Haptic-Assisted Virtual Osteotomy As a Training Tool

2017 ◽  
Author(s):  
Eder H. Govea-Valladares ◽  
Hugo I. Medellín-Castillo ◽  
Pedro J. García-Zugasti ◽  
Pablo A. Limon-Leyva
Keyword(s):  
Clinical Practice ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Surgical Planning ◽  
Planning Process ◽  
Maxillofacial Surgery ◽  
Free Form ◽  
Virtual Training ◽  
Training Tool ◽  
Virtual Osteotomy

The maxillofacial surgery is a complex surgical procedure to correct facial malformations located in the head of the patient. A precise and reliable surgical planning is necessary for a successful maxillofacial surgical procedure. The experience and clinical practice of surgeons play a very important role during the surgical procedures. Modern Computer Aided Systems (CAS) have been developed in order to speed up the surgical planning process and to increase the accuracy and reliability of the surgical procedure. However, CAS systems have not been focused on their ability to train and to provide experience and clinical practice to novice surgeons or medical student. In this way CAS systems could be a potential tool to improve the skill of surgeons in order to decrease human errors in the maxillofacial treatment and surgical procedures. This paper presents an investigation to evaluate the use of virtual reality and haptic systems as a training tool for maxillofacial surgeries, in particular osteotomies procedures. The aim is to evaluate the effect of virtual training on surgeon skills. Thus, a virtual osteotomy system has been developed and is presented. The system is based on an open source computer and programming resources, and makes use of haptic technologies to provide the users with the sense of touch. The virtual osteotomy procedures implemented are based on current surgical orthognathic surgery procedures. Free-form 3D manual cutting of bone is available in the system by means of the haptic device and the force feedback provided to the user, which increases the level of realism of the virtual procedure. The evaluation results show that the haptic-enabled virtual training of osteotomies increases the psychomotor skills of the practitioner, leading to an improved accuracy when carrying out the actual bone cut.

scholarly journals Current Practice in Preoperative Virtual and Physical Simulation in Neurosurgery

2020 ◽  
Vol 7 (1) ◽  
pp. 7 ◽  
Author(s):  
Elisa Mussi ◽  
Federico Mussa ◽  
Chiara Santarelli ◽  
Mirko Scagnet ◽  
Francesca Uccheddu ◽  
...  
Keyword(s):  
Clinical Practice ◽  
3D Printing ◽  
Surgical Planning ◽  
Physical Simulation ◽  
Planning Process ◽  
Preoperative Planning ◽  
Cost Effective ◽  
Patient Specific ◽  
Anatomical Models ◽  
Standard Clinical Practice

In brain tumor surgery, an appropriate and careful surgical planning process is crucial for surgeons and can determine the success or failure of the surgery. A deep comprehension of spatial relationships between tumor borders and surrounding healthy tissues enables accurate surgical planning that leads to the identification of the optimal and patient-specific surgical strategy. A physical replica of the region of interest is a valuable aid for preoperative planning and simulation, allowing the physician to directly handle the patient’s anatomy and easily study the volumes involved in the surgery. In the literature, different anatomical models, produced with 3D technologies, are reported and several methodologies were proposed. Many of them share the idea that the employment of 3D printing technologies to produce anatomical models can be introduced into standard clinical practice since 3D printing is now considered to be a mature technology. Therefore, the main aim of the paper is to take into account the literature best practices and to describe the current workflow and methodology used to standardize the pre-operative virtual and physical simulation in neurosurgery. The main aim is also to introduce these practices and standards to neurosurgeons and clinical engineers interested in learning and implementing cost-effective in-house preoperative surgical planning processes. To assess the validity of the proposed scheme, four clinical cases of preoperative planning of brain cancer surgery are reported and discussed. Our preliminary results showed that the proposed methodology can be applied effectively in the neurosurgical clinical practice both in terms of affordability and in terms of simulation realism and efficacy.

