Percutaneous Freehand™ System Intramuscular Electrode Placement

2002 ◽  
Vol 27 (5) ◽  
pp. 465-469 ◽  
Author(s):  
M. R. HAUSMAN ◽  
J. E. MASTERS
Keyword(s):  
Operative Time ◽  
Electrode Placement ◽  
Upper Limbs ◽  
Patient Morbidity ◽  
Intramuscular Electrodes ◽  
Placement Technique

The FreeHand™ (NeuroControl Corporation, USA) system is an implantable electronic neuroprosthesis designed to stimulate muscles of tetraplegic upper limbs to achieve lateral pinch and simple grasp. When first introduced, the system required insertion through multiple large incisions, but recently introduced intramuscular electrodes have allowed the development of a percutaneous electrode placement technique. The technique minimizes incisions, decreases overall operative time and patient morbidity and improves the outcome by minimizing tendon adhesions.

The effects of resident participation on patient morbidity and mortality in major gastrointestinal oncologic surgery.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 437-437 ◽  
Author(s):  
Geoffrey Bellini ◽  
Annabelle Teng ◽  
David Y Lee ◽  
Keith Rose
Keyword(s):  
Multivariate Analysis ◽  
Operative Time ◽  
Complex Nature ◽  
Oncologic Surgery ◽  
Resident Participation ◽  
Patient Morbidity ◽  
Average Operative Time ◽  
Acs Nsqip Database ◽  
Referral Bias ◽  
Comprehensive Study

437 Background: While the effects of resident participation have been documented in various studies, there has yet to be a comprehensive study analyzing resident participation in overall gastrointestinal (GI) oncologic surgery. The aim of this study was to compare outcomes in major GI oncologic cases performed by an attending alone and those performed by an attending and resident. Methods: The ACS-NSQIP database from 2005-12 was utilized to study major (GI) operations (esophagectomy, gastrectomy, pancreatectomy, enterectomy, hepatectomy, and colectomy/proctectomy) in patients with an ICD-9 cancer diagnosis. Major complications and 30-day mortality were then compared in those patients who underwent surgery with an attending alone (AA) to those patients who underwent surgery with an attending and resident (AR). Results: A total of 64,637 patients met criteria for the study; AR n = 48,022 and AA n = 16,615. In 76.6% of AR cases, the resident assistance was classified as senior level PGY-4 or higher. On average, operative time was significantly increased in AR cases compared to AA cases (228 ± 130 vs 163 ± 104 min, p < 0.001). On multivariate analysis, AR cases were more likely to develop superficial incisional infection (OR 1.3, CI 95% 1.2-1.4, p < 0.001) and urinary tract infection (OR 1.2, CI 95%, 1.1-1.4, p < 0.001) compared to AA cases. However, on multivariate analysis, resident participation was associated with less likelihood of returning to the operating room (OR 0.9, 95% CI 0.8-0.9, p < 0.001) and lower mortality (OR 0.7, CI 95% 0.6-0.8, p < 0.001). Conclusions: The majority of major GI oncologic operations in the NSQIP database are performed by an attending with the assistance of a senior level resident. This may be due to the complex nature of GI oncologic operation. Potentially, operative time in cases with resident participation may be increased by teaching or by the complex nature of the operation due to the referral bias to teaching centers. However, even with potentially more complex operations, there was less mortality in cases performed by a resident and an attending.

scholarly journals Simple Metric Measurement To Choose A keystone Flap Design On Extremities: A Cadaveric Study

2016 ◽  
Vol 3 (1) ◽  
pp. 13-19
Author(s):  
Narottama Tunjung Hariwangsa ◽  
Gentur Sudjatmiko
Keyword(s):  
Wound Closure ◽  
Operative Time ◽  
Cost Effective ◽  
Upper Limbs ◽  
Flap Necrosis ◽  
Aesthetic Outcome ◽  
Short Operative Time ◽  
Donor Area ◽  
Flap Design ◽  
Metric Measurement

