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surgical skills

Bradley Genovese, Steven Yin, Sohail Sareh, Michael DeVirgilio, Laith Mukdad, Jessica Davis, Veronica J Santos, Peyman Benharash
With changes in work hour limitations, there is an increasing need for objective determination of technical proficiency. Electromagnetic hand-motion analysis has previously shown only time to completion and number of movements to correlation with expertise. The present study was undertaken to evaluate the efficacy of hand-motion-tracking analysis in determining surgical skill proficiency. A nine-degree-of-freedom sensor was used and mounted on the superior aspect of a needle driver. A one-way analysis of variance and Welch's t test were performed to evaluate significance between subjects...
October 2016: American Surgeon
Arja Heliövaara, Annelise Küseler, Pål Skaare, William Shaw, Kirsten Mølsted, Agneta Karsten, Eli Brinck, Sara Rizell, Agneta Marcusson, Paul Sæle, Kirsti Hurmerinta, Elisabeth Rønning, Midia Najar Chalien, Jeanette Mooney, Phil Eyres, Gunvor Semb
BACKGROUND AND AIM: Good dentofacial growth is a major goal in the treatment of unilateral cleft lip and palate (UCLP). The aim was to evaluate dental arch relationships at age 5 years after four different protocols of primary surgery for UCLP. DESIGN: Three parallel randomised clinical trials were undertaken as an international multi-centre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. METHODS: Three different surgical procedures for primary palatal repair (Arms B, C, D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP...
October 25, 2016: Journal of Plastic Surgery and Hand Surgery
Yana Puckett, Benedicto C Baronia
With the recent advances in eye tracking technology, it is now possible to track surgeons' eye movements while engaged in a surgical task or when surgical residents practice their surgical skills. Several studies have compared eye movements of surgical experts and novices and developed techniques to assess surgical skill on the basis of eye movement utilizing simulators and live surgery. None have evaluated simultaneous visual tracking between an expert and a novice during live surgery. Here, we describe a successful simultaneous deployment of visual tracking of an expert and a novice during live laparoscopic cholecystectomy...
September 20, 2016: Curēus
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
Eddie Y Liu, Bo Li, Cindy M L Hutnik
Wet lab and surgical simulation can reduce the learning curve of difficult surgical techniques, accelerate the rate for trainees to achieve surgical competency, and improve patient safety. To provide the most up-to-date information and hands-on experiences with novel ophthalmic surgical techniques and instruments, the Department of Ophthalmology at Western University has created a wet lab-based, multilevel microsurgery skills transfer course through collaboration with various industry partners. Several elements in the course goal and design differentiate this type of surgical course from typical wet labs: the format is multileveled surgical training, with a beginner level targeting undergraduate medical students, an intermediate level for ophthalmology residents, and an advanced level for trained ophthalmologist...
October 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Anders J Davidson, Lucas P Neff, Joseph J DuBose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow but require additional vascular intervention and risk shunt thrombosis with prolonged use...
November 2016: Journal of Trauma and Acute Care Surgery
Martin de Santibañes, Eduardo de Santibañes, Juan Pekolj
The paradigm introduced by William Halsted for surgical residency training has been considered the most appropriate educational system to acquire the knowledge and surgical skills required to become a competent general surgeon. Hepato-pancreato-biliary (HPB) surgery is considered an important part of general surgery training because of its high prevalence and complexity. Nowadays, we are faced with a worldwide shortage of general surgeons candidates, restrictive working hours and less surgical exposure, situations that can undermine the objectives of training in HPB surgery during residency...
October 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
Aaron L Grant, Claire Temple-Oberle
OBJECTIVE: The purpose of this study is to determine the utility of self-assessment in microsurgical training using a previously validated rating scale. DESIGN: A prospective study of surgical residents taking a hands-on 5-day microsurgical training course. Learners completed multiple self-assessments of their technical skills using the University of Western Ontario Microsurgical Acquisition/Assessment instrument. Simultaneously, preceptors assessed the learners using the same scale...
October 17, 2016: Journal of Surgical Education
Poonam Malhotra Kapoor, Kanchi Muralidhar, Navin C Nanda, Yatin Mehta, Naman Shastry, Kalpana Irpachi, Aditya Baloria
In 1980, Transesophageal Echocardiography (TEE) first technology has introduced the standard of practice for most cardiac operating rooms to facilitate surgical decision making. Transoesophageal echocardiography as a diagnostic tool is now an integral part of intraoperative monitoring practice of cardiac anaesthesiology. Practice guidelines for perioperative transesophageal echocardiography are systematically developed recommendations that assist in the management of surgical patients, were developed by Indian Association of Cardiac Anaesthesiologists (IACTA)...
October 2016: Annals of Cardiac Anaesthesia
A Buia, F Stockhausen, N Filmann, E Hanisch
PURPOSE: 3D imaging is an upcoming technology in laparoscopic surgery, and recent studies have shown that the modern 3D technique is superior in an experimental setting. METHODS: All 14 members of the Asklepios Klinik Langen Department of Visceral and Thoracic Surgery, as well as two gynaecologists, were asked to undertake 2D vs. 3D laparoscopic black box skill training. The black box training was adapted to the "fundamentals of laparoscopic surgery" programme provided by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)...
