PubMed Health⌕ Search

PubMed · 14599132

Virtual simulator as a training tool for endonasal surgery.

Abstract

BACKGROUND: Virtual simulation could be an important tool for medical and surgical training as well as education. The efficacy of a simulator for endoscopic nasal procedures in a training program was evaluated. METHODS: The simulator is a medical and scientific tool for visualizing and interacting with three-dimensional volumetric data. Twenty endonasal operations with chronic rhinosinusitis were simulated by two 3rd-year residents and proctored by the senior surgeon 1 day before the actual surgery was performed with an endoscope and computer-aided surgery. A questionnaire was established. RESULTS: The surgical simulator may provide a better understanding of the morphology of the paranasal sinuses with a minor impact on performance of endoscopy by junior residents. Disadvantages identified were time consumption, absence of force feedback, and subtle handling of the joysticks. CONCLUSION: The virtual simulator allows the nonendoscopically nasal trained surgeon to understand and practice endonasal surgery using real-patient data but failed to make an impact on operating room performance. Furthermore, the simulator's effectiveness was limited by the absence of force feedback, subtle handling of the joysticks, and considerable time consumption.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Marco Caversaccio, Adrian Eichenberger, Rudolf Häusler. Virtual simulator as a training tool for endonasal surgery.. https://pubmed.ncbi.nlm.nih.gov/14599132/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

The feasibility of three-dimensional displays of the thorax for preoperative planning in the surgical treatment of lung cancer.

OBJECTIVE: Three-dimensional (3D) displays of anatomic structures have become feasible for preoperative planning in some surgical procedures. There have been no reports, however, on the use of 3D displays for surgical treatment of lung cancer. We hypothesized that 3D displays of the thorax are useful for preoperative planning for lung cancer. METHODS: Based on virtual reality technologies, we rendered 3D displays of the thorax from two-dimensional (2D) computed tomographic (CT) images of six anonymous patients, some of whom underwent surgical removal of lung cancer. For determining the resectability of lung cancer, we tested 17 participants with varying degrees of surgical skills to view 3D displays and read 2D CT images of these thoracic cavities in a randomized order. We measured their performance in terms of the accuracy of predicted resectability, the confidence of their prediction, planning time used, and workload experienced. RESULTS: The results demonstrated that viewing 3D displays of thoracic cavities has significant advantages over reading 2D CT images in determining the resectability of lung cancer: increasing the accuracy of predicted resectability by about 20%, enhancing the confidence of the prediction by about 20%, decreasing planning time by about 30%, and reducing workload by about 50%. All participants preferred viewing 3D displays to reading 2D CT images for preoperative planning. Junior residents found 3D displays of thoraces more useful than senior residents. CONCLUSIONS: It is feasible to use 3D displays of the thorax for preoperative planning in treating lung cancer. Using 3D displays in surgical treatment of lung cancer has potential benefits, once the technique is perfected.

Clinical Competence↗

The learning curve in the training of percutaneous nephrolithotomy.

OBJECTIVES: To investigate the learning curve in the training of percutaneous nephrolithotomy (PCNL). METHODS: A total of 104 PCNL cases were included in this evaluation to define the learning curve of a surgeon with no previous experience at performing solo PCNL. Two parameters of expertise were reviewed, namely the operation and fluoroscopic screening times. The operation time was calculated as the beginning of access with the needle until the nephrostomy tube was placed and secured. PCNL procedures were analyzed in seven sets of 15 cases regarding the operation and fluoroscopy times, stone size, stone clearance rate, blood transfusion rate, and estimated blood loss. RESULTS: The mean operation time was 2.4 h for the first 15 patients. It decreased to a mean of 1.5 h for cases 46 through 60. No further decrease in the operation time was observed after case 60. The fluoroscopic screening time was a peak of 17.5 min in the first 15 cases, whereas it dropped to a mean of 8.9 min for cases 46 through 60. The decline in the mean fluoroscopy screening time continued in cases 61 to 104, but the decline was not significant. There was no significant difference in stone size, stone clearance rate, blood transfusion rate, and estimated blood loss among each set of cases. CONCLUSIONS: This study suggests that the surgical competence in PCNL can be reached after 60 cases. PCNL and fluoroscopy times drop to a steady-state level after performing 60 procedures.

Clinical Competence↗

Critical overview of the management of neonatal jaundice in the UK.

AIM: To determine the current management of early neonatal jaundice in the UK and to evaluate whether the current practices are evidence based. METHODS: A questionnaire survey was carried out among identified lead paediatricians of neonatal intensive care units. RESULTS: The survey found markedly differing practices for the recognition, investigation and treatment of neonatal jaundice. This applies particularly to confirmation of the clinical suspicion of jaundice; use of invasive and non-invasive technologies for diagnosis; preferred wavelength and intensity of light used for treatment; and whether birth weight, gestational age and postnatal age should influence treatment. CONCLUSION: The study found a lack of consistency in the management of jaundiced infants in the UK. The evidence-based practice currently available does not appear to have been incorporated into treatment protocols.

Clinical Competence↗