Background: Closing defect on extremities can be challenging because of limited donor area in order to obtain similar quality, color, texture, and adequate size with the defect. The keystone flap has gained popularity as a tool for local reconstruction because of its simple design, short operative time, good aesthetic outcome, and cost-effective wound closure. The aim of this study is to introduce a method in choosing a keystone flap design based on simple metric measurement resulting in lower tension.. Methods: Four circular defects were created on 4 different regions of a fresh cadaver’s upper limbs. Diameters were 5 cm for upper arms and 3 cm for lower arms. Two options of keystone flaps designs were introduced. The keystone could be advanced in longitudinal manner or in transversal manner according to limb’s axis. We then calculated the percentage of the skin required to stretch, in order to close the defects. The less percentage of skin required to stretch between the two manners indicated the lower tension of the keystone flap. Results: Measurements in all of 4 regions of upper limbs showed that the percentage of skin stretch in closing the defects was lower in longitudinal advancement keystone flap compared to transversal advancement (19.88% versus 27.8% for upper arms and 15.71% versus 21.67% for lower arms) Conclusion: Simple metric measurements in choosing a keystone flap can be applied to defects on extremities. With less tension when raising the keystone flap, acceptable scar is expected and the occurrence of contracture and flap necrosis can be reduced.

scholarly journals The anisotropic structure of electro conductive leather studied by Van der Pauw method

2019 ◽  
Vol 2 (3) ◽  
pp. 136-144
Author(s):  
Aulon Shabani ◽  
Majlinda Hylli ◽  
Ilda Kazani ◽  
Pellumb Berberi ◽  
Orion Zavalani ◽  
...  
Keyword(s):  
Chemical Treatment ◽  
Electrical Resistance ◽  
Surface Resistance ◽  
Treatment Process ◽  
Electrode Placement ◽  
Conductive Materials ◽  
Measuring Surface ◽  
Van Der Pauw ◽  
Placement Technique ◽  
Van Der Pauw Method

Determining the surface resistance of electro conductive refined natural leather materials is in the focus of this paper. Natural leather samples are initially transformed to conductive by applying chemical treatment process known as polymerization. Due to the existence of various techniques for measuring electrical resistance of conductive materials, we are focused on measuring surface resistance by arranging four electrodes in the edges of square leather samples, also known as Van der Pauw method. Improving the results accuracy, we use a multi-variant electrode placement over the sample edges. The result is the average of all results gained for different placements. Moreover, we use this electrode placement technique to analyse the anisotropy of conductive samples. The results of this research provide important knowledge about leather chemical treatment and its electrical proprieties.

Modification of Patients’ Sensitivity to Galvanic Current After the Administered Systemic Cryotherapy

2021 ◽  
Vol 63 (2) ◽  
pp. 88-92
Author(s):  
Joanna Łuczak ◽  
Joanna Klonowska ◽  
Joanna Michalik
Keyword(s):  
Cycle Ergometer ◽  
Left Knee ◽  
Wilcoxon Test ◽  
Knee Joints ◽  
Electrode Placement ◽  
Study Group ◽  
Upper Limbs ◽  
Galvanic Current ◽  
Test Position ◽  
The Right

Aim: The purpose of the study was to evaluate the sensitivity of patients to galvanic current after systemic cryotherapy. Material and Methods: Study group: 77 physiotherapists – hospital employees, aged 21-64 (AVG 29.4±9.5). The sensitivity was evaluated four times: before and immediately after the systemic cryotherapy procedure (1 session, 2 minutes, temperature -120°C), after exercising on a vertical cycle ergometer (20 minutes) and 4 hours after the procedure. The intensity of the galvanic current, which caused a slight tingling, was recorded. Two electrode placements were used: longitudinal on the upper limbs and transverse over the knee joints. Results: Statistical analysis revealed that the mean sensitivity to the galvanic current measured on both upper limbs or over the knee joints increases statistically significantly after systemic cryotherapy treatments. This effect persists even after 4 hours (Friedman’s ANOVA, p<0.001). Statistically significant increases in sensitivity to galvanic current were found compared to initial values for each pair of measurements, irrespective of electrode placement and test position (Wilcoxon test, p<0.01). The increase in sensitivity according to the measuring position concerned 68.8; 63.6; 72.7% of the participants on the left upper limb, on the right 61.0; 68.8; 74.0%, over the left knee joint 61.0; 68.8; 72.7% and over the right 58.4, 75.3 and 80.5% of the subjects in the study group. Conclusions: 1. After the administered systemic cryotherapy, sensitivity to galvanic current increases in most patients. 2. The increase in sensitivity to galvanic current depends on the time difference between treatments and is individually variable.

