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Results for “Surgical simulation”

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At least 505 records · Page 28Linked to original sources

PubMed1991

MRI and stereotaxis. Choice of an approach route on an independent console.

The authors report their experience of cerebral stereotaxis for biopsy purposes. Since January 1990, they have been using MRI which provides vascular images and makes it possible to simulate surgical procedures beforehand. The authors have developed a specific program on an independent console. MRI sections are acquired with a 1.5 Tesla Sigma (G.E.) apparatus in 3DFT volume and T1-weighted SPRG sequence, after gadolinium injection. The sections are memorized and reconstructed by a SUN computer. After automatic recognition of the referential of a Leksell G plane, the target and the puncture vector are chosen by a radiologist and a neurosurgeon. The X, Y, Z co-ordinates of the point of puncture and the angles of penetration into the cerebral volume are delivered automatically. Provided the entire measurement chain is constantly tested and corrected if necessary, the precision of the system is of the order of one millimetre.

Brain Mapping↗

PubMed1985

Vascularization of cancellous chip bone grafts.

Fresh autogenous, frozen allogeneic, and commercially prepared xenogeneic cancellous chip bone grafts were placed into plug holes in the tibia and into surgically simulated nonunion defects in the ulna of dogs. The microvascular and correlated histologic reactions were studied at given times up to 12 weeks after the graft implantation. Marked and characteristic differences were noted among the 3 graft materials. Fresh autogenous chips were extensively vascularized by 1 week, and subsequent microscopic healing was rapid. Allogeneic chips were incorporated into all defects, but vascularization and histologic healing rates were slower than those with the fresh autogenous graft material. The xenogeneic graft was poorly incorporated. A foreign body reaction was seen histologically, and corresponding vascularization of the graft was slow and incomplete.

Angiography↗

PubMed1986

Computer graphic modeling in surgery.

The application of computer-based solid modeling techniques to human anatomy shows great promise for enhancing surgical instruction and research. Such advances will directly benefit patient care. The increasing availability of powerful modeling programs for the microcomputer and the interactive peripheral technologies make the delivery of this new modality practical at the present time. We continue to refine our methodology for producing accurate and esthetic anatomic models and have developed a technique for three-dimensional "sculpting" of elongated structures. We continue to explore the possibility of using sectional scanning data to create anatomic images. Several applications have been described, ranging from surgical simulations to a ballistic injury model, in order to indicate the potential scope of this powerful technology.

Computer Graphics↗

PubMed1986

The enhancement of host defenses against infection--search for the Holy Grail?

With the discovery of new and pharmacologically better described agents, the pursuit of a method for the enhancement of nonspecific host defense against bacterial infection has received a new infusion of interest. Work with the synthetic glycopeptide muramyl dipeptide has indicated its usefulness in a variety of surgically simulated illnesses in experimental animals. The extent of that work is described in detail and current mechanisms of action are explored that focus on the release of transmitter substances from the macrophage, the immediate impact on acute inflammatory cells, and an organ-by-organ dissection of the animal suggesting enhanced containment of experimental infection in animals treated with muramyl dipeptide.

Acetylmuramyl-Alanyl-Isoglutamine↗

PubMed1995

[Pharyngolaryngeal tumors: spiral X-ray computed tomography with 3-dimensional reconstruction].

Spiral CT allows the exploration of the whole larynx and hypopharynx in 30 seconds. This is a good adjustment between the technique and the organ. Performed on 15 patients during a 30 seconds' Valsalva maneuver, the exploration yields results from good to excellent. In two cases, conventional and helical CT are compared. The limitation of mA is not a drawback in such a thin region and there is no shift of organ or lesion between two scans, because the whole range is scanned in a single breathhold. 3D display of larynx and pharynx can be performed with some advantage, especially easiness of presentation for surgeon. They help topographic analysis and make correlation between endoscopic views and axial scans. They could be useful for surgical simulation and 3D photon treatment plannings.

Feasibility Studies↗

PubMed1995

[Three-dimensional longitudinal dissection view of hollow viscus].

