scholarly journals O57: GREATER USE OF NON-TECHNOLOGICAL SIMULATION METHODS IMPROVES SKILL ACQUISITION IN SURGICAL TEACHING

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
A Hill ◽  
M Thomas ◽  
D Williams
Keyword(s):  
Skill Acquisition ◽  
Local Anaesthetic ◽  
Haptic Feedback ◽  
Confidence Score ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
Simulation Methods ◽  
Simulation Techniques ◽  
Before And After ◽  
Surgical Teaching

Abstract Introduction Studies that have reviewed technologies including haptic feedback and virtual reality indicate the usefulness of simulation. However, these technologies are not universally available. Less technologically innovative simulation methods that utilise the learning environment, equipment and presentation can still effectively support surgical teaching. A review was undertaken to assess the effect of these lower fidelity simulation methods on surgical skill acquisition. Method Two courses enrolled 12 and 14 respectively, with trainees ranging in seniority from Foundation Year 1 to Core Trainee Year 2. Four basic surgical skills (suturing, hand tying, local anaesthetic and surgical instruments) were taught in 20 and 30 minute stations. These skills were used to assess trainee confidence before and after teaching, using a 5 point qualitative data collection scale ranging from Not Very to Very Confident. The faculty received a pre-course lecture on teaching methods to ensure standardisation. Result Mean confidence increased following participation in simulation teaching; 1st course demonstrated a post-teaching increase of 42%, 2nd a 60% increase. Individual skill confidence increased more following simulation-based course in hand tying (57% p=0.002, v 89% p=0.00007), local anaesthetic (30% p=0.001, v 41% p=0.005) and surgical instruments (44% p=0.005, v 89% p=0.0001). Suturing was not associated with increased mean confidence, but median confidence score increased more (33% p=0.005, v 60% p=0.0001). Conclusion Greater incorporation of simulation in training is generally associated with increased confidence with surgical skills. This is likely due to better contextualisation, leading to improved understanding of the place of the skills in the clinical setting. Take-home message Greater incorporation of simulation techniques, not necessarily of a technological nature, leads to increased confidence with surgical skills.

scholarly journals Development of an Interactive Remote Basic Surgical Skills Mini-Curriculum for Medical Students During the COVID-19 Pandemic

2021 ◽  
pp. 155335062110035
Author(s):  
Brian R Quaranto ◽  
Michael Lamb ◽  
John Traversone ◽  
Jinwei Hu ◽  
James Lukan ◽  
...  
Keyword(s):  
Medical Students ◽  
Confidence Score ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
First Person ◽  
Knot Tying ◽  
Surgical Equipment ◽  
Person Perspective ◽  
Early Results ◽  
Suturing Techniques

Introduction. Teaching surgical skills has historically been a hands-on activity, with instructors and learners in close physical proximity. This paradigm was disrupted by the COVID-19 pandemic, requiring innovative solutions to surmount the challenges of teaching surgical skills remotely. In this work, we describe our institution’s path and early results of developing an interactive remote surgical skills course for medical students in the surgical clerkship. Methods. 31 third-year medical students were distributed a set of surgical equipment and 3D printed phone dock. Each participant completed a baseline questionnaire and underwent 3 structured interactive remote sessions on surgical instruments, knot tying, and suturing techniques. Students were instructed on sharing their first-person viewpoint and received real-time feedback on their knot tying and suturing techniques from the course instructor. Pre- and post-session surveys were conducted and analyzed. Results. All students were able to complete the remote surgical skills course successfully, as defined by visually demonstrating successful two-handed knot and simple suture techniques. Students’ aggregate confidence score in their knot tying ability (pretest mean 7.9, SD 0.7 vs posttest mean 9.7, SD 0.9, t-statistic −2.3, P = .03) and suturing ability (pretest mean 8.0, SD 1.3 vs posttest mean 13.8, SD 0.9 t-statistic −5.5, P < .001) significantly improved after the intervention. Qualitative feedback from the students underscored the utility of the first-person perspective for teaching surgical technique. Conclusion. This study demonstrates that remote teaching of knot tying and simple suturing to medical students can be effectively implemented using a remote learning curriculum that was well received by the learners.

Experimental and numerical investigations of springback and residual stresses in bending of a three-ply clad sheet

2021 ◽  
pp. 146442072110370
Author(s):  
Pankaj K Sharma ◽  
Vijay Gautam ◽  
Atul K Agrawal
Keyword(s):  
Tensile Properties ◽  
Yield Criterion ◽  
Rolling Direction ◽  
Material Model ◽  
Simulation Methods ◽  
Simulation Techniques ◽  
Numerical Predictions ◽  
Clad Sheet ◽  
Before And After ◽  
The Individual

