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Surgical training

Samuel D Clark, Rachel Mikofsky, Jacqueline Lawson, David Sulzer
Multiphoton microscopy has been widely adapted for imaging neurons in vivo. Repeated imaging requires implantation of a cranial window or repeated thinning of the skull. Cranial window surgery is typically performed with a high speed rotary drill, and many investigators find it challenging to prevent the drill from damaging the delicate dura and blood vessels. Extensive training and practice is required to remove the bone without damage to underlying tissue and thus cranial window surgery can be difficult, time consuming, and produce tissue damage...
March 2, 2018: Journal of Visualized Experiments: JoVE
Miki Dalmau-Pastor, Jordi Vega, Francesc Malagelada, Fernando Peña, Maria Cristina Manzanares-Céspedes
The growing popularity of minimally invasive surgical (MIS) procedures makes it necessary that new anatomical references arise, to aid in tridimensional orientation and localization of structures that are not directly visible to the surgeon. This is especially critical for structures at risk like nerves or blood vessels. Optimization of the handling of cadaveric material and the combination of multiple techniques compensate for the limited availability of adequate specimens. The described protocol combines anatomical plane-by-plane dissection and sectional anatomy of fresh-frozen specimens to help localize relevant structures, such as nerves, arteries, veins and to correctly position the portals during MIS procedures...
February 17, 2018: Journal of Visualized Experiments: JoVE
Geoffrey S Meltzner, James T Heaton, Yunbin Deng, Gianluca De Luca, Serge H Roy, Joshua C Kline
Each year thousands of individuals require surgical removal of their larynx (voice box) due to trauma or disease, and thereby require an alternative voice source or assistive device to verbally communicate. Although natural voice is lost after laryngectomy, most muscles controlling speech articulation remain intact. Surface electromyographic (sEMG) activity of speech musculature can be recorded from the neck and face, and used for automatic speech recognition to provide speech-to-text or synthesized speech as an alternative means of communication...
December 2017: IEEE/ACM Transactions on Audio, Speech, and Language Processing
Sriram Garudeswaran, Sohyung Cho, Ikechukwu Ohu, Ali K Panahi
Recent technological progress offers the opportunity to significantly transform conventional open surgical procedures in ways that allow minimally invasive surgery (MIS) to be accomplished by specific operative instruments' entry into the body through key-sized holes rather than large incisions. Although MIS offers an opportunity for less trauma and quicker recovery, thereby reducing length of hospital stay and attendant costs, the complex nature of this procedure makes it difficult to master, not least because of the limited work area and constricted degree of freedom...
2018: Minimally Invasive Surgery
Cheryl I Anderson, Marc D Basson, Muhammad Ali, Alan T Davis, Robert L Osmer, Michael K McLeod, Pam S Haan, Robert G Molnar, Andi N Peshkepija, John C Hardaway, Karen A Chojnacki, Christopher C Pfeifer, Jeffrey M Gauvin, Mark W Jones, M Ashraf Mansour
BACKGROUND: It is increasingly important for faculty to teach deliberately and provide timely, detailed and formative feedback on surgical trainee performance. We initiated a multicenter study to improve resident evaluative processes and enhance teaching and learning behaviors while engaging residents in their education. METHODS: Faculty from seven U.S. postgraduate training programs rated resident operative performances using the perioperative briefing, intraoperative teaching, debriefing model (BID) and rated patient visits/academic performances using the entrustable professional activities (EPAs) model via a web-based platform...
March 15, 2018: Journal of the American College of Surgeons
Sevgi Buyukbese Sarsu, Aydin Budeyri
INTRODUCTION: Previously, the majority of wars were fought on remote battlefields between opposing armies due to conflicts preventing civilians from sustaining war-related burn injuries (WRBI). In recent years, WRBI has had a tremendous harmful impact on the pediatric population. This study aimed to investigate the demographics, causes, mechanisms of burns, surgical procedures, the major and minor risk factors affecting mortality, and outcomes of pediatric WRBI amidst the Syrian refugees and the Turkey neighborhood population, treated at our Burn Center...
March 15, 2018: Burns: Journal of the International Society for Burn Injuries
Eric Chung, Run Wang, David Ralph, Laurence Levine, Gerald Brock
BACKGROUND: Despite published guidelines on Peyronie's disease (PD), there are limited data on actual surgical practice among surgeons. AIM: To evaluate the surgical practice patterns in PD among surgeons from different continents and members of various sexual medicine societies. METHODS: An anonymous survey on various pre-, intra-, and postoperative aspects of PD surgical care was distributed in printed format during International Society of Sexual Medicine meetings and as an online survey to International Society of Sexual Medicine members...
March 14, 2018: Journal of Sexual Medicine
Katherine Rotker, Sarah Iosifescu, Grayson Baird, Simone Thavaseelan, Kathleen Hwang
OBJECTIVE: To examine surgical case volume characteristics in certifying urologists to evaluate practice patterns, given the long-standing understanding but unproven hypothesis that non-fellowship trained female general urologists perform more urogynecologic procedures compared to their equally trained male counterparts. MATERIALS AND METHODS: Case log data from certifying and recertifying urologists from 2000 to 2015 was obtained from the American Board of Urology (ABU)...