To visualize the pathologies of hollow viscus and their extension three-dimensionally, volume data of the larynx, trachea, stomach, rectum, and urinary bladder were obtained using helical CT with moderately thin slices. Longitudinal cut sections were made as in a simulated surgical cut, and the interior morphology was displayed along with the pathology. A cylindrical projection profile was made by making a longitudinal incision on one wall and pulling apart the flaps to reveal the interior, providing better visual perception. The detailed outline from the 3D profile and the cylindrical projection views constituted an added advantage over the existing procedures.

Humans↗

PubMed1993

[A clinical research of three dimensional computerized imaging in the aid of operative design for reconstructive surgery of the face].

This article reports the utilization of three dimensional imaging technique of computer in reconstructive surgery of the face. In 312 cases, the technique has been proved that it can make the preoperative analysis computerized, quantitated and picturized. The measurement and analysis through computer are quick and exact, rendering operative designs feasible. The use of the evaluation system can also help enhance the communication and understanding between the surgeon and his patient. The surgical simulation system can replace the traditional preoperative manual work such as paper molds, plaster casts, and wax mold, and it is therefore much valuable for practical use.

Computer-Aided Design↗

PubMed1996

Safety of thoracic transverse process fixation: an anatomical study.

An anatomical study of the passage of the implant placed around thoracic transverse process was undertaken in human cadavers to investigate the safety of thoracic transverse process fixation. A simulated surgical procedure for implant placement around the transverse processes of T1-T10 was carried out in eight fresh human cadavers using a mock plastic implant, 7.0 mm wide and 1.5 mm thick. A total of 80 implanted thoracic vertebrae were dissected systematically. One implanted spinal column was sectioned sagittally through the costotransverse space. The parietal pleura, the intercostal vessels, and intercostal nerves were not injured by the implants in any of the specimens. All the implants were located posterior to the intercostal nerves and vessels, lateral to the pedicles, and outside the spinal canal. The transverse processes of T1-T10 are safe structures for implant anchorage in posterior spinal instrumentation.

Aged↗

PubMed1996

[Three-dimensional echocardiography. Principles and applications].

Three-dimensional echocardiography is based on two methods of retrospective reconstruction from two-dimensional echocardiographic images. The acquisition of the two-dimensional images may be free or imposed, the transducer either carrying an emission-reception system or fixed to an articulated support providing data about its position. In the first system, manual tracing of the contours of the region of interest performed on each frame are superimposed after time sequencing (using the ECG) and spatial repositioning, so enabling three-dimensional visualisation of the contours of the cardiac structures: this approach provides reliable quantitative information (volumes, mass and ejection fractions) and has led to the redefinition of the echocardiographic criteria of mitral valve prolapse. The second system is based on equidistant sections obtained by progressive, controlled two-dimensional scanning (parallel, arc of a circle and rotational) of the structure of interest: a value of grey scale is assigned to the space between two adjacent pixels, enabling the formation of voxels which, when superimposed, give the required effects of volume and surface for three-dimensional imaging. It is then possible to obtain any section of the volume and simulate surgical views of the beating heart. This approach may significantly improve diagnostic accuracy compared with two-dimensional echocardiography and provides access to new quantitative and qualitative parameters.

Echocardiography, Doppler, Color↗

PubMed2006

Surgical training and simulation laboratory at Baystate Medical Center.

The work hour restrictions imposed by the surgical residency review committee, without a curriculum change, essentially reduces training programs by 30%. The logical result of this is the risk that a higher percentage of surgeons beginning independent practice will fall below the competence level. We believe that simulation will play a vital role in the curriculum to enhance the clinical environment and make the learning environment better and more efficient. Baystate Medical Center (Springfield, Mass) is an affiliate of Tufts University School of Medicine and provides tertiary medical care for the western portion of the state. Our surgical residency program has developed and maintained a simulation center specifically to augment training of surgical knowledge and manual skills. We are also actively involved in education research and curriculum design locally and on a national level. Our center is rapidly becoming a multidisciplinary environment incorporating other residency and clinical programs within the health system and beyond. We are actively pursuing the development of novel assessment technology that will not only integrate the simulation center with the clinical arena but also link educational and clinical outcomes. This will allow us to automatically tailor the educational environment to the individual needs of the learner as they change over time, as well as look at quality improvement related to our educational and research endeavors.

