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https://www.readbyqxmd.com/read/29457945/factors-that-influence-nurses-assessment-of-patient-acuity-and-response-to-acute-deterioration
#1
Mark Dalton, John Harrison, Anitra Malin, Conan Leavey
BACKGROUND: nurses play a crucial role in the early recognition and management of the deteriorating patient. They are responsible for the care they provide to their patients, part of which is the monitoring of vital signs (blood pressure, pulse, respiratory rate and temperature), which are fundamental in the surveillance of deterioration. The aim of this study was to discover what factors influence how nurses assess patient acuity and their response to acute deterioration. METHODS: a generic qualitative approach was used...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29427003/robotic-surgery-new-robots-and-finally-some-real-competition
#2
Pradeep P Rao
PURPOSE: For the last 20 years, the predominant robot used in laparoscopic surgery has been Da Vinci by Intuitive Surgical. This monopoly situation has led to rising costs and relatively slow innovation. This article aims to discuss the two new robotic devices for laparoscopic surgery which have received regulatory approval for human use in different parts of the world. MATERIALS: A short description of the Senhance Surgical Robotic System and the REVO-I Robot Platform and their pros and cons compared to the Da Vinci system is presented...
February 9, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29423742/the-effect-of-preoperative-pneumonia-on-postsurgical-mortality-and-morbidity-a-nsqip-analysis
#3
Sarah Jamali, Michael Dagher, Nadeem Bilani, Aurelie Mailhac, Mohamad Habbal, Salah Zeineldine, Hani Tamim
BACKGROUND: Currently, only indirect evidence suggests that preoperative pneumonia is a significant risk factor for poor postsurgical outcomes. Although this relationship is clinically intuitive, this is the first study that aims to quantify the extent to which pneumonia impacts morbidity and mortality. The objective of this study was to determine the impact of preoperative pneumonia on 30-day mortality and morbidity among both elective and emergency surgical patients. METHODS: We conducted a retrospective cohort study using 2008-2012 data from the American College of Surgeons National Surgical Quality Improvement Program database...
February 8, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29421921/robot-assisted-radical-prostatectomy-a-step-by-step-guide
#4
Linda My Huynh, Tom Ahlering
Radical prostatectomy has been performed as an open surgery for quite some time with good success, however as minimally invasive surgery has evolved, it has become possible to perform radical prostatectomies laparoscopically. Recent leaps in technology with the advent of Intuitive Surgical Inc.'s da Vinci robot have taken radical prostatectomy past laparoscopy to an all new level of success. In the hands of a skilled surgeon like Dr. Ahlering, of UC Irvine Medical in Orange County, this new tool allows the radical prostatectomy to be performed minimally invasively with greater precision and ease to both the patient and the surgeon than ever before...
February 8, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29401548/-current-status-of-therapy-and-prophylaxis-of-oropharyngeal-carcinoma
#5
Andreas Dietz, Markus Pirlich, Susanne Wiegand
Incidence of oropharyngeal carcinoma (OPSCC) is increasing significantly worldwide. Due to its association with chronic tobacco/alcohol consumption, but increasingly also with the human papillomavirus HPV-16, oropharyngeal carcinoma is a genetically heterogeneous tumor group with high prognostic diversification. HPV-associated OPSCC respond significantly better to previous treatment concepts than non-HPV-associated. Both after primary surgical as well as after radiotherapie, radiochemotherapie and anti-EGFR treatment, this tumor group shows a significantly better survival...
February 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29372873/a-novel-mesial-temporal-stereotactic-coordinate-system
#6
Kai J Miller, Casey H Halpern, Mark F Sedrak, John A Duncan, Gerald A Grant
OBJECTIVE Stereotactic laser ablation and neurostimulator placement represent an evolution in staged surgical intervention for epilepsy. As this practice evolves, optimal targeting will require standardized outcome measures that compare electrode lead or laser source with postprocedural changes in seizure frequency. The authors propose and present a novel stereotactic coordinate system based on mesial temporal anatomical landmarks to facilitate the planning and delineation of outcomes based on extent of ablation or region of stimulation within mesial temporal structures...
January 26, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29346106/spatial-position-measurement-system-for-surgical-navigation-using-3-d-image-marker-based-tracking-tools-with-compact-volume
#7
Zhencheng Fan, Guowen Chen, Junchen Wang, Hongen Liao
We develop a spatial position measurement system using three-dimensional (3-D) image marker-based tracking tools targeted at surgical navigation in minimally invasive surgery. We generate 3-D image markers with spatial information encoded to 2-D images, design tracking tools with the 3-D image markers, and analyze the tracking tools' theoretical spatial errors, which are primarily limited by the spatial distribution of reconstructed fiducial 3-D markers. A pattern analysis-based positional measurement algorithm is developed to calculate the tool's spatial information using its spatial configuration...
