scholarly journals Surgical process modeling

2017 ◽  
Vol 2 (3) ◽  
pp. 123-137 ◽  
Author(s):  
Thomas Neumuth
Keyword(s):  
Big Data ◽  
Workflow Management ◽  
Minimal Invasive ◽  
Use Cases ◽  
Process Models ◽  
Surgical Interventions ◽  
Surgical Workflow ◽  
Number Of Patients ◽  
Art Research ◽  
The One

AbstractDue to the rapidly evolving medical, technological, and technical possibilities, surgical procedures are becoming more and more complex. On the one hand, this offers an increasing number of advantages for patients, such as enhanced patient safety, minimal invasive interventions, and less medical malpractices. On the other hand, it also heightens pressure on surgeons and other clinical staff and has brought about a new policy in hospitals, which must rely on a great number of economic, social, psychological, qualitative, practical, and technological resources. As a result, medical disciplines, such as surgery, are slowly merging with technical disciplines. However, this synergy is not yet fully matured. The current information and communication technology in hospitals cannot manage the clinical and operational sequence adequately. The consequences are breaches in the surgical workflow, extensions in procedure times, and media disruptions. Furthermore, the data accrued in operating rooms (ORs) by surgeons and systems are not sufficiently implemented. A flood of information, “big data”, is available from information systems. That might be deployed in the context of Medicine 4.0 to facilitate the surgical treatment. However, it is unused due to infrastructure breaches or communication errors. Surgical process models (SPMs) alleviate these problems. They can be defined as simplified, formal, or semiformal representations of a network of surgery-related activities, reflecting a predefined subset of interest. They can employ different means of generation, languages, and data acquisition strategies. They can represent surgical interventions with high resolution, offering qualifiable and quantifiable information on the course of the intervention on the level of single, minute, surgical work-steps. The basic idea is to gather information concerning the surgical intervention and its activities, such as performance time, surgical instrument used, trajectories, movements, or intervention phases. These data can be gathered by means of workflow recordings. These recordings are abstracted to represent an individual surgical process as a model and are an essential requirement to enable Medicine 4.0 in the OR. Further abstraction can be generated by merging individual process models to form generic SPMs to increase the validity for a larger number of patients. Furthermore, these models can be applied in a wide variety of use-cases. In this regard, the term “modeling” can be used to support either one or more of the following tasks: “to describe”, “to understand”, “to explain”, to optimize”, “to learn”, “to teach”, or “to automate”. Possible use-cases are requirements analyses, evaluating surgical assist systems, generating surgeon-specific training-recommendation, creating workflow management systems for ORs, and comparing different surgical strategies. The presented chapter will give an introduction into this challenging topic, presenting different methods to generate SPMs from the workflow in the OR, as well as various use-cases, and state-of-the-art research in this field. Although many examples in the article are given according to SPMs that were computed based on observations, the same approaches can be easily applied to SPMs that were measured automatically and mined from big data.

scholarly journals LAPAROSCOPIC METHOD IN THE FORMATION OF INTERURETERAL PROXIMAL ANASTOMOSIS IN A CHILD WITH VAGINAL ECTOPIA AND URETEROHYDRONEPHROSIS OF THE UPPER SEGMENT OF A DUPLICATED LEFT KIDNEY

2018 ◽  
Vol 22 (2) ◽  
pp. 102-104
Author(s):  
S. G. Vrublevskiy ◽  
I. V. Poddubnyy ◽  
O. S. Shmyrov ◽  
E. N. Vrublevskaya ◽  
M. N. Lazishvili ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Urinary Tract ◽  
Single Unit ◽  
Left Kidney ◽  
Minimal Invasive ◽  
Proximal Anastomosis ◽  
Surgical Interventions ◽  
The One ◽  
Tract Infections ◽  
Complete Duplication

The duplication of the urinary tract is a developmental anomaly of the urinary system, which is represented in 0.8% of the population. In most cases, the duplication is incomplete and clinically insignificant. However, in the case of complete duplication, there is possible both an association with such pathologies as ureterocele, vesicoureteral reflux (VUR), urinary incontinence, ureterohydronephrosis and relation to recurrent urinary tract infections. Depending on the identified pathology it is possible to perform surgical interventions. These are organ-displacing operations (heminephroureterectomy) and reconstructive surgery - ureterocystoplasty of the one ureter or both ureters “as a single unit”, as well as the formation of interureteral anastomoses. Currently, there is the possibility to perform both open and endoscopic surgeries. We present a case report of endoscopic minimal invasive reconstructive intervention, performed to patient with ureterohydronephrosis ectopied in the vagina of the urethra of the duplicated left kidney and complaints of urinary incontinence.