Academic Medical Centers↗

PubMed2005

Identification and reduction of surgical error using simulation.

In recent years, the question of medical errors has received increasing attention. To minimize or avoid errors, it is important to understand both the error itself and the factors leading up to it, as well as the type of error that has been committed. Simulators, which have gained increasing importance in surgical training, can also be useful to "teach" errors, learn from them and develop strategies to avoid them - all of this in a safe environment free from any risk for patients. In this contribution, the nature of errors and their role in simulator training are discussed in detail.

Journal Article↗

PubMed2006

[Surgical training with simulators in training centers].

The development of new endoscopic procedures and minimally-invasive surgical interventions has led the methodology used to date to be questioned. Greater demand for safety by patients, the growth of the health budget and the reduced time available for training have led to the proliferation of centers with accredited personnel in which the knowledge and surgical skills necessary for the controlled incorporation of these techniques can be acquired. Simulators are available for the learning of both digestive endoscopy and laparoscopic techniques. These simulators are more or less dynamic, virtual, with viscera or mixed; even live animals can be used. Thus, the various techniques can be incorporated into clinical practice safely and effectively and at a reasonable cost. Simulators also allow evaluation and follow-up of the skills acquired.

Education↗

PubMed2004

The chick chorioallantoic membrane as a model tissue for surgical retinal research and simulation.

PURPOSE: We describe the use of chick chorioallantoic membrane (CAM) as a model system for the study of the precision and safety of vitreoretinal microsurgical instruments and techniques. METHODS: The CAM was prepared for experimentation with and without its inner shell membrane (ISM) attached for in vivo and in vitro experiments that simulated medical and surgical interventions on the retina. RESULTS: The CAM's ease of use, low cost, and anatomic structure make it a convenient model for surgical retinal and retinal vascular modeling. CONCLUSION: While CAM has been used extensively in the past for ocular angiogenesis studies, we describe the tissue as a useful tool for a variety of other applications, including (1) testing of novel surgical tools and techniques for cutting and coagulating retina and its vasculature, (2) testing vessel cannulation and injection techniques, (3) angiographic studies, and (4) endoscopic surgery.

Allantois↗

PubMed2001

Assessment of fatigue, monitor placement, and surgical experience during simulated laparoscopic surgery.

BACKGROUND: Laparoscopic surgery requires the surgeon to assume atypical postures for extended periods of time, potentially leading to fatigue and chronic injury. This study assessed the level of muscle activity and compared the effects of fatigue, monitor placement, and surgical experience during simulated laparoscopic surgery. METHODS: Four attending and four resident surgeons repeated a series of four tasks with a View site and a standard operating room monitor. Electromyography (EMG) activity and muscular discomfort scores were obtained before and after a "fatigue session." Two variables, the EMG amplitudes and discomfort scores, were analyzed. RESULTS: The EMG amplitudes generally exceed the recommended threshold limits of acceptable muscular load. EMG data and discomfort scores demonstrated a fatigue response in several muscle groups. Minimal differences between the two monitor positions were seen. Overall, the EMG data and discomfort scores showed less muscle activity and discomfort in the attending surgeons. CONCLUSION: Laparoscopic surgery required a relatively high muscular load, putting surgeons at risk for fatigue and injury. Altering the monitor placement did not reduce the surgeon's risk of fatigue. Experience slightly reduced the level of fatigue, but not enough to reduce the surgeon's risk category.

Adult↗

PubMedDate not supplied

Initial experience using an endoscopic simulator to train surgical residents in flexible endoscopy in a community medical center residency program.