In the present work, springback behaviour of a three-ply clad sheet metal, comprising of layers of SS430 and SS304 sandwiched with a layer of AA1050 is investigated in V-bending by using analytical, experimental and simulation techniques. The developed analytical model is based on theory of bending using Hill’s anisotropic yield criterion. The tensile properties of the clad sheet and individual layers oriented at three different directions w.r.t. the rolling direction are characterized. The tensile properties of the individual layers are used in the material model of analytical and numerical predictions of the springback. It is observed that the samples of the clad sheet which are transverse to the rolling direction, exhibit highest springback values due to higher tensile strength of the sheet when compared with the results acquired for other two orientations w.r.t. the rolling direction. These results are endorsed by the springback results obtained from analytical and simulation methods. The effect of sheet setting on the die during bending is also investigated using different techniques. The resulting longitudinal stresses before and after springback are analysed on inner and outer layers of the tested samples using experimental and numerical simulation procedures. In both the cases of sheet settings, the results of residual stress after springback predicted by simulations agree with the experimental results except a few cases.

scholarly journals Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

2021 ◽  
Author(s):  
Lars Aksel Pedersen ◽  
S. Dölvik ◽  
K. Holmberg ◽  
C. Ahlström Emanuelsson ◽  
H. Johansson ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Nasal Obstruction ◽  
General Health ◽  
Surgical Skills ◽  
Nasal Endoscopy ◽  
Experienced Surgeon ◽  
Senior Surgeon ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

scholarly journals Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures

2020 ◽  
Vol 6 (3) ◽  
pp. 571-574
Author(s):  
Anna Schaufler ◽  
Alfredo Illanes ◽  
Ivan Maldonado ◽  
Axel Boese ◽  
Roland Croner ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Haptic Feedback ◽  
Acoustic Emissions ◽  
Surgical Instruments ◽  
Additional Information ◽  
Tissue Interactions ◽  
Haptic Interactions ◽  
Visual Clues ◽  
To Receive ◽  
Expected Signal

AbstractIn robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visual clues are available to the surgeon to control the force applied to the tissue by the instruments, which poses a risk for iatrogenic injuries. Additional information on haptic interactions of the employed instruments and the treated tissue that is provided to the surgeon during robotic surgery could compensate for this deficit. Acoustic emissions (AE) from the instrument/tissue interactions, transmitted by the instrument are a potential source of this information. AE can be recorded by audio sensors that do not have to be integrated into the instruments, but that can be modularly attached to the outside of the instruments shaft or enclosure. The location of the sensor on a robotic system is essential for the applicability of the concept in real situations. While the signal strength of the acoustic emissions decreases with distance from the point of interaction, an installation close to the patient would require sterilization measures. The aim of this work is to investigate whether it is feasible to install the audio sensor in non-sterile areas far away from the patient and still be able to receive useful AE signals. To determine whether signals can be recorded at different potential mounting locations, instrument/tissue interactions with different textures were simulated in an experimental setup. The results showed that meaningful and valuable AE can be recorded in the non-sterile area of a robotic surgical system despite the expected signal losses.

scholarly journals Automation of surgical skill assessment using a three-stage machine learning algorithm

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joël L. Lavanchy ◽  
Joel Zindel ◽  
Kadir Kirtac ◽  
Isabell Twick ◽  
Enes Hosgor ◽  
...  
Keyword(s):  
Machine Learning ◽  
Learning Algorithm ◽  
Surgical Skills ◽  
Adverse Outcomes ◽  
Machine Learning Algorithms ◽  
Surgical Instruments ◽  
Skill Assessment ◽  
Surgical Skill ◽  
Surgical Skill Assessment ◽  
Motion Features

AbstractSurgical skills are associated with clinical outcomes. To improve surgical skills and thereby reduce adverse outcomes, continuous surgical training and feedback is required. Currently, assessment of surgical skills is a manual and time-consuming process which is prone to subjective interpretation. This study aims to automate surgical skill assessment in laparoscopic cholecystectomy videos using machine learning algorithms. To address this, a three-stage machine learning method is proposed: first, a Convolutional Neural Network was trained to identify and localize surgical instruments. Second, motion features were extracted from the detected instrument localizations throughout time. Third, a linear regression model was trained based on the extracted motion features to predict surgical skills. This three-stage modeling approach achieved an accuracy of 87 ± 0.2% in distinguishing good versus poor surgical skill. While the technique cannot reliably quantify the degree of surgical skill yet it represents an important advance towards automation of surgical skill assessment.

scholarly journals A Novel Suture Training System for Open Surgery Replicating Procedures Performed by Experts Using Augmented Reality

2021 ◽  
Vol 45 (5) ◽  
Author(s):  
Yuri Nagayo ◽  
Toki Saito ◽  
Hiroshi Oyama
Keyword(s):  
Augmented Reality ◽  
Motion Capture ◽  
Open Surgery ◽  
Three Dimensional ◽  
Training System ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
Interrupted Suture ◽  
Education Environment ◽  
Surgical Field

