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Precision Surgery

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https://www.readbyqxmd.com/read/28433213/three-dimensional-surgical-modelling-with-an-open-source-software-protocol-study-of-precision-and-reproducibility-in-mandibular-reconstruction-with-the-fibula-free-flap
#1
L Ganry, J Quilichini, C M Bandini, P Leyder, B Hersant, J P Meningaud
Very few surgical teams currently use totally independent and free solutions to perform three-dimensional (3D) surgical modelling for osseous free flaps in reconstructive surgery. This study assessed the precision and technical reproducibility of a 3D surgical modelling protocol using free open-source software in mandibular reconstruction with fibula free flaps and surgical guides. Precision was assessed through comparisons of the 3D surgical guide to the sterilized 3D-printed guide, determining accuracy to the millimetre level...
April 19, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28431804/prognostic-value-of-dynamic-mri-positive-enhancement-integral-color-mapping-in-osteosynthesis-of-undisplaced-femoral-neck-fractures
#2
Masatoshi Morimoto, Yoshinori Takahashi, Takahiro Kubo, Kosuke Sugiura, Yasuaki Tamaki, Shunichi Toki, Katsuyoshi Suganuma, Kazumasa Inoue, Keisuke Adachi, Takashi Chikawa, Koichi Sairyo, Akihiro Nagamachi
AIMS: The common treatment for an undisplaced femoral neck fracture is osteosynthesis. Two major complications of osteosynthesis are non-union and late collapse of the femoral head. We speculated that femoral head perfusion is one of the most important factors that affect the outcome of osteosynthesis after femoral neck fracture. We have preoperatively estimated femoral head perfusion by dynamic MRI positive enhancement integral color mapping (PEICM). The purpose of this study was to evaluate the outcomes of undisplaced femoral neck fractures based on PEICM...
April 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28431731/pericardial-conduit-for-pulmonary-artery-reconstruction-by-surgical-stapling
#3
Noriyuki Matsutani, Eiichi Kanai, Ryutaro Hanawa, Yusuke Takahashi, Hirofumi Uehara, Hisae Iinuma, Masafumi Kawamura
Pulmonary artery reconstruction in lung cancer surgery is an effective surgical method to avoid pneumonectomy that leads to longer survival times with few adverse effects. The pericardium is often used for the interposition of a prosthetic conduit. A pericardial conduit can be easily and precisely constructed by surgical stapling, which facilitates pulmonary artery reconstruction. In this report, the process and pitfalls of surgical stapling are described.
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28430323/povidone-iodine-3-minute-exposure-time-is-viable-in-preparation-for-cataract-surgery
#4
Chu Luan Nguyen, Lawrence J Oh, Eugene Wong, Ian C Francis
PURPOSE: Povidone-iodine (PI) is widely used to reduce the preoperative conjunctival bacterial load. This study aimed to evaluate the employment of PI 10% in an attempt to sterilize the ocular surface prior to cataract surgery, and to show that PI could be left in contact for 3 minutes. The viability of this exposure time in clinical practice, associated adverse events, and visual outcomes were documented. METHODS: In this prospective cohort study, phacoemulsification cataract surgery was performed in 604 patients by a single surgeon...
April 7, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28429637/analysis-of-rotation-angles-and-motions-of-the-flexible-mechanisms-in-bifurcated-blood-vessels
#5
Bin He, Shoulin Xu, An Ding, Yanmin Zhou
This article investigates the relationship of rotation angle of two ends of elastic guidewires, and motion method of guidewires and catheters in bifurcated blood vessels. The relationship of rotation angles of the two ends of the guidewire has first been studied by mathematical reasoning, indicating that the rotation angle of the front end of guidewire can be precisely described by that of the rear end. In order to satisfy the requirements of different vascular interventional surgeries, we further investigated a general model of bifurcated human blood vessels...
