scholarly journals Ear Reconstruction Using Autologus Costal Cartilage: A Steep Learning Curve

2018 ◽  
Vol 18 (3) ◽  
pp. 371-377 ◽  
Author(s):  
Paritkumar S. Ladani ◽  
Rajesh Valand ◽  
Hermann Sailer
Keyword(s):  
Learning Curve ◽  
Costal Cartilage ◽  
Ear Reconstruction ◽  
Steep Learning Curve

scholarly journals Laparoscopic pectopexy: the learning curve and comparison with laparoscopic sacrocolpopexy

2021 ◽  
Author(s):  
Fei Chi Chuang ◽  
Yu Min Chou ◽  
Ling Ying Wu ◽  
Tsai Hwa Yang ◽  
Wen Hsin Chen ◽  
...  
Keyword(s):  
Learning Curve ◽  
Operation Time ◽  
Synthetic Mesh ◽  
Laparoscopic Sacrocolpopexy ◽  
Apical Prolapse ◽  
Steep Learning Curve ◽  
Surgical Method ◽  
Surgical Field ◽  
Uncontrolled Bleeding

Abstract Introduction and hypothesis In addition to laparoscopic sacrocolpopexy (LS), laparoscopic pectopexy (LP) is a novel surgical method for correcting apical prolapse. The descended cervix or vaginal vault is suspended with a synthetic mesh by fixing the bilateral mesh ends to the pectineal ligaments. This study was aimed at developing a learning curve for LP and to compare it with results with LS. Methods We started laparoscopic/robotic pectopexy in our department in August 2019. This retrospective study included the initial 18 consecutive women with apical prolapse receiving LP and another group undergoing LS (21 cases) performed by the same surgeon. The medical and video records were reviewed. Results The age was older in the LP group than in the LS group (65.2 vs 53.1 years). The operation time of LP group was significantly shorter than that of the LS group (182.9 ± 27.2 vs 256.2 ± 45.5 min, p < 0.001). The turning point of the LP learning curve was observed at the 12th case. No major complications such as bladder, ureteral, bowel injury or uncontrolled bleeding occurred in either group. Postoperative low back pain and defecation symptoms occurred exclusively in the LS group. During the follow-up period (mean 7.2 months in LP, 16.2 months in LS), none of the cases had recurrent apical prolapse. Conclusions Laparoscopic pectopexy is a feasible surgical method for apical prolapse, with a shorter operation time and less postoperative discomfort than LS. LP may overcome the steep learning curve of LS because the surgical field of LP is limited to the anterior pelvis and avoids encountering the critical organs.

scholarly journals Ear Reconstruction Simulation: From Handcrafting to 3D Printing

2019 ◽  
Vol 6 (1) ◽  
pp. 14 ◽  
Author(s):  
Elisa Mussi ◽  
Rocco Furferi ◽  
Yary Volpe ◽  
Flavio Facchini ◽  
Kathleen S. McGreevy ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Surgical Reconstruction ◽  
Ear Reconstruction ◽  
Autologous Tissue ◽  
Aesthetic Appearance ◽  
History Of ◽  
Common Clinical Practice ◽  
The Aesthetic ◽  
Manufacturing Technologies ◽  
High Level

Microtia is a congenital malformation affecting one in 5000 individuals and is characterized by physical deformity or absence of the outer ear. Nowadays, surgical reconstruction with autologous tissue is the most common clinical practice. The procedure requires a high level of manual and artistic techniques of a surgeon in carving and sculpting of harvested costal cartilage of the patient to recreate an auricular framework to insert within a skin pocket obtained at the malformed ear region. The aesthetic outcomes of the surgery are highly dependent on the experience of the surgeon performing the surgery. For this reason, surgeons need simulators to acquire adequate technical skills out of the surgery room without compromising the aesthetic appearance of the patient. The current paper aims to describe and analyze the different materials and methods adopted during the history of autologous ear reconstruction (AER) simulation to train surgeons by practice on geometrically and mechanically accurate physical replicas. Recent advances in 3D modelling software and manufacturing technologies to increase the effectiveness of AER simulators are particularly described to provide more recent outcomes.

Learning curves for transradial access versus transfemoral access in diagnostic cerebral angiography: a case series

2021 ◽  
pp. neurintsurg-2021-017460
Author(s):  
Michael K Tso ◽  
Gary B Rajah ◽  
Rimal H Dossani ◽  
Michael J Meyer ◽  
Matthew J McPheeters ◽  
...  
Keyword(s):  
Learning Curve ◽  
Case Series ◽  
Learning Curves ◽  
Fluoroscopy Time ◽  
Access Site ◽  
Steep Learning Curve ◽  
Transradial Access ◽  
Primary Operator ◽  
Technical Proficiency ◽  
Over Time