scholarly journals IMPACT OF THE COVID-19 PANDEMIC ON SURGICAL PROCEDURES IN BRAZIL: A DESCRIPTIVE STUDY

2021 ◽  
Vol 23 (2) ◽  
pp. 139-148
Author(s):  
Bárbara Okabaiasse Luizeti ◽  
Victor Augusto Santos Perli ◽  
Gabriel Gonçalves da Costa ◽  
Igor da Conceição Eckert ◽  
Aluisio Marino Roma ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Surgical Procedure ◽  
Maxillofacial Surgery ◽  
Descriptive Study ◽  
Endocrine Gland ◽  
Primary Analysis ◽  
Upper Airways ◽  
Geographical Regions ◽  
The Mean ◽  
The Impact

COVID-19 pandemic has deeply affected medical practice, and conducts o minimize the overload of healthcare services were necessary. The objective of this study is to evaluate the impact of the pandemic in the practice of surgical procedures in Brazil. This is a descriptive study with data about hospitalizations for surgical procedures in Brazil from 2016 to 2020, collected from the Department of Informatics of Brazil’s Unified Health System (DATASUS). Primary analysis describes the variations in the number of elective, urgent and other types of surgical procedures performed during this period, by comparing the mean number of hospitalizations from 2016 to 2019 with the absolute number from 2020. Secondary analysis describe the variations in hospitalizations for surgical procedures during this period in each of Brazil’s geographical regions, and variations in different surgical procedure subgroups. There was a decrease of 14.88% [95% CI: 14,82-14,93] in hospitalizations for surgical procedures in 2020, when comparing to the mean between 2016-2019. Decrease rates were 34.82% [95% CI: 34,73-34,90] for elective procedures and 1.11% [95% CI: 1.07-1.13] for urgent procedures. Surgical procedure subgroups with highest decrease rates were endocrine gland surgery, breast surgery, oral-maxillofacial surgery and surgery of upper airways, face, head and neck. The overload of healthcare facilities demanded reductions in non-urgent activities to prevent services’ collapse. Further studies are needed to evaluate the social and clinical impact of such reductions and support the development of precise criteria defining which procedures should be prioritized.

Regenereation in periodontics

2018 ◽  
Author(s):  
Murtaza Kaderi ◽  
Mohsin Ali ◽  
Alfiya Ali ◽  
Tasneem Kaderi
Keyword(s):  
Tissue Engineering ◽  
Clinical Practice ◽  
Periodontal Disease ◽  
Disease Progression ◽  
Tissue Regeneration ◽  
Surgical Procedures ◽  
Periodontal Regeneration ◽  
Guided Tissue Regeneration ◽  
Periodontal Tissues ◽  
Extensive Documentation

The goals of periodontal therapy are to arrest of periodontal disease progression and to attain the regeneration of the periodontal apparatus. Osseous grafting and Guided tissue regeneration (GTR) are the two techniques with the most extensive documentation of periodontal regeneration. However, these techniques offer limited potential towards regenerating the periodontal tissues. Recent surgical procedures and application of newer materials aim at greater and more predictable regeneration with the concept of tissue engineering for enhanced periodontal regeneration and functional attachment have been developed, analyzed, and employed in clinical practice

scholarly journals Prognostic Nutritional Index Considering Resection Range Is Useful for Predicting Postoperative Morbidity of Hepatectomy

2021 ◽  
Author(s):  
Shigeyuki Nagata ◽  
Shohei Maeda ◽  
Satoko Nagamatsu ◽  
Seiichiro Kai ◽  
Yasuro Fukuyama ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Procedures ◽  
Predictive Value ◽  
Surgical Procedure ◽  
Major Hepatectomy ◽  
Prognostic Nutritional Index ◽  
Complication Rates ◽  
Immunological Status ◽  
Grade Ii ◽  
Prognostic Nutrition Index