The impact of fellowship surgical training on operative time and patient morbidity during robotics-assisted sacrocolpopexy

2017 ◽  
Vol 29 (9) ◽  
pp. 1317-1323 ◽  
Author(s):  
Charelle M. Carter-Brooks ◽  
Angela L. Du ◽  
Michael J. Bonidie ◽  
Jonathan P. Shepherd
Keyword(s):  
Surgical Training ◽  
Operative Time ◽  
Patient Morbidity ◽  
The Impact

scholarly journals Stable, three degree-of-freedom myoelectric prosthetic control via chronic bipolar intramuscular electrodes: a case study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Hendrik Adriaan Dewald ◽  
Platon Lukyanenko ◽  
Joris M. Lambrecht ◽  
James Robert Anderson ◽  
Dustin J. Tyler ◽  
...  
Keyword(s):  
Training Session ◽  
Degree Of Freedom ◽  
Skin Impedance ◽  
Electrode Placement ◽  
Movement Direction ◽  
Surface Electrode ◽  
Joint Movement ◽  
Prosthetic Control ◽  
Intramuscular Electrodes ◽  
Over Time

Abstract Background Modern prosthetic hands are typically controlled using skin surface electromyographic signals (EMG) from remaining muscles in the residual limb. However, surface electrode performance is limited by changes in skin impedance over time, day-to-day variations in electrode placement, and relative motion between the electrodes and underlying muscles during movement: these limitations require frequent retraining of controllers. In the presented study, we used chronically implanted intramuscular electrodes to minimize these effects and thus create a more robust prosthetic controller. Methods A study participant with a transradial amputation was chronically implanted with 8 intramuscular EMG electrodes. A K Nearest Neighbor (KNN) regression velocity controller was trained to predict intended joint movement direction using EMG data collected during a single training session. The resulting KNN was evaluated over 12 weeks and in multiple arm posture configurations, with the participant controlling a 3 Degree-of-Freedom (DOF) virtual reality (VR) hand to match target VR hand postures. The performance of this EMG-based controller was compared to a position-based controller that used movement measured from the participant’s opposite (intact) hand. Surface EMG was also collected for signal quality comparisons. Results Signals from the implanted intramuscular electrodes exhibited less crosstalk between the various channels and had a higher Signal-to-Noise Ratio than surface electrode signals. The performance of the intramuscular EMG-based KNN controller in the VR control task showed no degradation over time, and was stable over the 6 different arm postures. Both the EMG-based KNN controller and the intact hand-based controller had 100% hand posture matching success rates, but the intact hand-based controller was slightly superior in regards to speed (trial time used) and directness of the VR hand control (path efficiency). Conclusions Chronically implanted intramuscular electrodes provide negligible crosstalk, high SNR, and substantial VR control performance, including the ability to use a fixed controller over 12 weeks and under different arm positions. This approach can thus be a highly effective platform for advanced, multi-DOF prosthetic control.