BackgroundThe perception of a steep learning curve associated with transradial access has resulted in its limited adoption in neurointervention despite the demonstrated benefits, including decreased access-site complications.ObjectiveTo compare learning curves of transradial versus transfemoral diagnostic cerebral angiograms obtained by five neurovascular fellows as primary operator.MethodsThe first 100–150 consecutive transradial and transfemoral angiographic scans performed by each fellow between July 2017 and March 2020 were identified. Mean fluoroscopy time per artery injected (angiographic efficiency) was calculated as a marker of technical proficiency and compared for every 25 consecutive procedures performed (eg, 1–25, 26–50, 51–75).ResultsWe identified 1242 diagnostic angiograms, 607 transradial and 635 transfemoral. The radial cohort was older (64.3 years vs 62.3 years, p=0.01) and demonstrated better angiographic efficiency (3.4 min/vessel vs 3.7 min/vessel, p=0.03). For three fellows without previous endovascular experience, proficiency was obtained between 25 and 50 transfemoral angiograms. One fellow achieved proficiency after performing 25–50 transradial angiograms; and the two other fellows, in <25 transradial angiograms. The two fellows with previous experience had flattened learning curves for both access types. Two patients experienced transient neurologic symptoms postprocedure. Transradial angiograms were associated with significantly fewer access-site complications (3/607, 0.5% vs 22/635, 3.5%, p<0.01). Radial-to-femoral conversion occurred in 1.2% (7/607); femoral-to-radial conversion occurred in 0.3% (2/635). Over time, the proportion of transradial angiographic procedures increased.ConclusionTechnical proficiency improved significantly over time for both access types, typically requiring between 25 and 50 diagnostic angiograms to achieve asymptomatic improvement in efficiency. Reduced access-site complications and decreased fluoroscopy time were benefits associated with transradial angiography.

Sustainability, Ethics and Education

2014 ◽  
pp. 424-440
Author(s):  
Tehmina Khan
Keyword(s):  
Learning Curve ◽  
Sustainability Education ◽  
Accounting Education ◽  
Steep Learning Curve ◽  
Body Of Knowledge ◽  
Sustainability Ethics ◽  
Ethics Course ◽  
Royal Melbourne Institute ◽  
Institute Of Technology ◽  
Development Of Students

Accounting education has faced limitations as a highly technical and discipline-specific body of knowledge. The case presented in this chapter demonstrates and reflects on an attempt at incorporating the study of sustainability-related accounting knowledge through multiple forms of delivery and assessment. Sustainability-related material that draws from business, accounting and ethics' perspectives was included in an accounting ethics course for accounting majors at Royal Melbourne Institute of Technology (RMIT) University in Melbourne, Australia. This pedagogy has encouraged the development of students' soft skills including their emotional intelligence. Sustainability education has been found as engaging and thought provoking, albeit involving a steep learning curve for students as far as knowledge and awareness are concerned. It has allowed for the promotion of multiple and broader perspectives and education on key sustainability-related concerns, from a range of angles including ethics and accounting frameworks for sustainability as well as multidisciplinary approaches to sustainability and business.

Virtual Learning Environments

2011 ◽  
pp. 62-74 ◽  
Author(s):  
Mitzi P. Trahan ◽  
Nan B. Adams ◽  
Susan Dupre
Keyword(s):  
Distance Learning ◽  
Learning Curve ◽  
Learning Environments ◽  
Real Life ◽  
Virtual Learning ◽  
Learning Opportunities ◽  
Virtual Learning Environments ◽  
Development Model ◽  
Steep Learning Curve ◽  
Barriers To Access

The growing experimentation with multi-user virtual environments for educational purposes demands rigorous examination of all aspects of these digital worlds. While their use appears to enhance and expand traditional distance learning, educators acknowledge that barriers to access remain, including a steep learning curve for orienting users to MUVE navigation and functionality. The application of Adams’s Knowledge Development Model for Virtual Learning Environments provides a framework for the design of in-world learning opportunities and activities, many of which tend to mirror pedagogical best-practices in Real Life (RL).

Mixed Realities

2012 ◽  
pp. 209-216 ◽  
Author(s):  
Daniel Rolf
Keyword(s):  
Learning Curve ◽  
Mobile Phone ◽  
Mixed Reality ◽  
Training And Education ◽  
Steep Learning Curve ◽  
Technological Support ◽  
Specific Technology ◽  
Innovative Approaches

Teaching with technological support brings its own set of problems, some of them technical and others social in nature. Familiarity with specific technology can enhance the teacher’s, the practicing professional’s and the student’s experience, otherwise each will face a potentially steep learning curve before being able to achieve the best outcomes. We live in a time of rapid technical advancement bringing us new and ever more exciting opportunities at ever decreasing cost. In this chapter the authors will look at technologies which present opportunities in the virtuality continuum, from the ubiquitous mobile phone to more specialized augmented and mixed reality systems. They show examples from various fields of endeavor in an attempt to whet the appetite of those interested in new and innovative approaches to training and education.

Microtia Repair

2019 ◽  
pp. 461-470
Author(s):  
Melissa Kanack ◽  
Catherine Tsai ◽  
Amanda Gosman
Keyword(s):  
Skin Graft ◽  
Costal Cartilage ◽  
Ear Reconstruction ◽  
External Ear ◽  
Cartilage Graft ◽  
Associated Anomalies ◽  
Ear Canal ◽  
Genetic Syndrome ◽  
Definition Of ◽  
Costal Cartilage Graft

Microtia may occur as an isolated finding or in conjunction with other associated anomalies or a genetic syndrome. Ear reconstruction for these patients is typically performed no earlier than 6 years of age. In this chapter, a staged autogenous method of ear reconstruction is described using costal cartilage. In the first stage, a costal cartilage graft is harvested and placed. The next stages involve lobule transposition, detachment of the auricle with placement of a posterior skin graft, and further refinement of the external ear landmarks with tragus creation and definition of the conchal bowl and ear canal.

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