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Sakti Srivastava

Publications and source records attributed to Sakti Srivastava.

8 recordsLinked to original sources
PubMed2005

Comparison of training on two laparoscopic simulators and assessment of skills transfer to surgical performance.

BACKGROUND: Several studies have investigated the transfer of surgical trainees' skills acquired on surgical simulators to the operating room setting. The purpose of this study was to compare the effectiveness of two laparoscopic surgery simulators by assessing the transfer of skills learned on simulators to closely matched surgical tasks in the animal laboratory. STUDY DESIGN: In this post-test-only Control group study design, 46 surgically naive medical student volunteers were randomly assigned to one of three groups: Tower Trainer group (n = 16), LapSim group (n = 17), and Control group (n = 13). Outcomes measures included both time and accuracy scores on three laparoscopic tasks (Task 1: Grasp and Place; Task 2: Run the Bowel; Task 3: Clip and Cut) performed on live anesthetized pigs, and a global rating of overall performance as judged by four experienced surgeons. RESULTS: The Tower Trainer group performed significantly better than the Control group on 1 of 7 outcomes measures-Task 3: Time (p < 0.032), although the LapSim group performed significantly better than the Control group on 2 of 7 measures-Task 3: Time (p < 0.008) and Global score (p < 0.005). In comparing the two simulators, the LapSim group performed significantly better than the Tower Trainer group on 3 of 7 outcomes measures-Task 2: Time (p < 0.032), Task 2: Accuracy (p < 0.030) and Global score (p < 0.005), although the Tower Trainer group did not perform significantly better than the LapSim group on any measure. CONCLUSIONS: This study demonstrated that naive subjects trained on a virtual-reality part-task trainer performed better on live surgical tasks in a porcine model as compared with those trained with a traditional box trainer. These findings could aid in selection of appropriate training methodologies.

Adult↗
PubMed2004

Arthroscopic evaluation of scaphoid waist fracture stability and the role of the radioscaphocapitate ligament.

PURPOSE: The purpose of this article is to arthroscopically evaluate the effect of forearm rotation on scaphoid fracture displacement and the impact of intra-articular ligament sectioning. TYPE OF STUDY: Controlled laboratory study. METHODS: Scaphoid fracture stability is studied arthroscopically in 10 cadaveric upper limbs. Displacement of the osteotomized scaphoid with and without forearm rotation is arthroscopically evaluated before and after radioscaphocapitate (RSC) ligament sectioning. RESULTS: No rotation at the fracture site was identified in full pronation and full supination with the wrist immobilized. With the RSC ligament intact, no immobilization, and the wrist fully pronated, 25% of scaphoid fractures rotated less than 1 mm, 62.5% rotated 1 to 2 mm, and 12.5% rotated more than 2 mm. After sectioning the RSC ligament, the fully pronated wrist resulted in rotation of less than 1 mm in 75% and 1 to 2 mm in 25%. No rotation at the fracture site was seen with supination, with or without immobilization. No difference was found between loaded and unloaded trials. CONCLUSIONS: Based on this observational data, it appears safe to use a below-elbow thumb spica cast in the treatment of minimally displaced scaphoid waist fractures. Sectioning of the RSC ligament resulted in reduced amount of rotation at the scaphoid waist fracture; thus the RSC ligament may be a deforming force rather than a stabilizing force in scaphoid waist fractures. Arthroscopy may be a valuable tool in the study of the effect of ligament sectioning on fracture stability.

Arthroscopy↗
PubMed2004

LUCY: a 3-D pelvic model for surgical simulation.

Development of 3-D models of human anatomy for use in virtual reality simulators is anticipated to enhance surgical training. These models may be a valuable resource for gaining mastery of minimal-access procedures. The pelvis portion (hip to upper-thigh) of a 32-year-old female cadaver was frozen and sectioned axially in approximately 2-mm increments as the first step in producing an accurately representative 3-D model of the human female pelvis. Photographic exposures of the entire series of 95 sections were then converted to digital format. Adobe PhotoShop masks for each structure were created and converted into wire-frame and surface-textured models; this aggregate model set was named "LUCY." To date, 3-D representations of 40 pelvic structures (over 2200 individual masks) have been modeled In conjunction with haptic technology, these virtual anatomic models will enable users to practice fundamental surgical manipulations and procedures such as tubal ligation and ovariectomy. The deployment of surgical-simulation models such as LUCY may facilitate technical-performance aspects of surgical training, particularly those associated with minimal-access procedures. Manipulations and procedures can be practiced over the Internet, providing a host of flexible options to enhance the surgical curricula.

Adult↗
PubMed2004

The fundamental manipulations of surgery: a structured vocabulary for designing surgical curricula and simulators.

A structured vocabulary is proposed for supporting the design and development of advanced surgical simulators. Nine fundamental surgical instrument-tissue actions or manipulations are defined and common synonyms provided. The vocabulary focuses on "target skills" that are familiar to surgeons, in comparison with "enabling skills" from the lexicon of instructional designers and psychometricians. The adoption of this vocabulary can facilitate communication among surgeons and bioengineers developing "high-fidelity" surgical simulators.

Computer Simulation↗
PubMed2002

Volumetric virtual body structures.

Understanding the visuospatial aspects of anatomic structures is one of the most important goals of gross anatomy. Creation of realistic three-dimensional structures of human anatomy has thus been a goal of medical doctors and computer scientists. In this paper, we describe a PC/NT based system in which a user can easily select anatomical structures to be created, along with the chosen connected structures. The system then constructs a three-dimensional volumetric model, a virtual body structure, slice-by-slide. Once the virtual structure is assembled it is possible to "walk" through the volume with coronal, sagittal, and transverse views, or at any angle. The dynamic nature of the system is unique in that it allows for real time choice of volumetric body structures to be created, their rapid generation, and the ability to manipulate the resulting visualization.

Anatomy, Regional↗
PubMedDate not supplied

Initial evaluation of a shoulder arthroscopy simulator: establishing construct validity.

Formal evaluation of surgical simulators is essential before their introduction into training programs. We report our assessment of the Mentice Corp Procedicus shoulder arthroscopy simulator. This study tests the hypothesis of construct validity that experienced surgeons will score better on the simulator than individuals with minimal to no experience with the technique. Thirty-five subjects were stratified into three groups (novice, intermediate, and expert) based on their past 5 years' experience with shoulder arthroscopies. Each subject had an identical session on the simulator and completed anatomic identification, hook manipulations, and scope navigation exercises. We found statistically significant differences among the three groups in hook manipulation and scope navigation exercises, with the expert group performing the exercises more quickly (P =.013) and more accurately (P =.002) than the other two groups. No statistically significant differences were found among the groups in the identification of anatomic landmarks. Experts rated the simulator as an effective teaching tool, giving it a mean score of 4.22 and 4.44 (maximum, 5) for teaching instrument control and triangulation, respectively.

Arthroscopy↗
PubMedDate not supplied

Simulated medical learning environments on the Internet.

Learning anatomy and surgical procedures requires both a conceptual understanding of three-dimensional anatomy and a hands-on manipulation of tools and tissue. Such virtual resources are not available widely, are expensive, and may be culturally disallowed. Simulation technology, using high-performance computers and graphics, permits realistic real-time display of anatomy. Haptics technology supports the ability to probe and feel this virtual anatomy through the use of virtual tools. The Internet permits world-wide access to resources. We have brought together high-performance servers and high-bandwidth communication using the Next Generation Internet and complex bimanual haptics to simulate a tool-based learning environment for wide use. This article presents the technologic basis of this environment and some evaluation of its use in the gross anatomy course at Stanford University.

Anatomy↗