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Non surgical skills

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
Andrea Moglia, Luca Morelli, Vincenzo Ferrari, Mauro Ferrari, Franco Mosca, Alfred Cuschieri
BACKGROUND: There is an increasing interest for a test assessing objectively the innate aptitude for surgery as a craft specialty to complement the current selection process of surgical residents. The aim of this study was to quantify the size of individuals with high, average, and low level of innate psychomotor skills among medical students. METHODS: A volunteer sample of 155 medical students, without prior experience with surgical simulator, executed five tasks at a virtual simulator for robot-assisted surgery...
March 14, 2018: Surgical Endoscopy
L V Duggan, S L Lockhart, T M Cook, E P O'Sullivan, T Dare, P A Baker
In this exploratory study we describe the utility of smartphone technology for anonymous retrospective observational data collection of emergency front-of-neck airway management. The medical community continues to debate the optimal technique for emergency front-of-neck airway management. Although individual clinicians infrequently perform this procedure, hundreds are performed annually worldwide. Ubiquitous smartphone technology and internet connectivity have created the opportunity to collect these data. We created the 'Airway App', a smartphone application to capture the experiences of healthcare providers involved in emergency front-of-neck airway procedures...
March 13, 2018: Anaesthesia
Michail Sideris, John Hanrahan, Georgios Tsoulfas, Iakovos Theodoulou, Fatema Dhaif, Vassilios Papalois, Savvas Papagrigoriadis, George Velmahos, Patricia Turner, Apostolos Papalois
BACKGROUND: Essential Skills in the Management of Surgical Cases (ESMSC) is a novel 3-day international undergraduate surgical masterclass. Its current curriculum (Cores integrated for Research-Ci4R) is built on a tetracore, multiclustered architecture combining high-fidelity and low-fidelity simulation-based learning (SBL), with applied and basic science case-based workshops, and non-technical skills modules. We aimed to report our experience in setting up ESMSC during the global financial crisis...
March 8, 2018: Postgraduate Medical Journal
Dong-Yeong Lee, Young-Jin Park, Sang-Youn Song, Soon-Taek Jeong, Dong-Hee Kim
Study Design: A retrospective clinical case series. Purpose: To determine the strength of association between cage retropulsion and its related factors. Overview of Literature: Lumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignment. Although lumbar interbody fusion procedures have satisfactory clinical outcomes, peri- and postoperative complications regarding the cage remain challenging...
February 2018: Asian Spine Journal
Kevin Y Pei, Yawei Zhang, Timur Sarac, Kimberly A Davis
OBJECTIVES: There is evidence to suggest outcomes may be related to surgeon experience or skill level. Lower extremity amputations are performed by both general surgeons (GS) and vascular surgeons (VS); however, the effect of specialty on post-operative outcome in below-knee amputation is not known. This retrospective study compares outcomes in below-knee amputations between VS and GS. METHODS: Patients who underwent below-knee amputations (BKA) between 2005 and 2014 were identified from the American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database...
February 28, 2018: Annals of Vascular Surgery
Joel Bierer, Eustatiu Memu, Robert Leeper, Dalilah Fortin, Eric Fréchette, Richard Inculet, Richard Malthaner
BACKGROUND: Our vision was to develop an inexpensive training simulation in a functional operating room (in-situ) that included surgical trainees, nursing and anesthesia staff to focus on effective interprofessional communication and teamwork skills. METHODS: The simulation scenario revolved around a post-pneumonectomy airway obstruction by residual tumor. This model included our thoracic operating room with patient status displayed by an open access vital sign simulator and a reversibly modified Laerdal® airway mannequin...
February 27, 2018: Annals of Thoracic Surgery
Syed Ijlal Ahmed, Gohar Javed, Bakhtawar Mubeen, Syeda Beenish Bareeqa, Hiba Rasheed, Alizay Rehman, Masroor Mubeen Phulpoto, Syeda Sana Samar, Kashif Aziz
Robotic surgery has been the forte of minimally invasive stereo-tactic procedures for some decades now. Ongoing advancements and evolutionary developments require substantial evidence to build the consensus about its efficacy in the field of neurosurgery. Main obstacle in obtaining successful results in neurosurgery is fine neural structures and other anatomical limitations. Currently, human rationalisation and robotic precision works in symbiosis to provide improved results. We reviewed the current data about recent interventions...
February 2018: JPMA. the Journal of the Pakistan Medical Association
Jian Wu, Yue-Hong Guan, Sheng-Li Fan
OBJECTIVE: To investigate the risk factors of non-surgical vertebral fracture after percutaneous kyphoplasty (PKP) in patients with single segment thoracolumbar osteoporotic vertebral compression fracture(OVCF). METHODS: The clinical data of 219 patients with single segment thoracolumbar osteoporotic vertebral compression fracture underwent percutaneous kyphoplasty from January 2010 to December 2015 were retrospectively analyzed. There were 29 cases in non-surgical vertebral body fracture group with 7 males and 22 females aged (67...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Avital Kozlovsky, Alex Rapaport, Zvi Artzi
OBJECTIVES: The aim of this study is to evaluate the effect of operators experience and skill on treatment results of initial non-surgical periodontal therapy. MATERIALS AND METHODS: Initial periodontal treatment was carried out by either second-year periodontal residents (PR) or last year dental students (DS). From the treatment records of patients in each group, plaque and bleeding indices, and pocket depth (PD) at baseline and at re-evaluation were collected retrospectively on each tooth at six locations...