Surgical Workflow Management Schemata for Cataract Procedures

2012 ◽  
Vol 51 (05) ◽  
pp. 371-382 ◽  
Author(s):  
P. Liebmann ◽  
P. Wiedemann ◽  
J. Meixensberger ◽  
T. Neumuth
Keyword(s):  
Process Model ◽  
Workflow Management ◽  
Surgical Techniques ◽  
High Variability ◽  
Process Models ◽  
Work Flow ◽  
Surgical Workflow ◽  
Design And Implementation ◽  
Surgical Process Model ◽  
Learning Sets

SummaryObjective: Workflow guidance of surgical activities is a challenging task. Because of variations in patient properties and applied surgical techniques, surgical processes have a high variability. The objective of this study was the design and implementation of a surgical workflow management system (SWFMS) that can provide a robust guidance for surgical activities. We investigated how many surgical process models are needed to develop a SWFMS that can guide cataract surgeries robustly.Methods: We used 100 cases of cataract surgeries and acquired patient-individual surgical process models (iSPMs) from them. Of these, randomized subsets iSPMs were selected as learning sets to create a generic surgical process model (gSPM). These gSPMs were mapped onto workflow nets as work-flow schemata to define the behavior of the SWFMS. Finally, 10 iSPMs from the disjoint set were simulated to validate the workflow schema for the surgical processes. The measurement was the successful guidance of an iSPM.Results: We demonstrated that a SWFMS with a workflow schema that was generated from a subset of 10 iSPMs is sufficient to guide approximately 65% of all surgical processes in the total set, and that a subset of 50 iSPMs is sufficient to guide approx. 80% of all processes.Conclusion: We designed a SWFMS that is able to guide surgical activities on a detailed level. The study demonstrated that the high inter-patient variability of surgical processes can be considered by our approach.

A Decision Support Tool for Evaluating Big Data Investment in Transport: Empirical evidence from European use cases of NOESIS project

2020 ◽  
Author(s):  
Christos Katrakazas ◽  
Natalia Sobrino ◽  
Ilias Trochidis ◽  
Jose Manuel Vassallo ◽  
Stratos Arampatzis ◽  
...  
Keyword(s):  
Big Data ◽  
Decision Support ◽  
Empirical Evidence ◽  
Decision Support Tool ◽  
Use Cases ◽  
Support Tool

Quality of life after anti-reflux surgical interventions: possible solutions to the problem

2020 ◽  
pp. 3-25
Author(s):  
D. Lukanin ◽  
G. Rodoman ◽  
M. Klimenko ◽  
A. Sokolov ◽  
A. Sokolov
Keyword(s):  
Quality Of Life ◽  
Hiatal Hernia ◽  
Antireflux Surgery ◽  
Nissen Fundoplication ◽  
Laparoscopic Nissen Fundoplication ◽  
Partial Fundoplication ◽  
Surgical Interventions ◽  
Number Of Patients ◽  
Laparoscopic Nissen

The article presents the results of a prospective controlled parallel clinical study of a new modification of laparoscopic antireflux surgery in the treatment of gastroesophageal reflux disease in combination with a hiatal hernia compared with laparoscopic Nissen fundoplication in terms of assessing quality of life after surgery. Clinical and instrumental examination of patients was carried out a year after surgical interventions. In accordance with the results of instrumental examination after surgery, the proposed modification of laparoscopic partial fundoplication is not inferior to laparoscopic Nissen fundoplication both, in terms of relief of reflux esophagitis symptoms and in relation to the recurrence of hiatal hernia. Clinical monitoring indicates a significantly higher quality of life for patients after the modified antireflux surgery, which is associated with a number of factors. The implementation of this fundoplication led to a decrease in the number of patients with complaints of dysphagia, the development of which is directly related to the surgery performance, as well as to a statistically significant reduction of bloating in the upper abdomen. Another advantage of the modified surgery is a significantly smaller number of cases of gas-bloat syndrome. In addition, the disorders developing in the framework of the gas bloat syndrome after laparoscopic Nissen fundoplication are more severe.

