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At least 577 records · Page 32Linked to original sources
PubMed1997

Application of numerical modelling of osteotomy to orthopaedic practice.

During the development of an osteoarthritic hip joint, osteophytes, cysts as well as arthrosis originate on the contact boundary between the femoral head and the acetabulum in highly loaded human joints. The purpose of proximal femur osteotomy is to bring the femoral head into a new position inside the acetabulum. The corrective options of intertrochanteric osteotomy most frequently used in orthopaedic practice are valgization, varization, displacements, oblique displacements, lateralization, extension, rotation or shortening of the shaft. The present widespread tomographic measurement methods, such as computer tomography (CT), magnetic resonance imaging (MRI) and 2D or 3D reconstruction involve the simulation of surgical problems of osteotomy, as well as the simulation of the reconstruction of the function of the hip joint after the operation. The results of numerical modelling of osteotomy concerning contact problems, will be presented in the contribution.

Acetabulum↗
PubMed1977

Echocardiographic, angiocardiographic, and surgical correlations in right ventricular myxoma simulating valvar pulmonic stenosis.

The echocardiographic, angiographic and surgical correlations in a patients with a right ventricular myxoma simulating valvar pulmonic stenosis are presented. A dense mass of echoes was seen in the body of the right ventricle in diastole; in the right ventricular outflow tract throughout the cardiac cycle; and within the pulmonic valve in systole. These echocardiographic findings suggested the presence of a mass high in the right ventricle, which moved throught the pulmonic valve in systole. This impression was confirmed by angiography and surgery. A 53 mmHg gradient across the pulmonic valve was noted at cardiac catheterization. At operation a myxoma which originated above the crista supraventricularis was found. The tumor moved into the main pulmonary artery in systole. Surgical removal of the tumor resulted in the disappearance of the abnormal echoes.

Adolescent↗
PubMed1994

Simulation of intraoperative visualization of cardiac structures and study of dynamic surgical anatomy with real-time three-dimensional echocardiography.

Most prior efforts of 3-dimensional (3-D) reconstruction of echocardiographic images have focused on quantitation of ventricular size and function. The resulting images have been displayed in the wire mesh format. Recently, a method for 3-D transesophageal echocardiography using a computer-controlled probe that acquires parallel tomographic slices has been described. This technique provides dynamic 3-D volume-rendered images of the heart. This study was designed to determine if surgical visualization of intracardiac anatomy could be simulated using this imaging system. Data acquired from 8 patients with congenital and acquired heart disease were analyzed. Real-time 3-D images of the cardiac chambers and valves were obtained. Images of the cardiac pathology including fibrocalcific nodules on the aortic valve, mitral valve endocarditis, rheumatic mitral stenosis, and an ostium secundum atrial septal defect were displayed in 3 dimensions that simulated surgical exposure of these structures. These 3-D representations of cardiac anatomy were in some ways superior to standard intraoperative visualization in that they demonstrated the heart as a dynamic structure, as opposed to the empty, nonbeating heart observed while on cardiopulmonary bypass. In conclusion, 3-D images of cardiac structures as seen by the surgeon intraoperatively can be provided using a computer-driven tomographic transesophageal echocardiographic probe. This imaging system can be potentially useful in the planning and evaluation of cardiac surgery. Technical improvements such as 3-D representation of flow jets, the ability to manipulate images to simulate cardiac surgery, and on-line reconstruction can make this a powerful tool in the future.

Computer Simulation↗
PubMed1995

[Acute abdomen in anticoagulated patients. Its assessment and the surgical indications].

Bleeding complications associated with anticoagulant drugs can development abdominal pain simulating acute surgical conditions of abdomen. We report six cases of intraabdominal spontaneous haemorrhage presenting as an acute abdomen in patients on anticoagulant therapy: two rectus sheath hematomas, a abdominal wall hematoma, a spontaneous hemoperitoneum, a retroperitoneal hematoma and an intramural hematoma of the small bowel. The article conclude that computed tomography examination provided useful information in this complications because can demonstrate the size and location of the mass and its relation to normal intra-abdominal structures. Finally, authors expose the surgical indications of the different bleeding syndromes in this patients.