AbstractThe surgical education environment has been changing significantly due to restricted work hours, limited resources, and increasing public concern for safety and quality, leading to the evolution of simulation-based training in surgery. Of the various simulators, low-fidelity simulators are widely used to practice surgical skills such as sutures because they are portable, inexpensive, and easy to use without requiring complicated settings. However, since low-fidelity simulators do not offer any teaching information, trainees do self-practice with them, referring to textbooks or videos, which are insufficient to learn open surgical procedures. This study aimed to develop a new suture training system for open surgery that provides trainees with the three-dimensional information of exemplary procedures performed by experts and allows them to observe and imitate the procedures during self-practice. The proposed system consists of a motion capture system of surgical instruments and a three-dimensional replication system of captured procedures on the surgical field. Motion capture of surgical instruments was achieved inexpensively by using cylindrical augmented reality (AR) markers, and replication of captured procedures was realized by visualizing them three-dimensionally at the same position and orientation as captured, using an AR device. For subcuticular interrupted suture, it was confirmed that the proposed system enabled users to observe experts’ procedures from any angle and imitate them by manipulating the actual surgical instruments during self-practice. We expect that this training system will contribute to developing a novel surgical training method that enables trainees to learn surgical skills by themselves in the absence of experts.

Improving logistics processes of surgical instruments: case of RFID technology

2017 ◽  
Vol 23 (2) ◽  
pp. 448-466 ◽  
Author(s):  
Afrooz Moatari-Kazerouni ◽  
Ygal Bendavid
Keyword(s):  
Radio Frequency Identification ◽  
Business Processes ◽  
Surgical Instruments ◽  
Hospital Environment ◽  
Rfid Technology ◽  
Content Type ◽  
Realistic Potential ◽  
Simulation Techniques ◽  
Frequency Identification ◽  
Management Project

Purpose Since mid-2000s, hospitals have begun implementing radio-frequency identification (RFID) technology in order to improve their operations. The purpose of this paper is to explore the potential of RFID technology in improving the traceability of surgical instruments in a hospital environment. Design/methodology/approach A case study is conducted at a teaching hospital in Montreal, Canada. Business process reengineering approach and simulation techniques are used to assess the realistic potential of the RFID technology. The application of different scenarios and how they influence the efficiency of process flow between the central sterilization department and operating rooms of the hospital is investigated. Findings Research outcomes demonstrated how tagging individual instruments or their sets lead to reduction of the time spent in re-processing the soiled instrument as well as the reduction of costs related to staff. Furthermore, specific key performance indicators are identified and eventual issues related to implementation of the re-designed processes are discussed. Originality/value Implementing RFID-enabled solutions in hospital context is still an emerging phenomenon that involves various stakeholders in a change management project. While implementing RFID technology can benefit hospitals by improving business processes and workflows, the adoption is still slow, especially for managing surgical instruments. It is, hence, crucial to compare the advantages and drawbacks of RFID-enabled surgical instruments solutions with other well-established traceability technologies such as barcoding.

scholarly journals SP9.1.1 The Impact of Anaesthetic Use on Healing in Sub-cutaneous Abscess Management: A Retrospective Before and After Cohort Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Elkadi ◽  
Eleanor Dodd ◽  
Theodore Poulton ◽  
William Bolton ◽  
Joshua Burke ◽  
...  
Keyword(s):  
Wound Healing ◽  
Local Anaesthetic ◽  
Surrogate Endpoints ◽  
Incision And Drainage ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After ◽  
The Impact

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p &lt; 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

scholarly journals How Haptic Feedback in a Mixed Reality Pool Game Affects Real-Life Pool Performance

2019 ◽  
Vol 63 (1) ◽  
pp. 2323-2327
Author(s):  
Elaine Thai ◽  
Anil R. Kumar
Keyword(s):  
Video Game ◽  
Transfer Of Training ◽  
Haptic Feedback ◽  
Mixed Reality ◽  
Real Life ◽  
Before And After ◽  
Mixed Factorial Design ◽  
Set Up ◽  
Game Practice ◽  
Pool Game

Mechanisms for training pool skills have evolved from manually setting up balls in different positions on the table and hitting them one-by-one to now using technology to precisely set up these plays and practice the game virtually. The aim of this study was to investigate how adding haptic feedback into a pool video game affects transfer of training into real-life pool skills. A 2 x 4 mixed factorial design was used to see how haptic feedback (its absence or presence) and four types of shots affect pool performance. Half of the participants experienced the pool video game without haptic feedback while the other half experienced it with haptic feedback. Performance before and after the video game practice was recorded as successful or unsuccessful, with a series of the same 40 pre- and post-video-game shots. Results from 38 participants are presented, and their implications are discussed.

Surgical instruments, materials, and the acquisition of surgical skills

2011 ◽  
Author(s):  
G. O'Dair ◽  
G. R. McLatchie ◽  
David J. Leaper
Keyword(s):  
Surgical Skills ◽  
Surgical Instruments ◽  
Suture Materials ◽  
Endoscopic Equipment ◽  
Laparoscopic Equipment ◽  
Artery Forceps

Introduction 92Scalpel handles 94Needle holders 94Scissors—suture and dissecting 96Tissue dissecting forceps 98Tissue holding forceps 98Artery forceps 100Hand-held retractors 101Self-retaining retractors 103Bowel clamps 107Vascular instruments 109Suckers 111Endoscopic equipment 112Laparoscopic equipment 116Suture materials ...

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