April 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28428283/regulatory-aspects-of-optical-methods-and-exogenous-targets-for-cancer-detection
#6
Willemieke S Tummers, Jason M Warram, Kiranya E Tipirneni, John Fengler, Paula Jacobs, Lalitha Shankar, Lori Henderson, Betsy Ballard, Brian W Pogue, Jamey P Weichert, Michael Bouvet, Jonathan Sorger, Christopher H Contag, John V Frangioni, Michael F Tweedle, James P Basilion, Sanjiv S Gambhir, Eben L Rosenthal
Considerable advances in cancer-specific optical imaging have improved the precision of tumor resection. In comparison to traditional imaging modalities, this technology is unique in its ability to provide real-time feedback to the operating surgeon. Given the significant clinical implications of optical imaging, there is an urgent need to standardize surgical navigation tools and contrast agents to facilitate swift regulatory approval. Because fluorescence-enhanced surgery requires a combination of both device and drug, each may be developed in conjunction, or separately, which are important considerations in the approval process...
April 20, 2017: Cancer Research
https://www.readbyqxmd.com/read/28428034/near-anatomical-correction-using-a-ct-guided-technique-of-a-forearm-malunion-in-a-15-year-old-girl-a-case-report-including-surgical-technique
#7
Ralph M Jeuken, Roel P Hendrickx, Martijn G Schotanus, Edwin J Jansen
BACKGROUND: In this case report we describe a left-arm both-bone forearm fracture in a 15-year old girl who fell off of a swing. Conservative treatment with an above-elbow cast failed,resulting in a malunion with functional impairment. The pro- and supination were 90/0/10, respectively. The patient complained of difficulties performing daily activities. For this pediatric case a corrective osteotomy was proposed using a CT-guided technique aiming for maximum anatomical and functional outcome...
April 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28426148/three-dimensional-finite-element-based-deformable-image-registration-for-evaluation-of-pleural-cavity-irradiation-during-photodynamic-therapy
#8
Rozhin Penjweini, Michele M Kim, Timothy C Zhu
PURPOSE: Photodynamic therapy (PDT) is used after surgical resection to treat the microscopic disease for malignant pleural mesothelioma and to increase survival rates. As accurate light delivery is imperative to PDT efficacy, the deformation of the pleural volume during the surgery is studied on its impact on the delivered light fluence. In this study, a three-dimensional finite element-based (3D FEM) deformable image registration is proposed to directly match the volume of lung to the volume of pleural cavity obtained during PDT to have accurate representation of the light fluence accumulated in the lung, heart and liver (organs-at-risk) during treatment...
April 20, 2017: Medical Physics
https://www.readbyqxmd.com/read/28424084/durable-complete-remission-with-aromatase-inhibitor-therapy-in-a-patient-with-metastatic-uterine-carcinosarcoma-with-poor-performance-status-and-coagulation-disorders-a-case-report
#9
P Martin-Romano, M Jurado, M A Idoate, L Arbea, J L Hernandez-Lizoain, D Cano, J A Paramo, S Martin-Algarra
BACKGROUND: Chemotherapy is considered the most appropriate treatment for metastatic uterine sarcoma, despite its limited efficacy. No other treatment has been conclusively proved to be a real alternative, but some reports suggest that anti-hormonal therapy could be active in a small subset of patients. We report the case of a patient with metastatic uterine carcinosarcoma with positive hormonal receptors and a complete pathological response. CASE PRESENTATION: A 54-year-old white woman presented to our emergency room with hypovolemic shock and serious vaginal bleeding...
April 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28422434/rat-hindlimb-cryopreservation-and-transplantation-a-step-towards-organ-banking
#10
Amir Arav, Or Friedman, Yehudit Natan, Eyal Gur, Nir Shani
In 2016 over 5 million reconstructive procedures were performed in the USA. The recent successes of clinical vascularized composite allotransplantations (VCA), hand and face transplantations included, established the tremendous potential of these life-enhancing reconstructions. Nevertheless, Due to limited availability and lifelong immunosuppression, application is limited. Long term banking of composite transplants may increase the availability of esthetically compatible parts with partial or complete HLA matching, reducing the risk of rejection and the immunosuppressive burden...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28420248/creating-an-optimal-3d-printed-model-for-temporal-bone-dissection-training
#11
Kuniyuki Takahashi, Yuka Morita, Shinsuke Ohshima, Shuji Izumi, Yamato Kubota, Yutaka Yamamoto, Sugata Takahashi, Arata Horii
OBJECTIVE: Making a 3-dimensional (3D) temporal bone model is simple using a plaster powder bed and an inkjet printer. However, it is difficult to reproduce air-containing spaces and precise middle ear structures. The objective of this study was to overcome these problems and create a temporal bone model that would be useful both as a training tool and for preoperative simulation. METHODS: Drainage holes were made to remove excess materials from air-containing spaces, ossicle ligaments were manually changed to bony structures, and small and/or soft tissue structures were colored differently while designing the 3D models...