THE APPLICATION OF PETRI NETS TO WORKFLOW MANAGEMENT

1998 ◽  
Vol 08 (01) ◽  
pp. 21-66 ◽  
Author(s):  
W. M. P. VAN DER AALST
Keyword(s):  
Petri Nets ◽  
Petri Net ◽  
Business Processes ◽  
State Of The Art ◽  
Workflow Management ◽  
Explicit Representation ◽  
The Other ◽  
Application Domain ◽  
Analysis Techniques ◽  
The One

Workflow management promises a new solution to an age-old problem: controlling, monitoring, optimizing and supporting business processes. What is new about workflow management is the explicit representation of the business process logic which allows for computerized support. This paper discusses the use of Petri nets in the context of workflow management. Petri nets are an established tool for modeling and analyzing processes. On the one hand, Petri nets can be used as a design language for the specification of complex workflows. On the other hand, Petri net theory provides for powerful analysis techniques which can be used to verify the correctness of workflow procedures. This paper introduces workflow management as an application domain for Petri nets, presents state-of-the-art results with respect to the verification of workflows, and highlights some Petri-net-based workflow tools.

scholarly journals Challenges of Big Data analysis

2014 ◽  
Vol 1 (2) ◽  
pp. 293-314 ◽  
Author(s):  
Jianqing Fan ◽  
Fang Han ◽  
Han Liu
Keyword(s):  
Big Data ◽  
Data Analysis ◽  
Measurement Errors ◽  
Modern Society ◽  
Big Data Analysis ◽  
Small Scale ◽  
Paradigm Change ◽  
Statistical Inferences ◽  
The One ◽  
And Storage

Abstract Big Data bring new opportunities to modern society and challenges to data scientists. On the one hand, Big Data hold great promises for discovering subtle population patterns and heterogeneities that are not possible with small-scale data. On the other hand, the massive sample size and high dimensionality of Big Data introduce unique computational and statistical challenges, including scalability and storage bottleneck, noise accumulation, spurious correlation, incidental endogeneity and measurement errors. These challenges are distinguished and require new computational and statistical paradigm. This paper gives overviews on the salient features of Big Data and how these features impact on paradigm change on statistical and computational methods as well as computing architectures. We also provide various new perspectives on the Big Data analysis and computation. In particular, we emphasize on the viability of the sparsest solution in high-confidence set and point out that exogenous assumptions in most statistical methods for Big Data cannot be validated due to incidental endogeneity. They can lead to wrong statistical inferences and consequently wrong scientific conclusions.

Analysis of statistical indicators of the population of Saint Petersburg with malignant neoplasms of pancreas

2021 ◽  
Vol 23 (2) ◽  
pp. 155-164
Author(s):  
Vladislav E. Moiseenko ◽  
Alexander V. Pavlovsky ◽  
Dmitry A. Granov ◽  
Larisa V. Kochorova ◽  
Inna V. Dodonova ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Stage Iv ◽  
Malignant Neoplasms ◽  
Number Of Patients ◽  
Incidence And Mortality ◽  
Significant Downward Trend ◽  
Accumulation Index ◽  
One Year ◽  
The One ◽  
Statistical Indicators

Morbidity and mortality from pancreatic cancer is an urgent medical and social problem. Evaluation of statistical indicators in dynamics makes it possible to identify organizational and clinical problems in providing care to patients with malignant neoplasms of the pancreas. Medical and statistical indicators of incidence of malignant pancreatic neoplasms in St. Petersburg residents are evaluated. The assessment of medical and statistical indicators of the incidence of malignant neoplasms of the pancreas in residents of St. Petersburg. Statistical data were studied for the period from 2014 to 2019. The increase in the "rough" indicator of primary morbidity changed from 417.99 per 100 thousand population in 2014 to 505.6 in 2019. In the structure of primary cancer incidence, the indicator of active detection of pancreatic cancer glands in 2014 amounted to 3.6%, in 2019 3.8%. The proportion of patients with diagnoses confirmed morphologically increased from 48.9% to 61.4%. The proportion of patients with newly diagnosed stage IV of the disease changed from 39.5% in 2014 to 51.4% in 2019, and in patients with stage III in 2019 it was 33.3% (a decrease in comparison with 2014 15.3%). In 2019, the disease was diagnosed at stage II in 15.2% of patients. The proportion of patients with stage I in 2019 was 6.6%, this indicator in 2014 was registered at the level of 19.2%. From 2014 to 2019, the one-year mortality rate did not change and amounted to 67.9 and 67.4%, respectively (the decrease was 0.7%). Over the past 5 years, there has been no significant downward trend in the "rough" incidence and mortality rates from pancreatic cancer. However, in the dynamics, there was an increase in the number of patients registered for 5 or more years, and an increase in the accumulation index of the contingent of patients with pancreatic cancer.

