Human Cadaveric Artificial Lung Tumor-Mimic Training Model

Introduction: An important phase in surgical training is gaining experience in real human anatomical situations. When a cadaver is available it may complement the various artificial practice models. However, it is often necessary to supplement the characteristics of the cadavers with a simulation of a tumor. Our objective was to develop an easy-to-create, realistic artificial tumor-mimic model for peripheral lung tumor resection practice.Methods: In our work we injected barium sulphate enriched silicone suspension into 10 isolated, non-fixed lungs of human cadavers, through the puncture of the visceral pleura. Four lesions–apical, hilar and two peripheral–were created in each of ten specimens. After fixation CT scans were obtained and analyzed. The implanted tumor-mimics were examined after anatomical preparation and slicing. Also performed CT-guided percutaneous puncture was also performed to create the lesions in situ in two lungs of human cadavers.Results: Analyzing the CT data of 10 isolated lungs, out of 40 lesions, 34 were nodular (85.0%) and in the nodular group five were spiculated (12.5%). Satellite lesions were formed in two cases (5.0%). Relevant outflow into vessels or airway occurred in five lesions (12.5%). Reaching the surface of the lung occured in 11 lesions (27.5%). The tumor-mimics were elastic and adhered well to the surrounding tissue. The two lesions, implanted via percutaneous puncture, both were nodular and one also showed lobulated features.Conclusion: Our artificial tumor-mimics were easy to create, varied in shape and size, and with percutaneous implantation the lesions provide a model for teaching every step of a surgical procedure.

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Lung Tumor Resection Ups Melanoma Survival

Skin & Allergy News ◽

10.1016/s0037-6337(07)70555-7 ◽

2007 ◽

Vol 38 (7) ◽

pp. 46

Author(s):

ALICIA AULT

Keyword(s):

Lung Tumor ◽

Tumor Resection

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Perioperative outcomes of combined heart surgery and lung tumor resection: A systematic review and meta-analysis

10.21203/rs.3.rs-86694/v1 ◽

2020 ◽

Author(s):

Shizhao Cheng ◽

Yiyao Jiang ◽

Xin Li ◽

Xike Lu ◽

Xun Zhang ◽

...

Keyword(s):

Complication Rate ◽

Subgroup Analysis ◽

Heart Surgery ◽

Lung Tumor ◽

Meta Analysis ◽

Tumor Resection ◽

Perioperative Outcomes ◽

Off Pump ◽

Lung Cancer Patients ◽

Pump Cabg

Abstract Objective: The coexistence of concomitant lesions of the heart and lungs needed surgical intervention is increasing. Simultaneous cardiac surgery with pulmonary resection can solve the lesions at the same time, thus avoiding the second operation. However, concern exists regarding the potentially increased mortality and complication rate of simultaneous surgery and the adequacy of lung exposure during heart surgery. Therefore, we performed a meta-analysis to evaluate the perioperative mortality and complication rate of combined heart surgery and lung tumor resection.Methods: A comprehensive literature search was performed in July 2020. PubMed, Embase and Web of Science databases were searched to collect studies reported the perioperative outcomes of combined heart surgery and lung tumor resection. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies. Pooled proportion and its 95% confidence intervals (95% CI) was performed by R version 3.6.1 using the meta package.Results: A total of 536 patients from 29 studies were included in this analysis. Overall, the results of this meta-analysis showed that the pooled proportion of operative mortality was 0.01 (95% CI: 0.00, 0.03) and the pooled proportion of postoperative complications was 0.40 (95% CI: 0.24, 0.57) for patients underwent combined cardiothoracic surgery. Subgroup analysis by lung pathology revealed that, for lung cancer patients, the pooled proportion of anatomical lung resection was 0.99 (95% CI: 0.95, 1.00), and the pooled proportion of systematic lymph node dissection or sampling was 1.00 (95% CI: 1.00, 1.00). Subgroup analysis by heart surgery procedures found that the pooled proportion of postoperative complications of coronary artery bypass grafting (CABG) patients using off-pump method was 0.17 (95% CI: 0.01, 0.43), while the pooled proportion of on-pump method was 0.61 (95% CI: 0.38, 0.82).Conclusion: This study presented that combined heart surgery and lung tumor resection had a low mortality rate and an acceptable complication rate. Subgroup analysis revealed most lung cancer patients underwent uncompromised anatomical resection and mediastinal lymph node sampling or dissection during combined cardiothoracic surgery, and showed off-pump CABG could potentially reduce the complication rate compared with on-pump CABG. While further researches are still needed.

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Usefulness of a Newly Developed Ultrasonic Microdissector in Neurosurgery: A Preliminary Experimental Study

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0038-1675782 ◽

2018 ◽

Vol 80 (02) ◽

pp. 096-101

Author(s):

Tetsuya Goto ◽

Yusuke Fujii ◽

Yoshiki Hanaoka ◽

Kazuhiro Hongo ◽

Jun Okamoto ◽

...