October 19, 2016: Langenbeck's Archives of Surgery
Toshihiro Ogiwara, Tetsuyoshi Horiuchi, Alhusain Nagm, Tetsuya Goto, Kazuhiro Hongo
PURPOSE: It is generally accepted that dopamine agonists (DA) represent the first-line treatment for most patients with prolactinoma, and patients become candidates for surgical intervention when DA is contraindicated. Surgical indication for cystic prolactinoma remains controversial. This study was performed to investigate the significance of surgery for cystic prolactinoma. METHODS: A total of 28 patients that underwent transsphenoidal resection of prolactinoma between February 2004 and May 2016 were reviewed...
October 18, 2016: Pituitary
Nidal Farhan Al Deek, Donald H Lalonde
Fu-Chan Wei is a world-renowned plastic and reconstructive surgeon. He is clearly one of the most influential and innovative surgeons in the history of plastic surgery. The Taiwanese legend is the innovator of the osteoseptocutaneous fibula flap, which revolutionized the reconstruction of composite bone and soft tissue defects in the jaw and extremities. He has pioneered several perforator flaps, including the free style variety. He has taken toe-to-hand microsurgical transplantation to a whole new level. He is not only recognized for his surgical skills and clinical innovations, but also for his vision, leadership, and teaching...
September 2016: Plastic and Reconstructive Surgery. Global Open
Mark Hochberg, Russell Berman, Jennifer Ogilvie, Sandra Yingling, Sabrina Lee, Martin Pusic, H Leon Pachter
BACKGROUND: The Liaison Committee on Medical Education requires midclerkship formative (low stakes) feedback to students regarding their clinical skills. Student self-assessment is not commonly incorporated into this evaluation. We sought to determine the feasibility of collecting and comparing student self-assessment with that of their preceptors using an iPad application. These student self-ratings and preceptor ratings are jointly created and reviewed as part of a face-to-face midclerkship feedback session...
September 20, 2016: American Journal of Surgery
Natalie Wagner, Christine Fahim, Krista Dunn, Diane Reid, Ranil Sonnadara
BACKGROUND: Residency training programs worldwide are experiencing a shift from the traditional time-based curriculum to competency based medical education (CBME), due to changes in the healthcare system that have impacted clinical learning opportunities. Otolaryngology-Head and Neck Surgery (OTL-HNS) programs are one of the first North American surgical specialties to adopt the new CBME curriculum. OBJECTIVE OF REVIEW: The purpose of this scoping review is to examine the literature pertaining to CBME in OTL-HNS programs worldwide, to identify the tools that have been developed, and identify potential barriers to the implementation of CBME...
October 18, 2016: Clinical Otolaryngology
Abib Agbetoba, Amber Luong, Jin Keat Siow, Brent Senior, Claudio Callejas, Kornel Szczygielski, Martin J Citardi
BACKGROUND: Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. METHODS: Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups...
October 18, 2016: International Forum of Allergy & Rhinology
Peter Szasz, Esther M Bonrath, Marisa Louridas, Andras B Fecso, Brett Howe, Adam Fehr, Michael Ott, Lloyd A Mack, Kenneth A Harris, Teodor P Grantcharov
OBJECTIVES: The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. BACKGROUND: Scores on performance assessments are difficult to interpret in the absence of established standards...
July 28, 2016: Annals of Surgery
Anton H Schwabegger
Minimally invasive repair of pectus excavatum (MIRPE) or similar procedures for pectus excavatum (PE) repair, nowadays no longer performed by one single speciality, may not always achieve sufficient aesthetic results, particularly in the infrapectoral or infraxiphoidal region. Reasons for this include the diaphragm inhibiting correct positioning of the bars, as well as asymmetric deformities which may still be present after remodelling attempts. Furthermore, some cases develop a mild recurrence or partial concavity once the correction bar is removed...
September 2016: Annals of Cardiothoracic Surgery
Harneet Gujral, Annmarie Vilkins, Nisse Clark, Alison B Vogell, Kelly N Wright
STUDY OBJECTIVE: To compare the operative time of contained hand tissue extraction to power morcellation and to quantify the learning curve required to develop this skill. DESIGN: Retrospective cohort study DESIGN: Classification: II-3 SETTING: Lahey Hospital and Medical Center, a suburban academic tertiary care center serving a broad base of patients. PATIENTS: Eighty-eight women undergoing laparoscopic hysterectomy requiring morcellation or tissue extraction from 2012 through 2015...
October 13, 2016: Journal of Minimally Invasive Gynecology
Irene Brunk, Stefan Schauber, Waltraud Georg
The depth of medical student knowledge of human anatomy is often controversially discussed. In particular, members of surgical disciplines raise concerns regarding deficits in the factual anatomical and topographical knowledge of upper-year students. The question often raised is whether or not medical students have sufficient anatomical and topographical knowledge when they graduate from medical school. Indeed, this question is highly relevant for curricular planners. Therefore, we have addressed it by evaluating the performance of students in the 5th and 6th years of their studies on anatomical multiple choice questions from the Berlin Progress Test Medicine performed at 10 German university medical schools...
October 13, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Lei Xia, Ming-Xing Liu, Jun Zhong, Ning-Ning Dou, Bin Li, Hui Sun, Shi-Ting Li
Although the microvascular decompression (MVD) surgery has become an effective remedy for cranial nerve rhizopathies, it is still challengeable and may result in a fatal sequel sometimes. Therefore, the operative skill needs to be further highlighted with emphasis on the safety and a preplan for management of postoperative fatal complications should be established. We retrospectively analyzed 6974 cases of MVD. Postoperatively, 46 patients (0.66 %) presented decline in consciousness with a positive finger-nose test (or failure to be tested) after wake up from the anesthesia, whom were focused on in this study...
October 12, 2016: Neurosurgical Review
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