Abstract Background Poor preoperative nutritional and immunological status are major risk factors for postoperative complications in patients with various malignancies. Lower preoperative prognostic nutrition index (PNI) is associated with higher rates of postoperative complications and poorer prognosis in those patients. The aim of this study was to analyze the predictive value of the PNI for post-hepatectomy complications in patients with hepatocellular carcinoma (HCC), and evaluate its utility in the surgical procedure. Methods This retrospective study included 510 patients who underwent open hepatectomies for HCC. The predictive value of the preoperative nutritional and immunological status for postoperative complications was assessed using the PNI. Postoperative complications were defined as grade II or higher per the Clavien-Dindo classification. Postoperative complication rates were compared according to surgical procedure (major hepatectomy vs minor hepatectomy). Results Patients with postoperative complications had significantly lower PNIs than those without (43.1 ± 5.5 vs 47.0 ± 5.7, P < 0.001). In the multivariate analysis, low preoperative PNI (< 45) was an independent risk factor for postoperative complications after hepatectomy (hazard ratio, 3.85). When patients were classified per their PNI (high vs low) and extent of surgical procedures (major vs minor), there were more complications among patients with low PNI than those with high PNI, regardless of the extent of surgical procedures. Specifically, the group of patients with low PNI who underwent major hepatectomy had significantly higher rates of postoperative complications than the other groups. Conclusions Adding the resection range to the PNI is useful for predicting the postoperative morbidities of hepatectomy patients.

VOLUME MANIPULATION FOR SIMULATING FACIAL CONTOURING SURGERY

2014 ◽  
Vol 26 (01) ◽  
pp. 1450016 ◽  
Author(s):  
Ming-Dar Tsai ◽  
Feng-Chou Tsai ◽  
Chih-Lung Lin ◽  
Ming-Shium Hsieh
Keyword(s):  
Wound Healing ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Tissue Deformation ◽  
Bone Morphology ◽  
Facial Bone ◽  
High Quality ◽  
3D Images ◽  
Case Examples ◽  
The Face

In facial contouring surgery, surgeons operate the facial bone to correct bone morphology and thus achieve esthetic feminine face. To evaluate the face appearance after surgery and rehearse every surgical procedure in facial contouring surgery, simulations for tissue peeling, incising and suturing on the face together with bone burring and grafting on the facial bone are required. This paper presents a method that transforms respective tissue vertices to simulate tissue peeling. The transformation is based on specified incisions and clamps as in real facial contouring surgery. This paper also uses an auxiliary structure to represent and record tissue boundary changes inside the face. The elastic, partially plastic and plastic tissue deformation and wound formation during an incision can be simulated by manipulating these boundary changes. The incised wound recorded in the auxiliary structure is also manipulated to simulate tissue generation in wound healing during a suture. This volume manipulation method is combined with the reported method for bone burring and grafting simulations so that high-quality 3D images for illustrating surgical procedures both on the face and facial bone can be achieved. Simulations of two case examples including tissue peeling, incising and suturing procedures, and three modalities of facial contouring surgery demonstrate the effectiveness of the proposed method and system.

Optimizing Outcomes in Neck Lift Surgery

2021 ◽  
Author(s):  
Thomas Gerald O’Daniel
Keyword(s):  
Surgical Planning ◽  
Planning Process ◽  
Objective Evaluation ◽  
Volumetric Analysis ◽  
Anterior Neck ◽  
Surgical Specimen ◽  
Neck Lift ◽  
Fat Reduction ◽  
The Mean ◽  
The Impact

Abstract Background In certain patients there is an imbalance between the volume of the anterior neck and the mandibular confines that require reductional sculpting and repositioning of the hyoid to optimize neck lifting procedures. Objectives A quantitative volumetric analysis of impact of the management of supraplatysmal and subplatysmal structures of the neck by comparing surgical specimen was performed to determine the impact of reduction on cervical contouring. Methods In 152 patients undergoing deep cervicoplasty, the frequency of modification of each surgical maneuver and amount of supraplatysmal and subplatysmal volume removed was measured in cubic centimeters using a volume displacement technique. Results The mean volume of total volume remove from the supraplatysmal and subplatysmal planes during deep cervicoplasty was 22.3 cm3 with subplatysmal volume representing 73%. Subplatysmal volume was reduced in 152 patients. Deep fat was reduced in 96% of patients with mean volume of 7 cm3, submandibular glands (76%) with mean volume 6.5cm, anterior digastric muscles (70%) with mean volume 2cm3, peri-hyoid fascia (32%) with mean volume &lt;1cm3 and mylohyoid reduction (14%) with mean volume &lt; 1cm3 in the series. The anterior digastric muscles were plicated to reposition the hyoid in 34% of cases. Supraplatysmal fat reduction was 6.3 cm3 in 40% of patients. Conclusions The study provides a comprehensive analysis of the impact of volume modification of the central neck during deep cervicoplasty. This objective evaluation of neck volume may help guide clinicians in the surgical planning process and provide a foundation for optimizing cervicofacial rejuvenation techniques.