February 2018: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/29340922/prevention-of-internal-hernia-during-robotic-total-gastrectomy-for-gastric-cancer
#8
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Toshiaki Tsuji, Shimpei Maruoka, Hiroki Yamaue
BACKGROUND: Postoperative internal hernia (IH) is a potentially life-threatening acute protrusion of viscus through an iatrogenic mesenteric defect. In our retrospective study of 1943 consecutive gastric cancer (GC) patients who had undergone surgery, the incidence of IH after laparoscopic total gastrectomy (LTG) was 4.9%.1 This high incidence seems to be caused by decreased adhesion formation after LTG. There is no consensus regarding orifice management during robotic total gastrectomy (RTG)...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29324498/five-steps-to-successfully-implement-and-evaluate-propensity-score-matching-in-clinical-research-studies
#9
Steven J Staffa, David Zurakowski
In clinical research, the gold standard level of evidence is the randomized controlled trial (RCT). The availability of nonrandomized retrospective data is growing; however, a primary concern of analyzing such data is comparability of the treatment groups with respect to confounding variables. Propensity score matching (PSM) aims to equate treatment groups with respect to measured baseline covariates to achieve a comparison with reduced selection bias. It is a valuable statistical methodology that mimics the RCT, and it may create an "apples to apples" comparison while reducing bias due to confounding...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29307098/a-single-incision-thoracoscopic-and-robotic-hybrid-procedure-via-the-axillary-approach-in-a-patient-with-thyroid-lung-and-mediastinal-tumors
#10
Norihiko Ishikawa, Yumiko Ohtake, Go Watanabe
A 66-year-old woman was referred to our institute for an enlarging tumor of the thyroid, and neck and chest computed tomography scan showed not only a thyroid tumor, but also an anterior mediastinal tumor and ground-glass nodules in the lung. Because of persisting symptoms, an enlarging thyroid mass, and the possibility of cancer, excision of the tumors was proposed. A 6-cm-long vertical skin incision was made in the right axilla, a mini-thoracotomy was made in the third intercostal space, and an additional port was placed in the fifth intercostal space...
January 6, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29303068/soft-robotic-manipulator-for-improving-dexterity-in-minimally-invasive-surgery
#11
Alessandro Diodato, Margherita Brancadoro, Giacomo De Rossi, Haider Abidi, Diego Dall'Alba, Riccardo Muradore, Gastone Ciuti, Paolo Fiorini, Arianna Menciassi, Matteo Cianchetti
BACKGROUND: Combining the strengths of surgical robotics and minimally invasive surgery (MIS) holds the potential to revolutionize surgical interventions. The MIS advantages for the patients are obvious, but the use of instrumentation suitable for MIS often translates in limiting the surgeon capabilities (eg, reduction of dexterity and maneuverability and demanding navigation around organs). To overcome these shortcomings, the application of soft robotics technologies and approaches can be beneficial...
December 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/29300963/no-touch-aorta-robot-assisted-atrial-septal-defect-repair-via-two-ports
#12
Norihiko Ishikawa, Go Watanabe, Tatsuya Tarui
OBJECTIVES: Atrial septal defect (ASD) repairs have been successfully performed on arrested hearts with robotic assistance. The present study assessed the feasibility, safety, and efficacy of totally endoscopic cardiac surgery using a no-touch aorta technique for ASD via only 2 ports, and we named this procedure two-port robotic cardiac surgery (TROCS). METHODS: Between May 2014 and June 2016, 8 consecutive patients underwent TROCS for ASD using the da Vinci surgical system (Intuitive Surgical Inc...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29288372/robotic-assisted-laparoscopic-surgery-for-pediatric-tumors-a-bicenter-experience
#13
P Meignan, Q Ballouhey, J Lejeune, K Braik, B Longis, A R Cook, H Lardy, L Fourcade, Aurélien Binet
Mini-invasive surgery is more and more integrated in pediatric surgery. The robotic-assisted surgery brought new advantages from which the patient and the surgeon could benefit compared to laparoscopy. Its use in oncological surgery is still controversial. 12 robotic-assisted tumor resections with the da Vinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA) were attempted in 11 children (mean age 7.65 years; age range 0.75-16.75 years; mean weight 30.3 kg; weight range 8.6-62 kg) in two centers. Mean total operative time was 145 min (range 72-263 min)...
December 29, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29235270/lamellar-keratoplasty-using-position-guided-surgical-needle-and-m-mode-optical-coherence-tomography
#14
Sungwon Shin, Jung Kweon Bae, Yujin Ahn, Hyeongeun Kim, Geonho Choi, Young-Sik Yoo, Choun-Ki Joo, Sucbei Moon, Woonggyu Jung
Deep anterior lamellar keratoplasty (DALK) is an emerging surgical technique for the restoration of corneal clarity and vision acuity. The big-bubble technique in DALK surgery is the most essential procedure that includes the air injection through a thin syringe needle to separate the dysfunctional region of the cornea. Even though DALK is a well-known transplant method, it is still challenged to manipulate the needle inside the cornea under the surgical microscope, which varies its surgical yield. Here, we introduce the DALK protocol based on the position-guided needle and M-mode optical coherence tomography (OCT)...
