PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Surgical simulation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed2006

Simulation: a new frontier in surgical education.

Simulation offers a new frontier in surgical education that promises to enhance the current approaches to training. It addresses the operational and fiscal realities of current healthcare deliveries while adhering to principles of educational psychology. Challenges for educators include systematic validation of simulation methods, attracting research funding agencies to support this cause, and development of appropriate funding mechanisms for the sometimes high facility and hardware costs. The greatest challenge, however, is instituting simulation into the minds of a surgical community that is already steeped in a long and entrenched tradition of Halstedian surgical training.

Clinical Competence↗
PubMed2002

Public domain computer-aided surgery (CAS) in orthodontic and maxillofacial surgery.

BACKGROUND: Computer-aided virtual three-dimensional (3D) surgical simulation assists the necessary visual understanding of complex pathological situations but has so far been dependent on expensive hardware and software. METHOD: For the first time a non-commercial, user-orientated application for orthognathic and craniofacial surgical simulation has been introduced, based on freeware NIH Image 1.62 provided by the National Institute of Mental Health (NIMH). Use and limitations are demonstrated here by the example of hypertelorism surgery. The osteotomy lines and the amount of resection for outward positioning of the orbits were determined by the surgeon on a workstation using CT data. Possible movement patterns of the osteotomy fragments were rotations, sagittal and transversal movements or combinations of these. The program then allows the calculation of anatomical distances on the screen in a 1:1 relation. Normative values according to age and pathological anatomy determine the degree of displacement. The program calculates the new position of the osteotomy fragments and transfers the data of the segment movement to the original CT data. RESULTS: 3D visualization of bone and soft tissue contours have been produced with an acceptable quality on a workstation for the demonstration and visual understanding of the surgical plan. Evaluation of a postoperative CT showed that the amount of movement and size of bone resection in the simulation was slightly overestimated rather than underestimated. This was also dependent on the complexity of the pathological anatomy and on how experienced the surgeon was. CONCLUSION: The use of 3D simulation programs allows a better understanding of the pathological anatomy in all dimensions, and in many cases enables limitations to be recognized in advance. The public domain program makes a major contribution to the quality of orthognathic and craniofacial surgical planning through cost-free usability, and supports continuous development and exchange of experience.

Cephalometry↗
PubMed2005

Application of a rapid-prototyped temporal bone model for surgical planning.

CONCLUSION: This 3D prototyped model constructed using a selective laser sintering method serves as a good material for surgical simulation of a malformed ear. OBJECTIVE: In order to perform surgery of the malformed ear, a thorough understanding of the anatomy of the ear is required, together with sufficient experience. The aim of this study was to investigate the validity of a prototyped temporal bone model for surgical simulation. MATERIAL AND METHODS: Simulated 3D models of two cases of congenital aural atresia were prototyped using a selective laser sintering method. Conventional surgical instruments were used to dissect the models. RESULTS: Abnormal structures of the middle ear, such as the ossicles, labyrinth and facial nerve, were identified by dissecting the model. Presurgical dissection informed the surgeon of the optimum orientation for surgery. The model was disinfected and could be handled by the surgeon in the operating room. Surgery could be carried out safely although in one case it was canceled because of the highly abnormal location of the middle ear cleft and facial nerve.

Adult↗
PubMed1994

Emerging medical applications of virtual reality: a surgeon's perspective.

Medical applications for virtual reality (VR) technologies are just beginning to emerge. These include VR surgical simulators, telepresence surgery, complex medical database visualization, and rehabilitation. These applications are mediated through the computer interface and embody VR as an integral part of a paradigm shift in the field of medicine. The Green Telepresence Surgery System consists of two components, the surgical workstation and the remote worksite. At the remote site there is a 3-D camera system and responsive manipulators with sensory input. At the workstation there is a 3-D monitor and dexterous handles with force feedback. The VR surgical simulator is a stylized recreation of the human abdomen with several essential organs. Using a head-mounted display and DataGlove, a person can learn anatomy from a new perspective by 'flying' inside and around the organs, or can practice surgical procedures with a scalpel and clamps. Database visualization creates 3-D images of complex medical data for new perspectives in analysis. VR applications in rehabilitation medicine permit impaired individuals to perform tasks not otherwise available to them, allow accurate assessment and therapy for their disabilities, and help architects understand their critical needs in public or personal space. And to support these advanced technologies, the operating room and hospital of the future will be first designed and tested in virtual reality, bringing together the full power of the digital physician.