Abdomen, Acute↗
PubMed2000

Stereotactic surgery: what is past is prologue.

Two old and simple simple concepts, a three-dimensional positioning stage and a coordinate system, were combined in 1906 to create a new one: the stereotactic method. For 25 years, it found little application until it was rediscovered for investigations in small animals. After the first human subcortical stereotactic procedure was performed in 1947, stereotactic methods found greatest application in the placement of subcortical lesions in the treatment of movement disorders. Rapid advances in the development of instrumentation, methods, and understanding of human neuroanatomy and neurophysiology resulted. However, a dormant period followed the introduction of L-dopa in 1968. The advent of computer-based medical imaging applied to the stereotactic method encouraged adaptation of stereotactic methods to the management of intracranial tumors, the rapid development of new surgical hardware, and the rediscovery of old methods and evolution of new ones for the treatment of movement disorders. In addition, the incorporation of computer systems as stereotactic surgical instruments further increased the capabilities of stereotactic methods. Radiosurgical applications increased with the proliferation of gamma units and the development of linear accelerator-based radiosurgical methods. Computers are used to fuse and reformat imaging databases for surgical planning, simulation, and frameless stereotactic intraoperative guidance. As a result, surgical procedures have become more effective in meeting preoperative goals and less invasive. Low-cost, high-speed, microprocessor-based workstation computers and intuitive user interfaces have increased the acceptance into mainstream neurosurgery. It is anticipated that a significant portion of neurosurgery, and probably most surgical procedures in general, will comprise computer-based interventions guided by volumetric imaging-defined data sets acquired preoperatively or by intraoperative imaging systems. The stereotactic surgery of the future may employ all or a combination of the following technologies: frameless stereotactic surgery, robotic technology, microrobotic dexterity enhancement, and telepresence robotics.

Brain↗
PubMed2004

Intracranial aneurysms: reproduction of the surgical view using 3D-CT angiography.

Our purpose was to describe a technique for simulating the surgical view of ruptured intracranial aneurysms, using volume-rendering techniques in spiral computed tomography (CT) angiography data. The 3D (three-dimensional) rendered images were assessed by a team consisted of four radiologists, one neurosurgeon and one medical physicist. The resultant 'surgical view' image was standardized in space using a three-dimensional coordinate system, which allowed for its reproduction in the operating theatre. The surgical views are a potentially useful tool for the surgical planning of intracranial aneurysms.

Adolescent↗
PubMed2006

Evaluation of target scores and benchmarks for the traversal task scenario of the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) laparoscopy simulator.

BACKGROUND: The Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) simulator is validated for laparoscopy training, but benchmarks and target scores for assessing single tasks are needed. METHODS: Control data for the MIST-VR traversal task scenario were collected from 61 novices who performed the task 10 times over 3 days (1 h daily). Data were collected on the time taken, error score, economy of movement, and total score. Test differences were analyzed through percentage scores and t-tests for paired samples. RESULTS: Improvement was greatest over tests 1 to 5 (improvement: test(1.2), 38.07%; p = 0.000; test(4.5), 10.66%; p = 0.010): between tests 5 and 10, improvement slowed and scores stabilized. Variation in participants' performance fell steadily over the 10 tests. CONCLUSION: Trainees should perform at least 10 tests of the traversal task-five to get used to the equipment and task (automation phase; target total score, 95.16) and five to stabilize and consolidate performance (test 10 target total score, 74.11).

Adult↗
PubMed2005

[Prognosis of the facial profile line using the finite element method].

AIM: The aim of the present study was to verify how realistic the prediction of the clinical appearance of the patient's profile is by using the finite element method to simulate orthodontic and surgical intervention. MATERIAL AND METHOD: This single-case study explains step by step interdisciplinary treatment planning in a case with angle class III. Orthodontic and surgical procedures can be simulated and visualized using the lateral cephalogram and the Onyx Ceph software. The facial profile line is calculated over the skeletal surface using the finite element method. The morphing feature of the Onyx Ceph software is used to create an image of the predicted appearance of the patient's profile using a preoperative lateral photograph. RESULTS: The comparison of the simulated profile and the clinical result after bimaxillary surgery showed high concordance. CONCLUSION: The finite element method represents a useful tool for the prediction of the postoperative appearance in patients undergoing fixed orthodontic appliance and orthognathic surgery.

