatment of cardiovascular disease, including coronary heart disease, cardiac angina and atherosclerosis in Asia, in particular, China. The present study aimed to determine the effect of S. miltiorrhiza and ligustrazine injection (SLI) on myocardial ischemia/reperfusion (I/R) and hypoxia/reoxygenation (H/R) injuries via the Akt serine/threonine kinase (Akt)‑endothelial nitric oxide synthase (eNOS) signaling pathway...
October 11, 2016: Molecular Medicine Reports
Jody M Kaban, Anand Dayama, Srinivas H Reddy, Sheldon Teperman, Melvin E Stone
OBJECTIVE: Our institution began Advanced Trauma Operative Management (ATOM) simulation course in 2007 for senior residents with the aim of increasing opportunities for surgical trainees to gain operative trauma experience. The aim of our study was to evaluate the effect of the ATOM simulation course on residents' choice of trauma as a career as demonstrated by entrance into surgical critical care (SCC) fellowships. DESIGN: Retrospective study of institutional data on graduating residents from 2002 to 2015...
October 11, 2016: International Journal of Surgery
Yan-Lin Liu, Guo-Yang Li, Ping He, Ze-Qi Mao, Yanping Cao
Determining the mechanical properties of brain tissues is essential in such cases as the surgery planning and surgical training using virtual reality based simulators, trauma research and the diagnosis of some diseases that alter the elastic properties of brain tissues. Here, we suggest a protocol to measure the temperature-dependent elastic properties of brain tissues in physiological saline using the shear wave elastography method. Experiments have been conducted on six porcine brains. Our results show that the shear moduli of brain tissues decrease approximately linearly with a slope of -0...
September 21, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Jacques Vermeulen
PURPOSE: To investigate the difference in accuracy between freehand and guided single-implant placement in situations with one or more missing teeth as performed by experienced surgeons. MATERIALS AND METHODS: A total of 80 implants were placed by 10 experienced clinicians in the anterior site of maxillary models, made of polyamide by selective laser sintering and mounted in a dummy head. Each clinician performed the same four single-implant cases via freehand surgery and then with a three-dimensional fabricated SIMPLANT Guide...
October 14, 2016: International Journal of Oral & Maxillofacial Implants
Jennifer Weller, Ian Civil, Jane Torrie, David Cumin, Alexander Garden, Arden Corter, Alan Merry
AIM: Unintended patient harm is a major contributor to poor outcomes for surgical patients and often reflects failures in teamwork. To address this we developed a Multidisciplinary Operating Room Simulation (MORSim) intervention to improve teamwork in the operating room (OR) and piloted it with 20 OR teams in two of the 20 District Health Boards in New Zealand prior to national implementation. In this study, we describe the experience of those exposed to the intervention, challenges to implementing changes in clinical practice and suggestions for successful implementation of the programme at a regional or national level...
October 14, 2016: New Zealand Medical Journal
K K Ganina, Yu L Dugina, E S Zhavbert, I A Ertuzun, O I Epshtein, V N Mukhin, I N Abdurasulova
AIM: On amnesia models induced by (icv) injection of β-amyloid fragment 25-35 peptide were evaluated antiamnestic actitity. MATERIAL AND METHODS: It was used of active antibody preparations (RA AT) to protein S100 (tenoten), to eNOS (impaza) and combinations (divaza) antiamnestic activity behavioral tests novel object conditioned response passive avoidance. RESULTS: Under the influence of RA AT S100 observed recovery of violation of the β-amyloid short-term memory (1 hour after the initial presentation of objects), and RA AT eNOS were more effective when tested 24 hours later...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
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