February 15, 2018: Clinical Oral Investigations
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
Cuan M Harrington, Vishwa Chaitanya, Patrick Dicker, Oscar Traynor, Dara O Kavanagh
BACKGROUND: Video gaming demands elements of visual attention, hand-eye coordination and depth perception which may be contiguous with laparoscopic skill development. General video gaming has demonstrated altered cortical plasticity and improved baseline/acquisition of minimally invasive skills. The present study aimed to evaluate for skill acquisition associated with a commercially available dedicated laparoscopic video game (Underground) and its unique (laparoscopic-like) controller for the Nintendo®Wii U™ console...
February 14, 2018: Surgical Endoscopy
Andrea Giannini, Eleonora Russo, Antonio Cano, Peter Chedraui, Dimitrios G Goulis, Irene Lambrinoudaki, Patrice Lopes, Gita Mishra, Alfred Mueck, Margaret Rees, Levent M Senturk, John C Stevenson, Petra Stute, Pauliina Tuomikoski, Tommaso Simoncini
Management of pelvic organ prolapse (POP) is a common and challenging task. Nowadays older women are more active than they were in the past, and the development of POP disrupts quality of life and impairs social and personal activities. The menopausal transition is a time of vulnerability, during which many women start experiencing symptoms and signs of POP. The role of hormonal changes or of hormonal therapies in influencing the development or progression of POP has been explored extensively. The management of POP requires considerable clinical skills...
February 6, 2018: Maturitas
Karl-Friedrich Kowalewski, Mona W Schmidt, Tanja Proctor, Moritz Pohl, Erica Wennberg, Emir Karadza, Philipp Romero, Hannes G Kenngott, Beat P Müller-Stich, Felix Nickel
BACKGROUND: There is limited evidence on the transferability of conventional laparoscopic and open surgical skills to robotic-assisted surgery. The primary aim of this study was to evaluate the transferability of expertise in conventional laparoscopy and open surgery to robotic-assisted surgery using the da Vinci Skills Simulator (dVSS). Secondary aims included evaluating the influence of individual participants' characteristics. METHODS: Participants performed four tasks on the dVSS: Peg Board 1 (PB), Pick and Place (PP), Thread the Rings (TR), and Suture Sponge 1 (SS)...
February 12, 2018: Surgical Endoscopy
Carolina Millán, Mercedes Rey, Manuel Lopez
OBJECTIVE: Acquiring surgical skills requires regular practice. Medical evidence supports that these skills can be learned outside the operating room (OR). The aim of the current study was to describe the first laparoscopic simulator for ureteral reimplantation (LAP-SPUR) following Lich- Gregoir technique. MATERIALS AND METHODS: LAP-SPUR was manufactured using reusable and disposable materials. The technique can be summarized in the following five steps: (1) a transperitoneal approach; (2) extra-vesical ureteral dissection; (3) detrusor division until exposing the mucosa; (4) reimplanting ureter into the new tunnel; and (5) reapproximation and suturing of the detrusor...
January 31, 2018: Journal of Pediatric Urology
Vandana Tripathi, Sohier Elneil, Lauri Romanzi
INTRODUCTION AND HYPOTHESIS: There is a need for expanded access to safe surgical care in low- and middle-income countries (LMICs) as illustrated by the report of the 2015 Lancet Commission on Global Surgery. Packages of closely-related surgical procedures may create platforms of capacity that maximize impact in LMIC. Pelvic organ prolapse (POP) and genital fistula care provide an example. Although POP affects many more women in LMICs than fistula, donor support for fistula treatment in LMICs has been underway for decades, whereas treatment for POP is usually limited to hysterectomy-based surgical treatment, occurring with little to no donor support...
February 6, 2018: International Urogynecology Journal
Dianne Marshall, Mary Finlayson
AIMS AND OBJECTIVES: To identify the non-technical skills (NTS) required of nurses in general surgical wards for safe and effective care. BACKGROUND: As the largest occupational group, nurses are in an ideal position to block the vulnerabilities of patient adverse events in a surgical ward. Previous studies in the surgical environment have identified the NTS required of nurses for safe care in operating rooms however these skills have not been identified for nurses in general surgical wards...
February 5, 2018: Journal of Clinical Nursing
John Asger Petersen
Clinical deterioration of patients hospitalized on general wards is often preceded by worsening vital signs. If identified early and acted upon quickly, it is conjectured that further deterioration can be prevented. To this means the early warning score (EWS) was implemented in all hospitals in the Capital Region of Denmark in 2013. EWS consists of an aggregated weighted track-and-trigger system (TTS), to identify at-risk patients early, and a treatment protocol to escalate care appropriately and determine the level of competency of the provider...
February 2018: Danish Medical Journal
Ibrahim Alkatout, Thilo Wedel, Nicolai Maass
Endometriosis is the second most common benign female genital disease after uterine myoma. This review discusses the management of individual patients. This should take into account the severity of the disease and whether the patient desires to have children. Particular emphasis is laid on the anatomical intersections which, when injured, can lead to persistent damage of the anterior, middle or posterior compartment and are not infrequently the cause of urological and urogynaecological follow-up measures. Typical symptoms of endometriosis include chronic pelvic pain, subfertility, dysmenorrhoea, deep dyspareunia, cyclical bowel or bladder symptoms (e...
February 2018: Aktuelle Urologie
Chou Phay Lim, Mark Roberts, Tony Chalhoub, Jason Waugh, Laura Delegate
Background: Fresh frozen cadaver training has been proposed as a better model than virtual reality simulators in laparoscopy training. We aimed to explore the relationship between cadaveric surgical training and increased surgical confidence.To determine feasibility, we devised two 1-day cadaveric surgical training days targeted at trainees in obstetrics and gynaecology. Seven defined surgical skills were covered during the course of the day. The relationship between surgical training and surgical confidence was explored using both quantitative (confidence scores) and qualitative tools (questionnaires)...
2018: Gynecological Surgery
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