Computer Graphics↗
PubMed1994

Craniofacial computer-assisted surgical planning and simulation.

Computer-assisted planning and simulation of craniofacial surgery has progressed from development, through validation, and into clinical use. CT scans are transferred from the radiology department to a graphics workstation in the surgeon's office or laboratory, where data postprocessing and visualization for anatomic evaluation and surgical simulation are performed. Quantitative and qualitative comparative analyses between the plan/simulation and the actual postoperative result provide the feedback that validates or refutes the preoperative assessment and simulated intervention. The optimum surgical solution can be chosen from many possibilities. Interactive computer-assisted surgical simulation is also useful for morbidity-free training of inexperienced surgeons.

Child↗
PubMed1995

Medical applications of virtual reality.

Medical applications for virtual reality (VR) are just beginning to emerge. These include VR surgical simulators, telepresence surgery, complex medical database visualization, and rehabilitation. These applications are mediated through the computer interface and as such are the embodiment of VR as an integral part of the paradigm shift in the field of medicine. The Green Telepresence Surgery System consists of two components, the surgical workstation and remote worksite. At the remote site there is a 3-D camera system and responsive manipulators with sensory input. At the workstation there is a 3-D monitor and dexterous handles with force feedback. The VR surgical simulator is a stylized recreation of the human abdomen with several essential organs. Using a helmet mounted display and DataGlove, a person can learn anatomy from a new perspective by 'flying' inside and around the organs, or can practice surgical procedures with a scalpel and clamps. Database visualization creates 3-D images of complex medical data for new perspectives in analysis. Rehabilitation medicine permits impaired individuals to explore worlds not otherwise available to them, allows accurate assessment and therapy for their disabilities, and helps architects understand their critical needs in public or personal space. And to support these advanced technologies, the operating room and hospital of the future will be first designed and tested in virtual reality, bringing together the full power of the digital physician.

Computer Graphics↗
PubMed2004

Haptic rendering of tissue cutting with scissors.

Current surgical simulations that involve cutting with scissors lack display of forces "between the fingers" of the operator. The objective of this work is to develop a fast, realistic haptic rendering technique for scissor cutting that can be easily integrated into soft tissue models commonly used in surgical simulators. A virtual environment was created for combined graphic and haptic display of cutting. Two 2-dimensional deformable mass-spring-damper models were developed: The first is a large mesh that is used to calculate translational forces. The second is a smaller, one-element-thick mesh that is used to calculate cutting (angular) forces. This technique was implemented on the haptic scissors, a haptic interface that allows motion and force feedback in translation and cutting.

Computer Graphics↗
PubMed2006

Can skills assessment on a virtual reality trainer predict a surgical trainee's talent in laparoscopic surgery?

BACKGROUND: A number of studies have investigated several aspects of feasibility and validity of performance assessments with virtual reality surgical simulators. However, the validity of performance assessments is limited by the reliability of such measurements, and some issues of reliability still need to be addressed. This study aimed to evaluate the hypothesis that test subjects show logarithmic performance curves on repetitive trials for a component task of laparoscopic cholecystectomy on a virtual reality simulator, and that interindividual differences in performance after considerable training are significant. According to kinesiologic theory, logarithmic performance curves are expected and an individual's learning capacity for a specific task can be extrapolated, allowing quantification of a person's innate ability to develop task-specific skills. METHODS: In this study, 20 medical students at the University of Basel Medical School performed five trials of a standardized task on the LS 500 virtual reality simulator for laparoscopic surgery. Task completion time, number of errors, economy of instrument movements, and maximum speed of instrument movements were measured. RESULTS: The hypothesis was confirmed by the fact that the performance curves for some of the simulator measurements were very close to logarithmic curves, and there were significant interindividual differences in performance at the end of the repetitive trials. CONCLUSIONS: Assessment of perceptual motor skills and the innate ability of an individual with no prior experience in laparoscopic surgery to develop such skills using the LS 500 VR surgical simulator is feasible and reliable.

Adult↗
PubMed2002

A new approach for the synthesis of glistening effect in deformable anatomical objects displayed with haptic feedback.