INTRODUCTION: The importance of training surgical residents in GI endoscopy has been recognized for years. Despite advice from SAGES and the RRC, few programs have managed to incorporate effective flexible endoscopy training into their curriculum, making it difficult for their graduates to be credentialed in GI endoscopy. Prior to October 2001, our residents obtained their entire clinical experience in the endoscopy unit with staff surgical endoscopists. Attendance was inconsistent because of their many other responsibilities, and residents often used much of their clinical endoscopic exposure gaining basic familiarity with the equipment, precluding the development of therapeutic facility. Since October 2001, we have used the Simbionix endoscopic simulator to supplement resident training in GI endoscopy. With the advent of virtual-reality simulators, and studies validating their effectiveness in teaching fundamental technical skills, we report our initial success in implementing a formal GI endoscopy curriculum using a virtual reality endoscopic simulator to provide basic experience before the clinical endoscopic experience begins. METHODS: Residents are given monthly assignments of simulated cases on the GI Mentor simulator. Junior residents complete the diagnostic case modules; senior residents complete the therapeutic modules. Data were accumulated over the course of two years with a total of five PGY-I and eight senior surgical residents completing assigned cases on the simulator. Objective criteria were measured from their performance on the simulator to determine the efficiency of the examination for each case completed. RESULTS: Preliminary data collected over the course of two years indicates that residents improve the efficiency of their endoscopic examinations over time as measured by objective criteria. Junior surgery residents attained an aggregate average of 59% efficiency in their examinations whereas senior surgical residents who had previous experience with the simulator, attained an aggregate efficiency of 80%. CONCLUSIONS: A formal flexible endoscopy curriculum enhances surgical resident training and positively impacts careers in general and gastrointestinal surgery. Endoscopic simulators allow surgical residents to master the technical aspects of GI endoscopy quickly, thereby permitting them more benefit from their clinical exposure in the endoscopy unit. We anticipate that our formal curriculum in GI endoscopy training will prepare our graduates well for careers that include flexible endoscopy as a component of their clinical practices, and position them to be credentialled in GI endoscopy upon graduation.

Colonoscopy↗

PubMed2006

Self-assessment of performance among surgical trainees during simulated procedures in a simulated operating theater.

BACKGROUND: The ability of surgeons to assess their own performance is essential for training and self-regulation. The latter is based on the premise that they recognize their weaknesses and seek remedial action accordingly. METHODS: Twenty-seven surgical trainees performed a simulated saphenofemoral high-tie on a synthetic model in a simulated operating theater. The performance assessment consisted of blinded rating of technical skills and a global rating of team skills by a human factors expert and a trained surgical research fellow. Subjects also were asked to assess their own performance using the same methods. Spearman's rho was used for data analysis. RESULTS: There was a strong correlation between the experts rating of technical skills and self-assessment (rho = .64). However, the correlation improved with increasing experience. It was .24 for junior trainees, .43 for those with intermediate experience, and .52 for senior trainees. There was a low correlation between the self-assessment and the expert scores for human factors skills (rho = .31). The correlation was higher for the 2 junior groups compared with the senior trainees. CONCLUSIONS: Unlike other studies on self-assessment, this study found that senior surgical trainees are accurate in their self-assessment of technical skills. However, this was not true in the case of human factors skills.

Clinical Competence↗

PubMed2006

Realistic irrigation visualization in a surgical wound debridement simulator.

Wound debridement refers to the removal of necrotic, devitalized, or contaminated tissue and/or foreign material to promote wound healing. Surgical debridement uses sharp instruments to cut dead tissue from a wound and it is the quickest and most efficient method of debridement. A wound debridement simulator can ensure that a medical trainee is competent prior to performing a procedure on a genuine patient. Irrigation is performed at different stages of debridement in order to remove debris and reduce the bacteria count through rinsing the wound. This paper presents a novel approach for realistic irrigation visualization based on texture representations of debris. This approach applies image processing techniques to a series of images, which model the cleanliness of the wound. The active texture is generated and updated dynamically based on the irrigation state, location, and range. Presented results demonstrate that texture mapping and image processing techniques can provide effective and efficient solutions for irrigation visualization in the wound debridement simulator.

Algorithms↗

PubMed2000

Computer-assisted three-dimensional surgical planning and simulation: 3D virtual osteotomy.

A computer-assisted three-dimensional virtual osteotomy system for orthognathic surgery (CAVOS) is presented. The virtual reality workbench is used for surgical planning. The surgeon immerses in a virtual reality environment with stereo eyewear, holds a virtual "scalpel" (3D Mouse) and operates on a "real" patient (3D visualization) to obtain pre-surgical prediction (3D bony segment movements). Virtual surgery on a computer-generated 3D head model is simulated and can be visualized from any arbitrary viewing point in a personal computer system.

Algorithms↗