Treatment of frostbite in an open way (without dressings)

1937 ◽  
Vol 33 (1) ◽  
pp. 84-86
Author(s):  
V. A. Petrovykh
Keyword(s):  
Recovery Period ◽  
Climatic Conditions ◽  
The Other ◽  
Critical Approach ◽  
Tatar Strait ◽  
Other Hand ◽  
Number Of Patients ◽  
The One ◽  
Apparent Similarity ◽  
Methods Of Treatment

The harsh climatic conditions of the coast of the Tatar Strait make explainable the large number of patients with frostbite who passed under our supervision during the winter of 1935-36 and amounted to 2.8% (26 people) of the total contingent of inpatients. The variety of recommended methods for treating frostbite, on the one hand, and the relatively long recovery period for all of them, on the other hand, made us take a critical approach to the proposed methods of treatment. All currently existing methods are reduced to the treatment of frostbite areas with bandages; and on the locus morbi apply indifferent or slightly disinfecting ointments, or a similar property of a powder, or wipes moistened with slightly disinfecting solutions, for example, Sol. kalii hyperm. 1: 1000. The apparent similarity of the external manifestations of frostbite and burns inspired us with the idea of ​​conducting frostbite therapy in an "open way", which has long occupied a well-deserved place in the treatment of burns.

MORPHOLOGICAL EVALUATION OF EFFECTIVENESS OF NECROFASCIOTOMY AND INFILTRATION WITH OZONATED SALINE AREA OF DEEP CIRCULAR BURN OF SKIN WITH UNDERLYING TISSUES COMPLICATED BY COMPARTMENT SYNDROME

2020 ◽  
pp. 28-33
Author(s):  
Teimur Ahaliievich Kurbanov ◽  
O. V. Kravtsov ◽  
M. S. Myroshnychenko ◽  
Yu. I. Isaev
Keyword(s):  
Compartment Syndrome ◽  
Physiological Solution ◽  
Burn Wound ◽  
Local Pressure ◽  
Tissue Pressure ◽  
Surgical Interventions ◽  
Morphological Evaluation ◽  
General Pathology ◽  
Saline Area ◽  
The One

Compartment syndrome is one of the complications of tissue damage of various origins, the basis of which is the compression of blood vessels and disruption of blood supply to tissues due to an increased local pressure in the closed space of the fascial sheath. The consequences of compartment syndrome can be local and general. An effective treatment of compartment syndrome in burns is to perform a necrotomy, which due to decompression helps to reduce intra−tissue pressure and diminish the scale of necrotic changes in tissues. In order to morphologically evaluate the effectiveness of necrofasciotomy, as well as the one in combination with infiltration of ozonated saline area of deep circular skin burns with underlying tissues, complicated by compartment syndrome, an experimental study was conducted. Circular deep burns, complicated by the formation of compartment syndrome, were simulated in 18 WAG rats. To reduce the pressure in the burned and surrounding tissues, surgical interventions such as necrofasciotomy were performed, which provided a notable reduction in pressure. In parallel, infiltration of damaged tissues with ozonated saline was performed, which was bubbled for 15 minutes at a dissolved ozone concentration of 4.0±0.2 mg / l, which improved microcirculation and reduced tissue hypoxia. The findings indicate that the compartment syndrome is characterized by a significant severity of general pathology. Performance of necrofasciotomy of a burn wound with its infiltration by ozonated physiological solution in comparison with just necrofasciotomy has more positive medical effect, and efficiency of these medical measures increases when they are performed at early terms (day 1) of formation of a burn wound in comparison with late terms (day 3). Key words: burns, surgical treatment, compartment syndrome, histological examinations.

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