April 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28419537/electromagnetic-tracking-for-femoral-derotation-osteotomy-an-in-vivo-study
#12
Andreas Geisbüsch, Christoph Auer, Hartmut Dickhaus, Cornelia Putz, Thomas Dreher
Femoral derotation osteotomy delivers good to excellent results in the treatment of rotational gait abnormalities and especially in internal rotation gait. The outcome of the procedure has been evaluated in numerous short and long term studies. Although reasons for recurrence and over-/under-correction have been unveiled in earlier studies the mechanisms are still not fully understood. False intra-operative assessment of the derotation angle may contribute to imprecise outcomes. In a recent saw-bone study we evaluated an electromagnetic tracking system in comparison to conventional goniometer measurement and a CT reference measurement and found it to be extremely accurate, whereas the use of a conventional goniometer for derotation measurement showed a high inter- and intra-rater variability...
April 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28419041/accuracy-of-computer-aided-techniques-in-orthopaedic-surgery-how-can-it-be-defined-measured-experimentally-and-analyzed-from-a-clinical-perspective
#13
Olivier Cartiaux, Jean-Yves Jenny, Leo Joskowicz
Surgical accuracy is multifactorial. Therefore, it is crucial to consider all influencing factors when investigating the accuracy of a surgical procedure, such as the surgeon's experience, the assistive technologies that may be used by the surgeon, and the patient factors associated with the specific anatomical site. For in vitro preclinical investigations, accuracy should be linked to the concepts of trueness (e.g., distance from the surgical target) and precision (e.g., variability in relation to the surgical target) to gather preclinical, quantitative, objective data on the accuracy of completed surgical procedures that have been performed with assistive technologies...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28414721/a-novel-smart-navigation-system-for-intramedullary-nailing-in-orthopedic-surgery
#14
Jaesuk Choi, Jihun Kim, Jae Youn Hwang, Minkyu Je, Jun-Young Kim, Shin-Yoon Kim
This paper proposes a novel smart surgical navigation system for intramedullary nailing in orthopedic surgery. Using a handle-integrated laser guidance module, the system can target a drill insertion point onto skin, indicating an accurate target position to perpendicularly access an invisible distal hole. The proposed handle-integration-based fixation of the laser guidance module precisely defines the relative position of the module with respect to the distal hole. Consequently, unlike conventional systems, the proposed system can indicate the target insertion point without any help from bulky and costly external position-tracking equipment that is usually required for compensating disturbances generated by external impacts...
2017: PloS One
https://www.readbyqxmd.com/read/28413736/targeted-intraspinal-radiofrequency-ablation-for-lumbar-spinal-stenosis
#15
Robert E Jacobson, Michelle Granville, Jesse Hatgis DO
INTRODUCTION: By using a combination of magnetic resonance imaging (MRI) and computed tomography (CT) of the lumbar spine, it is possible to distinguish between spinal stenosis caused by bone compression and specific soft tissue epidural intraspinal lesions that cause localized spinal canal stenosis and neural compression. Examples include facet cysts and yellow ligament hypertrophy. Many of these patients are elderly with medical comorbidities that make open surgery problematic. MATERIALS & METHODS: This is a study of patients with predominantly soft tissue stenosis being treated with targeted intraspinal radiofrequency (RF) heat ablation...