172 Scenario-based Training Is an Effective Tactic for Teaching Applied Livestock Management Practices to Extension Personnel

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 92-92
Author(s):  
Jennie L Ivey ◽  
Lew G Strickland ◽  
Justin D Rhinehart
Keyword(s):  
Management Practices ◽  
Teaching Effectiveness ◽  
Training Session ◽  
Real Life ◽  
Extension Agents ◽  
Adult Educator ◽  
Topic Area ◽  
Virtual Training ◽  
Training Tool ◽  
Instructor Effectiveness

Abstract Developing livestock and equine trainings to empower county Extension agents is challenging, especially when spanning in-person and online delivery modules. Real life application of training concepts is difficult, particularly when participants have varied backgrounds and experience. Thus, we assessed if scenario-based training modules were an effective training method across in-person and virtual formats. The same scenario-based training was delivered at three, regional in-person trainings (n = 42), and one virtual training (n = 32). Training format consisted of four, species-specific lectures addressing various production topics. Small groups then developed recommendations for a specific scenario, followed by a debriefing session consisting of group reactions and specialist recommendations. Topic-area application to county programs, instructor effectiveness, and overall benefit of the training session were evaluated (Qualtrics, in-person n = 26, 62% completion; virtual n = 17, 53% completion). Data were assessed using analysis of variance and mean comparisons (α=0.05), with Tukey’s pairwise post hoc analysis where appropriate (STATA 16). Across all sessions, likert scale responses (1=poor and 5=excellent, n = 43) indicated lecture sessions were applicable to county areas of need across material content (mean±SD, cattle=4.71±0.57, equine=4.64±0.50), teaching effectiveness (cattle=4.77±0.42, equine=4.75±0.43), and overall quality (cattle=4.68±0.57, equine=4.67±0.51), respectively. Scenario-based training benefit was not influenced by the number of times an agent had attended in-service training on livestock species, agent appointment (youth vs. adult educator), or training location (p &gt;0.05). Attendance at previous in-service trainings (cattle P = 0.005; equine P = 0.013) and agent appointment (cattle P = 0.0006; equine P = 0.05) had a significant impact on the number of questions agents reported to have received on scenario topics in the last 12 months. More topic area questions were reported by agents with adult education responsibilities and previous training attendance. Based upon these results, scenario-based training is an effective in-person and virtual training tool for 4-H and adult Extension agents of varying experience.

scholarly journals A Survey of Competency-Based Training of Senior House Officers in Performing Minor Surgical Procedures

2006 ◽  
Vol 88 (6) ◽  
pp. 576-578 ◽  
Author(s):  
Samuel CL Leong ◽  
Alison J Waghorn
Keyword(s):  
Surgical Procedures ◽  
Surgical Procedure ◽  
Perianal Abscess ◽  
Incision And Drainage ◽  
Minor Surgical Procedures ◽  
Surgical Trainees ◽  
Competency Based ◽  
A Minor ◽  
Second Procedure ◽  
And Training

INTRODUCTION The aim of this survey was to ascertain the level of competency and training of basic surgical trainees (SHOs) in performing incision and drainage of a perianal abscess (a minor surgical procedure). MATERIALS AND METHODS Questionnaires were sent to SHOs enquiring about preferred methods of incision and drainage and the teaching received to perform this procedure. RESULTS Of respondent SHOs, 10% did not receive teaching when performing their first incision and drainage and over half did not received any feedback from their trainers. A mere 65% received practical supervision. Use of the curette and de-roofing of the abscess are not routine methods used. In addition, 13% reported inadequate incision and drainage, which required a second procedure. CONCLUSIONS Competency-based training in minor surgical procedures benefits not only from didactic teaching, immediate supervision and appraisal but also from frequent practise. This was found to be lacking for incision and drainage of perianal abscesses by basic surgical trainees surveyed in the study.

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