Low Cost Traınıng Models For Videothoracoscopic Surgical Training

2021 ◽  
Vol 17 ◽  
Author(s):  
Zeynep Bilgi ◽  
Çağatay Çetinkaya ◽  
Hasan Fevzi Batirel
Keyword(s):  
Minimally Invasive ◽  
Thoracic Surgery ◽  
Surgical Simulation ◽  
Learning Experience ◽  
Low Cost ◽  
Lung Nodule ◽  
Simulation Models ◽  
Artificial Lung ◽  
Case Volume ◽  
Training Models

Objective: We designed novel practical simulation models for VATS lung nodule palpation and vessel dissection, subsequently evaluated the performances of the residents in our thoracic surgery program to account for an appropriate level of difficulty, and grade the learning experience. Methods: Artificial lung nodules were formed by injecting sheep heart-lung blocks with either cyanoacrylate or construction-grade silicone diluted with synthetic thinner. An artificial lung and vessel environment was formed using a sponge, tube balloon placed inside a tunnel within the sponge and fixed with a flexible glue. Both models were placed in a standard laparoscopy training box; both conventional and minimally invasive surgery instruments were used as applicable per the attendee's discretion. Results: In the lung nodule simulation, among 4 residents (postgraduate year (PGY) 1, 3, 4, and 4) average time to palpating the first nodule was 57 seconds, the average time of whole lung palpation was 7,7 minutes. In the vascular dissection model, five residents (PGY 4, 3, 3, 3, 1) median distance dissected at the first attempt was 3,1 cm (1-4,7), and it was shorter 2,5 cm (2-3,2) in the second attempt. Median dissection duration was shorter in the second attempt (5 vs 3 minutes). All residents were able to complete the dissection of the balloon from the sponge within 9 attempts. Conclusion: Surgical simulation models can be created with minimal resources, allowing for enough difficulty to maintain engagement and progressive skill accomplishment through practice. As clinics shift case volume to minimally invasive procedures, resident exposure to open cases can become more scarce, so simulation training in thoracic surgery can not be perceived as a luxury. It has to be accessible even though the learning environment does not have the resources to invest in virtual reality sets or computerized simulators.

scholarly journals Design and Printing of a Low-Cost 3D-Printed Nasal Osteotomy Training Model: Development and Feasibility Study

10.2196/19792 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19792
Author(s):  
Michelle Ho ◽  
Jared Goldfarb ◽  
Roxana Moayer ◽  
Uche Nwagu ◽  
Rohan Ganti ◽  
...  
Keyword(s):  
Teaching And Learning ◽  
Surgical Simulation ◽  
Low Cost ◽  
Model Development ◽  
Simulation Models ◽  
Training Model ◽  
Tactile Feedback ◽  
3D Printer ◽  
3D Printed ◽  
Free Open Source

Background Nasal osteotomy is a commonly performed procedure during rhinoplasty for both functional and cosmetic reasons. Teaching and learning this procedure proves difficult due to the reliance on nuanced tactile feedback. For surgical simulation, trainees are traditionally limited to cadaveric bones, which can be costly and difficult to obtain. Objective This study aimed to design and print a low-cost midface model for nasal osteotomy simulation. Methods A 3D reconstruction of the midface was modified using the free open-source design software Meshmixer (Autodesk Inc). The pyriform aperture was smoothed, and support rods were added to hold the fragments generated from the simulation in place. Several models with various infill densities were printed using a desktop 3D printer to determine which model best mimicked human facial bone. Results A midface simulation set was designed using a desktop 3D printer, polylactic acid filament, and easily accessible tools. A nasal osteotomy procedure was successfully simulated using the model. Conclusions 3D printing is a low-cost, accessible technology that can be used to create simulation models. With growing restrictions on trainee duty hours, the simulation set can be used by programs to augment surgical training.

scholarly journals Design and Printing of a Low-Cost 3D-Printed Nasal Osteotomy Training Model: Development and Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Michelle Ho ◽  
Jared Goldfarb ◽  
Roxana Moayer ◽  
Uche Nwagu ◽  
Rohan Ganti ◽  
...  
Keyword(s):  
Teaching And Learning ◽  
Surgical Simulation ◽  
Low Cost ◽  
Model Development ◽  
Simulation Models ◽  
Training Model ◽  
Tactile Feedback ◽  
3D Printer ◽  
3D Printed ◽  
Free Open Source

BACKGROUND Nasal osteotomy is a commonly performed procedure during rhinoplasty for both functional and cosmetic reasons. Teaching and learning this procedure proves difficult due to the reliance on nuanced tactile feedback. For surgical simulation, trainees are traditionally limited to cadaveric bones, which can be costly and difficult to obtain. OBJECTIVE This study aimed to design and print a low-cost midface model for nasal osteotomy simulation. METHODS A 3D reconstruction of the midface was modified using the free open-source design software Meshmixer (Autodesk Inc). The pyriform aperture was smoothed, and support rods were added to hold the fragments generated from the simulation in place. Several models with various infill densities were printed using a desktop 3D printer to determine which model best mimicked human facial bone. RESULTS A midface simulation set was designed using a desktop 3D printer, polylactic acid filament, and easily accessible tools. A nasal osteotomy procedure was successfully simulated using the model. CONCLUSIONS 3D printing is a low-cost, accessible technology that can be used to create simulation models. With growing restrictions on trainee duty hours, the simulation set can be used by programs to augment surgical training.

scholarly journals Nem tapintható tüdőgócok drót- és izotópjelölés segítségével történő minimálinvazív műtéti eltávolítása

