Pre-Deployment Simulation Training for U.S. Army Forward Surgical Teams

2011 ◽  
Author(s):  
Mark L. Ryan ◽  
Chad M. Thorson ◽  
Christian A. Otero ◽  
George D. Garcia
2016 ◽  
Vol 38 (03) ◽  
pp. 235-244
Author(s):  
Brandon Lucke-Wold ◽  
Aclan Dogan ◽  
Justin Cetas ◽  
William Cameron ◽  
Jeremy Ciporen

Purpose Simulation training offers a useful opportunity to appreciate vascular anatomy and develop the technical expertise required to clip intracranial aneurysms of the posterior circulation. Materials and Methods In cadavers, a comparison was made between the endoscopic transclival approach (ETA) alone and a combined multiportal approach using the ETA and a transorbital precaruncular approach (TOPA) to evaluate degrees of freedom, angles of visualization, and ergonomics of aneurysm clip application to the posterior circulation depending on basilar apex position relative to the posterior clinoids. Results ETA alone provided improved access to the posterior circulation when the basilar apex was high riding compared with the posterior clinoids. ETA + TOPA provided a significantly improved functional working area for instruments and visualization of the posterior circulation for a midlevel basilar apex. A single-shaft clip applier provided improved visualization and space for instruments. Proximal and distal vascular control and feasibility of aneurysmal clipping were demonstrated. Conclusions TOPA is a medial orbital approach to the central skull base; a transorbital neuroendoscopic surgery approach. This anatomical simulation provides surgical teams an alternative to the ETA approach alone to address posterior circulation aneurysms, and a means to preoperatively prepare for intraoperative anatomical and surgical instrumentation challenges.


Author(s):  
George Attilakos ◽  
Tim Draycott ◽  
Alison Gale ◽  
Dimitrios Siassakos ◽  
Cathy Winter
Keyword(s):  

2020 ◽  
Vol 17 (S1) ◽  
pp. 110-119 ◽  
Author(s):  
Jennifer N. Engler ◽  
Perri B. Druen ◽  
Laura West Steck ◽  
Mary Ligon ◽  
Steve Jacob ◽  
...  
Keyword(s):  

EMJ Radiology ◽  
2020 ◽  

Retained foreign bodies have become very rare in countries where the safety rules in the operating theatre are very rigorous and follow precise guidelines. There are low-income countries where hospital structures are precarious, in which the implementation of surgical safety rules has only been effective recently. Surgical teams in these countries are not yet well trained in the observance of the guidelines concerning swab count, meaning that textilomas are not uncommon. Abdominal textiloma may be asymptomatic, or present serious gastrointestinal complications such as bowel obstruction, perforation, or fistula formation because of misdiagnosis. It may mimic abscess formation in the early stage or soft tissue masses in the chronic stage. This case report presents a 27-year-old female who underwent an emergency laparotomy in a rural surgical centre for an ectopic pregnancy. Two months later, a swelling had appeared on the left side of her abdomen, gradually increasing in size, which was not very painful but caused digestive discomfort and asthenia. Intermittent fever was described and treated with antibiotics. The patient was referred to a better equipped centre to benefit from a CT scan. A textiloma was strongly suspected on the CT but a left colic mass was not excluded. Laparotomy confirmed the diagnosis of textiloma and the postoperative course was uneventful. Prevention rules must be strengthened in these countries where patients can hardly bear the costs of iterative surgeries for complications that are avoidable.


Sign in / Sign up

Export Citation Format

Share Document