March 14, 2018: Urology
Aneeq Zia, Irfan Essa
PURPOSE: Manual feedback in basic robot-assisted minimally invasive surgery (RMIS) training can consume a significant amount of time from expert surgeons' schedule and is prone to subjectivity. In this paper, we explore the usage of different holistic features for automated skill assessment using only robot kinematic data and propose a weighted feature fusion technique for improving score prediction performance. Moreover, we also propose a method for generating 'task highlights' which can give surgeons a more directed feedback regarding which segments had the most effect on the final skill score...
March 16, 2018: International Journal of Computer Assisted Radiology and Surgery
Angelena Crown, Nicketti Handy, Flavio G Rocha, Janie W Grumley
INTRODUCTION: Oncoplastic breast conserving surgery (BCS) can enhance both cosmetic and oncologic breast cancer outcomes. This study evaluates the outcomes and complications associated with oncoplastic reduction mammaplasty performed by surgical breast oncologists. METHODS: A single institution retrospective chart review of patients undergoing oncoplastic reduction mammaplasty by a surgical breast oncologist for the treatment of breast cancer. RESULTS: Seventy-one patients were identified...
February 28, 2018: American Journal of Surgery
Joseph D Tobias
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation...
April 2018: Seminars in Pediatric Surgery
Nadine Oppermann, Jürgen Weitz, Christoph Reißfelder, Sören Torge Mees
In Germany, medical students in their final year will work in hospitals or medical offices to gain clinical experience. The final year is designed to prepare medical students for their work as junior doctors. It is divided into three parts and includes internal medicine and general surgery as mandatory parts. Many students develop enthusiasm or lack of enthusiasm while working in specific disciplines and often apply for jobs based on their experience in their final year. Despite the importance of this educational phase, the 36 medical faculties have implemented several different curricula and there is significant heterogeneity...
March 16, 2018: Zentralblatt Für Chirurgie
Michael J Ingargiola, Felipe Molina Burbano, Amy Yao, Saba Motakef, Paymon Sanati-Mehrizy, Nikki M Burish, Lisa R David, Peter J Taub
Background: The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the ACGME highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. Objectives: The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States...
March 14, 2018: Aesthetic Surgery Journal
Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Kimberly A Bagley, Sarah E Dunn, Eliseu Y Chuang, Victoria J Dorr, Julie A Thompson, Sophia K Smith
BACKGROUND: A community hospital combined its medical and surgical patients with cancer on one unit, which resulted in nurses not trained in oncology caring for this patient population. OBJECTIVES: The Oncology Intensives Initiative (ONCii) involved the (a) design and implementation of a daylong didactic boot camp class and a four-hour simulation session and (b) the examination of nurses' worries, attitudes, self-efficacy, and perception of interdisciplinary teamwork...
April 1, 2018: Clinical Journal of Oncology Nursing
Eugène Zoumenou, Martin Chobli, Bernard le Polain de Waroux, Philippe Louis Baele
Belgium has been collaborating for 20 years with Abomey-Calavi University in Cotonou, Republic of Benin, to train anesthesiologists for Sub-Saharan, French-speaking African countries. With 123 graduates from 15 countries and 46 residents still in training, this program has succeeded in reversing the trend of a decreasing anesthesiology workforce in those countries, thus improving the quality of anesthesia and patient safety. Belgian government sources, as well as hospitals and anesthesia teams, provided most of the financial resources...
April 2018: Anesthesia and Analgesia
Fauzia A Khan, Alan F Merry
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries...
April 2018: Anesthesia and Analgesia
Laurent Mathieu, Michel Levadoux, Emmanuel Soucany de Landevoisin, Tarun J McBride Windsor, Sylvain Rigal
INTRODUCTION: Noncombat-related hand injuries are common in current theatres of operations. Crushing is one of the most frequent mechanisms that may cause traumatic amputations of digits. In the military setting, management of these digital amputations is challenging regarding limitation in microsurgical means in medical treatment facilities and aeromedical evacuation delays out of the combat zone. METHODS: Two cases of digital replantation performed in French forward surgical units are described...
2018: SICOT-J
Alexander H Tuttle, Mark J Molinaro, Jasmine F Jethwa, Susana G Sotocinal, Juan C Prieto, Martin A Styner, Jeffrey S Mogil, Mark J Zylka
Grimace scales quantify characteristic facial expressions associated with spontaneous pain in rodents and other mammals. However, these scales have not been widely adopted largely because of the time and effort required for highly trained humans to manually score the images. Convoluted neural networks were recently developed that distinguish individual humans and objects in images. Here, we trained one of these networks, the InceptionV3 convolutional neural net, with a large set of human-scored mouse images...
January 2018: Molecular Pain
P Stefan, M Pfandler, P Wucherer, S Habert, J Fürmetz, S Weidert, E Euler, U Eck, M Lazarovici, M Weigl, N Navab
Surgical simulators are being increasingly used as an attractive alternative to clinical training in addition to conventional animal models and human specimens. Typically, surgical simulation technology is designed for the purpose of teaching technical surgical skills (so-called task trainers). Simulator training in surgery is therefore in general limited to the individual training of the surgeon and disregards the participation of the rest of the surgical team. The objective of the project Assessment and Training of Medical Experts based on Objective Standards (ATMEOS) is to develop an immersive simulated operating room environment that enables the training and assessment of multidisciplinary surgical teams under various conditions...
March 15, 2018: Der Unfallchirurg
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