Robotic Surgical Assistant Rehearsal: Combining 3-Dimensional-Printing Technology With Preoperative Stereotactic Planning for Placement of Stereoencephalography Electrodes

2019 ◽  
Vol 19 (2) ◽  
pp. 190-194
Author(s):  
David J Bonda ◽  
Rachel Pruitt ◽  
Todd Goldstein ◽  
Anish Varghese ◽  
Amar Shah ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Trajectory Planning ◽  
3D Model ◽  
Operative Time ◽  
Preoperative Planning ◽  
Electrode Placement ◽  
Robotic Technology ◽  
Patient Model ◽  
3D Printed ◽  
Epilepsy Monitoring

Abstract BACKGROUND The use of frameless stereotactic robotic technology has rapidly expanded since the Food and Drug Administration's approval of the Robotic Surgical Assistant (ROSA) in 2012. Although the use of the ROSA robot has greatly augmented stereotactic placement of intracerebral stereoelectroencephalography (sEEG) for the purposes of epileptogenic focus identification, the preoperative planning stages remain limited to computer software. OBJECTIVE To describe the use of a 3-dimensionally (3D)-printed patient model in the preoperative planning of ROSA-assisted depth electrode placement for epilepsy monitoring in a pediatric patient. METHODS An anatomically accurate 3D model was created and registered in a preoperative rehearsal session using the ROSA platform. After standard software-based electrode trajectory planning, sEEG electrodes were sequentially placed in the 3D model. RESULTS Utilization of the 3D-printed model enabled workflow optimization and increased staff familiarity with the logistics of the robotic technology as it relates to depth electrode placement. The rehearsal maneuvers enabled optimization of patient head positioning as well as identification of physical conflicts between 2 electrodes. This permitted revision of trajectory planning in anticipation of the actual case, thereby improving patient safety and decreasing operative time. CONCLUSION Use of a 3D-printed patient model enhanced presurgical positioning and trajectory planning in the placement of stereotactic sEEG electrodes for epilepsy monitoring in a pediatric patient. The ROSA rehearsal decreased operative time and increased efficiency of electrode placement.

Interferential therapy electrode placement technique in acute low back pain: A preliminary investigation

2001 ◽  
Vol 82 (4) ◽  
pp. 485-493 ◽  
Author(s):  
Deirdre A. Hurley ◽  
Patrick M. Minder ◽  
Suzanne M. McDonough ◽  
Deirdre M. Walsh ◽  
Ann P. Moore ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Preliminary Investigation ◽  
Electrode Placement ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Interferential Therapy ◽  
Placement Technique

scholarly journals Sacral Neuromodulation: Standardized Electrode Placement Technique

2017 ◽  
Vol 20 (8) ◽  
pp. 816-824 ◽  
Author(s):  
Klaus E. Matzel ◽  
Emmanuel Chartier-Kastler ◽  
Charles H. Knowles ◽  
Paul A. Lehur ◽  
Arantxa Muñoz-Duyos ◽  
...  
Keyword(s):  
Sacral Neuromodulation ◽  
Electrode Placement ◽  
Placement Technique

Temporal-Gap Detection by Cochlear Prosthesis Users

1989 ◽  
Vol 32 (4) ◽  
pp. 849-856 ◽  
Author(s):  
John P. Preece ◽  
Richard S. Tyler
Keyword(s):  
Magnitude Estimation ◽  
Stimulus Level ◽  
Electrode Placement ◽  
Frequency Effect ◽  
Gap Detection ◽  
Cochlear Prosthesis ◽  
Sensation Level

Minimum-detectable gaps for sinusoidal stimuli were measured for three users of a multi electrode cochlear prosthesis as functions of stimulus level, frequency, and electrode place within the cochlea. Stimulus level was scaled by sensation level and by growth-of-loudness functions generated for each condition by direct magnitude estimation. Minimum-detectable gaps decreased with increase in either sensation level or loudness, up to a plateau. When compared at equal sensation levels, the minimum-detectable gaps decreased with frequency increases. The frequency effect on minimum-detectable gaps is reduced if the data are considered at equal loudness. Comparison across place of stimulation within the cochlea showed minimum-detectable gaps to be shorter for more basal electrode placement at low stimulus levels. No differences in minimum-detectable gap as a function of place were found at higher stimulus levels.

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