December 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29199481/the-conversational-position-in-endoscopic-pituitary-surgery
#15
Jinendra Ekanayake, Irene Baudracco, Anjum Quereshi, Tom Vercauteren, Neil L Dorward
We describe a novel patient position for endoscopic transphenoidal surgery - the 'conversational position'. This position is a safe and effective alternative to the standard supine position, incorporating a semi-sitting position with the additional innovation of achieving a 'conversational position' by flexing the neck and turning the patient's head turned to face the surgeon. The 'conversational' position offers improvements in the surgical approach to sellar region, addressing specific intraoperative challenges such as maintaining a bloodless operative field, and enabling more intuitive and ergonomic surgical workflow...
December 4, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29193643/performance-metrics-for-guidance-active-constraints-in-surgical-robotics
#16
Nima Enayati, Giancarlo Ferrigno, Elena De Momi
Active constraint (AC)/virtual fixture (VF) is among the most popular approaches towards the shared execution of subtasks by the surgeon and robotic systems. As more possibilities appear for the implementation of ACs in surgical scenarios, the need to introduce methods that guarantee a safe and intuitive user-interaction increases. The presence of the human in the loop adds a layer of interactivity and adaptability that renders the assessment of such methods non-trivial. In most works, guidance ACs have been evaluated mainly in terms of enhancement of accuracy and completion time with little regard for other aspects such as human factors, even though the continuous engagement of these methods can considerably degrade the user experience...
November 28, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29188681/targeted-muscle-reinnervation-for-improved-control-of-myoelectric-upper-limb-prostheses
#17
G Vadalà, G Di Pino, L Ambrosio, L Diaz Balzani, V Denaro
Targeted muscle reinnervation (TMR) is a novel surgical technique developed to improve the control of myoelectric upper limb prostheses. Nerves transected by the amputation, which retain their original motor pathways even after being severed, are redirected to residual denervated muscles that serve as target for consequent reinnervation. Once the process is complete, reinnervated muscles will contract upon voluntary activation of transferred nerves while attempting to move missing regions of the amputated limb, generating EMG signals that can be recorded and used to control a prosthetic device...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29184659/multi-modal-imaging-model-based-tracking-and-mixed-reality-visualisation-for-orthopaedic-surgery
#18
Sing Chun Lee, Bernhard Fuerst, Keisuke Tateno, Alex Johnson, Javad Fotouhi, Greg Osgood, Federico Tombari, Nassir Navab
Orthopaedic surgeons are still following the decades old workflow of using dozens of two-dimensional fluoroscopic images to drill through complex 3D structures, e.g. pelvis. This Letter presents a mixed reality support system, which incorporates multi-modal data fusion and model-based surgical tool tracking for creating a mixed reality environment supporting screw placement in orthopaedic surgery. A red-green-blue-depth camera is rigidly attached to a mobile C-arm and is calibrated to the cone-beam computed tomography (CBCT) imaging space via iterative closest point algorithm...
October 2017: Healthcare Technology Letters
https://www.readbyqxmd.com/read/29179285/-efficacy-of-3d-print-guide-technique-in-one-stage-posterior-approach-for-the-treatment-of-cervical-and-thoracic-tuberculosis-with-kyphosis
#19
Nazierhan Shaxika, Z G Sun, H Yuan, H Wang
Objective: To investigate the application of 3D printing technology in the treatment of patients with cervical kyphosis and paraplegia in different segments of the cervical spine after one-stage debridement, bone graft fusion and pedicle screw fixation. Methods: From January 2008 to January 2017, a total of 31 patients with thoracolumbar tuberculosis were treated in the Department of Orthopaedics, the Xinjiang Uygur Autonomous Region people's Hospital.Lesions of the thoracic spine (T1-T4) in 8 cases, (C5-C7) in 10 cases, cervical and thoracic segment in 13 cases, involving a total of 2 cases of vertebral body in 7 cases, 3 cases of vertebral body in 14 cases, 4 cases of vertebral body...
November 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29175494/unfolding-the-hippocampus-an-intrinsic-coordinate-system-for-subfield-segmentations-and-quantitative-mapping
#20
Jordan DeKraker, Kayla M Ferko, Jonathan C Lau, Stefan Kӧhler, Ali R Khan
The hippocampus, like the neocortex, has a morphological structure that is complex and variable in its folding pattern, especially in the hippocampal head. The current study presents a computational method to unfold hippocampal grey matter, with a particular focus on the hippocampal head where complexity is highest due to medial curving of the structure and the variable presence of digitations. This unfolding was performed on segmentations from high-resolution, T2-weighted 7T MRI data from 12 healthy participants and one surgical patient with epilepsy whose resected hippocampal tissue was used for histological validation...
November 23, 2017: NeuroImage
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