March 10, 2017: Curēus
https://www.readbyqxmd.com/read/28412983/piezoelectric-technology-in-otolaryngology-and-head-and-neck-surgery-a-review
#16
C Meller, T E Havas
BACKGROUND: Piezoelectric technology has existed for many years as a surgical tool for precise removal of soft tissue and bone. The existing literature regarding its use specifically for otolaryngology, and head and neck surgery was reviewed. METHODS: The databases Medline, the Cochrane Central Register of Controlled Trials, PubMed, Embase and Cambridge Scientific Abstracts were searched. Studies were selected and reviewed based on relevance. RESULTS: Sixty studies were identified and examined for evidence of benefits and disadvantages of piezoelectric surgery and its application in otolaryngology...
April 17, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28412070/evaluation-of-femtosecond-laser-intrastromal-incision-location-using-optical-coherence-tomography
#17
Li Wang, Lai Jiang, Katie Hallahan, Zaina N Al-Mohtaseb, Douglas D Koch
PURPOSE: To use optical coherence tomography (OCT) to evaluate the femtosecond laser intrastromal incisions made during cataract surgery to reduce corneal astigmatism. DESIGN: Retrospective case series. PARTICIPANTS: Seventy-seven eyes of 77 patients. METHODS: Paired intrastromal incisions were created using the Catalys femtosecond laser (Abbott Medical Optics, Inc., Santa Ana, CA). The planned intrastromal incision parameters were 20% uncut anterior, 20% uncut posterior, midpoint depth of 50%, and 90° side cut angle...
April 12, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28409364/distraction-and-proficiency-in-laparoscopy-2d-versus-robotic-console-3d-immersion
#18
Steven Kim, Audriene May, Heidi Ryan, Adnan Mohsin, Shawn Tsuda
INTRODUCTION: Studies have shown that using robotic-assisted laparoscopy (RL) increases performance compared to conventional laparoscopy (CL) due to its mechanical advantages but have not assessed distraction as a factor. To determine whether the immersive aspect of the 3D optics in RL contributes to improved performance, we compared the outcomes of laparoscopic skills by using just the 3D optics of the da Vinci versus the conventional 2D monitor with and without distraction. METHODS: Thirty-two participants without any laparoscopic experience were randomized evenly into four groups: RL, robotic-assisted laparoscopy with distraction (RL + D), CL, and conventional laparoscopy with distraction (CL + D)...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28409259/agreement-of-tricuspid-annular-systolic-excursion-measurement-between-transthoracic-and-transesophageal-echocardiography-in-the-perioperative-setting
#19
Anna Flo Forner, Elham Hasheminejad, Sergi Sabate, Michael A Ackermann, Edwin W Turton, Joerg Ender
OBJECTIVE: The aim of our study was to evaluate the level of agreement between tricuspid annular plane systolic excursion (TAPSE) measured by transthoracic echocardiography (TTE) and TAPSE measured using transesophageal echocardiography (TEE) in anesthetized patients. MATERIALS AND METHODS: Thirty patients scheduled for elective cardiac surgery were prospectively studied. Shortly after induction of anesthesia before the operation, TAPSE was measured by TTE using M-mode in apical 4chamber view (4CH) and by TEE in six different views: using 2D echocardiography in midesophageal (ME) 4CH view, using M-mode in deep transgastric right ventricle (dTG RV) view at 0° and dTG RV longaxis view (LAX) as well as using anatomical M-mode (AM-mode) in ME 4CH, dTG RV at 0° and dTG RV LAX views...
April 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28409207/the-precise-repositioning-instrument-for-genioplasty-and-a-three-dimensional-printing-technique-for-treatment-of-complex-facial-asymmetry
#20
Lin Wang, Dan Tian, Xiumei Sun, Yanju Xiao, Li Chen, Guomin Wu
BACKGROUND: Facial asymmetry is very common in maxillofacial deformities. It is difficult to achieve accurate reconstruction. With the help of 3D printing models and surgical templates, the osteotomy line and the amount of bone grinding can be accurate. Also, by means of the precise repositioning instrument, the repositioning of genioplasty can be accurate and quick. In this study, we present a three-dimensional printing technique and the precise repositioning instrument to guide the osteotomy and repositioning, and illustrate their feasibility and validity...
April 13, 2017: Aesthetic Plastic Surgery
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