2018 ◽  
Vol 159 (34) ◽  
pp. 1399-1404
Author(s):  
Attila Farkas ◽  
Ákos Kocsis ◽  
Judit Andi ◽  
István Sinkovics ◽  
László Agócs ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Thoracic Surgery ◽  
Lung Nodule ◽  
Lung Nodules ◽  
Resection Line ◽  
The Wire ◽  
Minimally Invasive Thoracic Surgery ◽  
Surgery Department ◽  
Atypical Resection ◽  
Lung Lobes

Abstract: Introduction: Nowadays ever smaller, sub-centimetre lung nodules are screened and diagnosed. For these, minimally invasive resection is strongly recommended both with diagnostic and therapeutic purpose. Aim: Despite many advantages of minimally invasive thoracic surgery, thorough palpation of the lung lobes and thus the localization of lung nodules are still limited. There are several options to solve this problem. From the possibilities we have chosen and tried wire- and isotope-guided lung nodule localization. Materials and methods: In 2017, at the Thoracic Surgery Department of the National Institute of Oncology we performed wire- and isotope-guided minimally invasive pulmonary nodule resection in five patients. The diameter of the lung nodules was between 0.5 and 1.2 cm. The age of the patients was between 44 and 65 years and none of them had severe comorbidities, which meant low risk for complications. Results: We successfully performed the minimally invasive atypical resection in all cases. After the wire and isotope placement we found a 2–3 mm pneumothorax in one patient that did not need urgent drainage. In another patient we found that high amount of intraparenchymal bleeding surrounded the channel of the wire. During the operation, two wires were displaced when the lung collapsed, and in another case the mentioned bleeding got into the thoracic cavity and made it difficult to detect the nodule. In one case we resected the wire-guided lung tissue, but the isotope-guided lung nodule was below the resection line. Conclusion: Both techniques could help to localize the non-palpable lung nodules. Based on our initial experiences, the isotope-guided method provides more details to estimate the exact depth of the nodule from the visceral surface of the pleura and we can avoid the unpleasantness of wire displacement. On the other hand, the production of the isotope requires a more developed infrastructure and the exact timing of the operation after the isotope injection is more strict. Orv Hetil. 2018; 159(34): 1399–1404.

Performance Evaluation of a Sensorized Arthroscopic Grasper

2015 ◽  
Author(s):  
Behnaz Poursartip ◽  
Daniel Yurkewich ◽  
Marie-Eve LeBel ◽  
Rajni V. Patel ◽  
Ana Luisa Trejos ◽  
...  
Keyword(s):  
Performance Evaluation ◽  
Minimally Invasive ◽  
Learning Experience ◽  
Low Cost ◽  
Force Sensing ◽  
Surgical Simulators ◽  
Fiber Bragg Grating Sensors ◽  
Objective Performance ◽  
Advanced Robotics ◽  
Minimally Invasive Instruments

Force sensing minimally invasive instruments have gained increasing attention in recent years. Integrating these instruments within currently available surgical simulators can enhance the learning experience by measuring the forces applied by trainees and supplementing objective performance assessment. Recently, an arthroscopic grasper was designed and sensorized with Fiber Bragg Grating Sensors at Canadian Surgical Technologies and Advanced Robotics (CSTAR). Moreover, a custom low-cost (LC) interrogation system was developed to accompany the proposed sensorized tool. In this study, the custom LC interrogator was used and compared to the commercially-available Micron Optics sm130 (MO) interrogator. The hypothesis is that both of these systems can be used to measure forces within ±0.5 N as the acceptable margin for accuracy. Experimental results showed that the MO system meets the required accuracy for certain force directions. The LC system demonstrated 49% of the accuracy of the MO interrogator. The main advantage of the LC interrogator is its cost, which is 18% of the commercial interrogation system. For certain force directions, the performance was comparable to the defined criteria.

scholarly journals A low-cost wireless endoscope camera: a preliminary report

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
J. M. Lazarus ◽  
M. Ncube
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Video Transmission ◽  
Low Cost ◽  
Battery Life ◽  
Resource Constrained ◽  
High Definition ◽  
Industry Standard ◽  
Constrained Environments ◽  
The Cost

Abstract Background Technology currently used for surgical endoscopy was developed and is manufactured in high-income economies. The cost of this equipment makes technology transfer to resource constrained environments difficult. We aimed to design an affordable wireless endoscope to aid visualisation during rigid endoscopy and minimally invasive surgery (MIS). The initial prototype aimed to replicate a 4-mm lens used in rigid cystoscopy. Methods Focus was placed on using open-source resources to develop the wireless endoscope to significantly lower the cost and make the device accessible for resource-constrained settings. An off the shelf miniature single-board computer module was used because of its low cost (US$10) and its ability to handle high-definition (720p) video. Open-source Linux software made monitor mode (“hotspot”) wireless video transmission possible. A 1280 × 720 pixel high-definition tube camera was used to generate the video signal. Video is transmitted to a standard laptop computer for display. Bench testing included latency of wireless digital video transmission. Comparison to industry standard wired cameras was made including weight and cost. The battery life was also assessed. Results In comparison with industry standard cystoscope lens, wired camera, video processing unit and light source, the prototype costs substantially less. (US$ 230 vs 28 000). The prototype is light weight (184 g), has no cables tethering and has acceptable battery life (of over 2 h, using a 1200 mAh battery). The camera transmits video wirelessly in near real time with only imperceptible latency of < 200 ms. Image quality is high definition at 30 frames per second. Colour rendering is good, and white balancing is possible. Limitations include the lack of a zoom. Conclusion The novel wireless endoscope camera described here offers equivalent high-definition video at a markedly reduced cost to contemporary industry wired units and could contribute to making minimally invasive surgery possible in resource-constrained environments.

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