An environment mapping approach for texture mapping of anatomical objects with glistening was studied and implemented in surgical simulation. A classifier based on the generalized goal of achieving glistening effect, which depends on the underlying physics and the mapped data, was used as a visual metric and shown to be realistic in the presence of achieving the desired quality in real time in the presence of haptic feedback. The proposed approach was compared with the standard texture mapping approaches used in existing surgical simulation methods that generally suffer from texture stretching and with little or no glistening effect. In our work, we have successfully applied environment mapping techniques for realistic real-time rendering of anatomical objects. We also show several examples of anatomical objects with glistening effects that mimic real anatomical objects.

Computer Simulation↗
PubMed1998

Clinical value of computer-generated acrylic skull replicas produced by laser lithography.

To determine for what deformity and utility the computer-generated acrylic (CGA) skull replica has the greatest value, we analyzed retrospectively a consecutive series of patients with craniomaxillofacial deformities (N = 54) whose treatment involved the utilization of CGA skull replicas. Application of the CGA skull replica was divided retrospectively into four groups: (1) use as an aid for preoperative analysis of osseous deformity, (2) use as material for preoperative surgical simulation, (3) use as a navigational aid during an operation, and (4) use as a negative template. Based on the aspects of these utilizations, we evaluated for what deformity the CGA skull replica was useful. Analysis of the data led us to conclude the following. First, the CGA skull replica is a valuable tool in craniomaxillofacial surgery, especially for patients with asymmetrical deformities and delicate convexities and concavities of the skull surface. Second, the largest function that CGA skull replicas can satisfy is standardization of craniomaxillofacial surgery. In carrying out preoperative surgical simulation utilizing a replica, drawing osteotomy lines on it, sterilizing it, and then bringing it to the operating table for consultation whenever required during an operation, we are able to proceed with greater precision and speed than if it was not available.

Acrylic Resins↗
PubMed1986

Three-dimensional computer-assisted design of craniofacial surgical procedures: optimization and interaction with cephalometric and CT-based models.

A computer program is described which aids the clinician in planning craniofacial surgical procedures. It operates on a three-dimensional landmark data base derived by combining posteroanterior and lateral cephalograms from the patient and from the Bolton normative standards. A three-dimensional surgical simulation program based on computerized tomographic (CT) data is also described which can be linked to the cephalometrically based program. After the clinician has selected the number and type of osteotomies to be performed on the patient, an automated optimization program computes the postoperative positions of these fragments which best fit the appropriate normal cephalometric form. The clinician then interactively modifies the design to account for such variables as bone-graft resorption, relapse tendency, occlusal disparities, and the condition of the overlying soft-tissue matrix. Osteotomy movement specifications are easily transferred between the CT-based and the cephalometrically based surgical simulation programs. This allows the automated positioning step to be performed on the cephalometrically based model while the interactive step is performed using the superior image provided by the CT-based model.

Cephalometry↗
PubMed1986

Simulation in surgical training using freeze dried material.

The acquisition of manual dexterity and surgical skills is usually achieved in the operating theatre under supervision. We describe an efficient way of learning intestinal anastomosis procedures with the use of gamma irradiated, lyophilized porcine or bovine tissues together with a purpose designed holding jig. Preliminary evaluation of this method with untrained subjects showed that they were able to improve their performance. Because the tissues are sterile, health hazards are avoided and no special laboratory facilities are required. This approach has promise as an aid to evaluation as well as training.

Animals↗
PubMed2002

[Simulation of surgical techniques in graduate education of the surgeon. An analysis of value and effect].

The course in Gastrointestinal Surgery (GISC) aims at teaching and training resection, reconstruction and suture techniques of the upper gastrointestinal tract. Prior to, after and 5 years following the first course, participants were asked to answer a questionnaire requesting information regarding the adequacy of surgical training in their residency program and how much they had benefited from the GISC. While 1/3 of the participants described the surgical training during their residency as inadequate, more than 90% benefited from the GISC. Although the single-layer-continuous suture technique was implemented by only 8% of the participating surgeons, other techniques such as cross-section gastroenterostomy were accepted by 38%. Only 7% of the participants rejected these new techniques, while 41% of the senior surgeons at home could not be convinced. Besides the teaching of new techniques, participants benefited above all from the repetitive training in surgical procedures.

Animals↗