Adult↗
PubMed2005

Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training.

SUMMARY BACKGROUND DATA: To inform surgeons about the practical issues to be considered for successful integration of virtual reality simulation into a surgical training program. The learning and practice of minimally invasive surgery (MIS) makes unique demands on surgical training programs. A decade ago Satava proposed virtual reality (VR) surgical simulation as a solution for this problem. Only recently have robust scientific studies supported that vision METHODS: A review of the surgical education, human-factor, and psychology literature to identify important factors which will impinge on the successful integration of VR training into a surgical training program. RESULTS: VR is more likely to be successful if it is systematically integrated into a well-thought-out education and training program which objectively assesses technical skills improvement proximate to the learning experience. Validated performance metrics should be relevant to the surgical task being trained but in general will require trainees to reach an objectively determined proficiency criterion, based on tightly defined metrics and perform at this level consistently. VR training is more likely to be successful if the training schedule takes place on an interval basis rather than massed into a short period of extensive practice. High-fidelity VR simulations will confer the greatest skills transfer to the in vivo surgical situation, but less expensive VR trainers will also lead to considerably improved skills generalizations. CONCLUSIONS: VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills.

Attention↗
PubMedDate not supplied

Conceptual framework for laparoscopic VR simulators.

Availability of YR laparoscopic simulation for surgical training has increased significantly. Nevertheless, few studies have explored such simulators' requirements and the degree of fidelity necessary to provide effective educational tools. The authors aim to identify which didactic resources available in YR simulation technologies are most important for laparoscopic training.

Computer Graphics↗
PubMed2004

A comparison of a forced-air warming system to traditional thermal support for rodent microenvironments.

Thermal homeostasis is important for the well-being of laboratory rodents during experimental investigations involving chemical restraint. Anaesthesia-induced hypothermia may alter physiological processes, prolong recovery times, or result in death. Therefore, active warming may be needed to prevent excess heat loss from the rodent to the environment. Three methods of active warming were evaluated in typical rodent procedural areas and recovery cages: a forced-air warming system, infra-red heat emitter and circulating-water blanket. The first experiment involved recording the temperature of the immediate environment of the three devices, with and/or without the accompanying plastic drape, to simulate a surgical situation. In the second experiment, temperatures were recorded within cages that simulated a recovery situation with the same modalities. Forced-air warmer blankets (FAWB) were either wrapped around or placed underneath standard polycarbonate rodent cages and the results were compared with cage temperatures warmed by the heat emitter and circulating-water blanket. Temperatures were recorded at 0, 20, 40, and 60 min for each warming treatment, to determine mean temperature (+/- SEM) and the magnitude of increase (+/- SEM) between 0 and 60 min. All three devices showed an increase in temperature, but the FAWB with a plastic drape heated the procedural area microenvironment (Experiment 1) quickly and to a final temperature of 38.6 degrees C (101.5 degrees F) at 60 min, compared with 25 degrees C (77 degrees F) for the heat emitter and 28 degrees C (82.4 degrees F) for the circulating-water blanket. The magnitude of increase was significantly different for each treatment, but the FAWB with a plastic drape climbed 16.3 degrees C (29.3 degrees F) in 60 min. In Experiment 2, the FAWB wrapped around a cage, covered with a plastic drape, heated recovery cages to 32.5 degrees C (90.5 degrees F) compared to the heat emitter 26.4 degrees C (79.5 degrees F) and circulating-water blanket with drape 26.3 degrees C (79.3 degrees F). The magnitude of increase in the microenvironmental temperature was significantly higher for the FAWB, with the plastic drape wrapped around the recovery cage, compared to the other treatments. In both experiments, forced-air warming proved superior to the more traditional thermal support treatments in heating the microenvironments quickly and to an optimum ambient temperature. Forced-air warming devices should be considered when thermal support is required for rodent procedural areas and recovery cages.

Anesthesia↗