Keyword(s):

Experimental Study ◽

Brain Tumor ◽

Tumor Resection ◽

Brain Parenchyma ◽

Surrounding Tissue ◽

Ultrasonic Power ◽

New Device ◽

Tissue Degeneration ◽

Affected Tissue ◽

Brain Tumor Resection

Background Dissection and division of tissues are widely performed in microscopic neurosurgery, especially in brain tumor resection. Dissection maneuvers can be divided into two types: sharp dissection with microscissors and blunt dissection using a dissector. It is essential to use the appropriate method according to the intraoperative situation and conditions. Therefore, specific tools for each type of dissection maneuver are required. We developed an ultrasonic microdissector, a newly designed tool that functions as both microscissors and dissector to further advance brain tumor surgery. This preliminary experimental study was performed to evaluate the usefulness of this new device. Methods Solfy F (J. Morita Mfg. Corp., Kyoto, Japan), a dental ultrasonic instrument, was used to provide power in this study. Two experiments were performed. The first one involved touching the brain parenchyma of a pig cadaver with the tip of the ultrasonic microdissector under various conditions to investigate its side effects. In the second experiment, the rat femoral artery, vein, and nerve were dissected from surrounding structures using a prototype of the ultrasonic microdissector. The effects of this device were then investigated histologically. Results The amount of tissue damage was greater with the higher ultrasonic power. No irrigation and a long manipulation time also affected tissue degeneration. Dissection using the ultrasonic microdissector was superior to conventional dissection methods in terms of time (p < 0.05) and safety without any additional histologic damages. Conclusions The newly developed ultrasonic microdissector can dissect soft tissue without damage to the surrounding tissue. Further studies are required to determine the optimal intensity for its clinical use.

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Diagnostic and Therapeutic Challenges of a Large Pleural Inflammatory Myofibroblastic Tumor

Case Reports in Pulmonology ◽

10.1155/2012/102196 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Judith Loeffler-Ragg ◽

Johannes Bodner ◽

Martin Freund ◽

Michael Steurer ◽

Christian Uprimny ◽

...

Keyword(s):

Inflammatory Myofibroblastic Tumor ◽

Residual Disease ◽

Tumor Resection ◽

Intravenous Immunoglobulins ◽

Tissue Reaction ◽

Empiric Antibiotic Therapy ◽

Incomplete Resection ◽

Ct Guided ◽

The Right ◽

Fdg Pet Ct

We report a 48-year-old woman with a pleural pseudoneoplasm requiring different diagnostic and therapeutic strategies. After initial presentation with increasing dyspnoea, temperature, dry cough, and interscapular pain diagnostic processing showed a large mediastinal mass with marked pleural effusion and high metabolic activity in the 18F-FDG-PET/CT. Extensive CT-guided biopsy of the tumor reaching from the visceral pleura into the right upper lobe revealed no malignancy, but a marked inflammatory tissue reaction containing foam cells. Initial empiric antibiotic therapy was temporarily successful. However, in the further course the mass relapsed and was resistant to antibiotics and a corticosteroid trial. With the working hypothesis of an inflammatory myofibroblastic tumor the patient underwent surgical tumor resection, finally confirming the suspected diagnosis. Due to residual disease intravenous immunoglobulins were administered leading to sustained response. This case with a pleural localisation of a large inflammatory pseudotumor with responsiveness to immunomodulation after incomplete resection extends the reported spectrum of thoracopulmonary manifestations of this rare entity.

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Targeting accuracy of transcranial magnetic resonance–guided high-intensity focused ultrasound brain therapy: a fresh cadaver model

Journal of Neurosurgery ◽

10.3171/2013.1.jns12559 ◽

2013 ◽

Vol 118 (5) ◽

pp. 1046-1052 ◽

Cited By ~ 48

Author(s):

Dorian Chauvet ◽

Laurent Marsac ◽

Mathieu Pernot ◽

Anne-Laure Boch ◽

Rémy Guillevin ◽

...

Keyword(s):

High Intensity ◽

Focused Ultrasound ◽

High Intensity Focused Ultrasound ◽

Human Cadaver ◽

Fresh Cadaver ◽

Array Transducer ◽

Human Cadavers ◽

Ct Data ◽

The Right ◽

Human Cadaver Model

Object This work aimed at evaluating the accuracy of MR-guided high-intensity focused ultrasound (MRgHIFU) brain therapy in human cadaver heads. Methods Eighteen heads of fresh human cadavers were removed with a dedicated protocol preventing intracerebral air penetration. The MR images allowed determination of the ultrasonic target: a part of the thalamic nucleus ventralis intermedius implicated in essential tremor. Osseous aberrations were corrected with simulation-based time reversal by using CT data from the heads. The ultrasonic session was performed with a 512-element phased-array transducer system operating at 1 MHz under stereotactic conditions with thermometric real-time MR monitoring performed using a 1.5-T imager. Results Dissection, imaging, targeting, and planning have validated the feasibility of this human cadaver model. The average temperature elevation measured by proton resonance frequency shift was 7.9°C ± 3°C. Based on MRI data, the accuracy of MRgHIFU is 0.4 ± 1 mm along the right/left axis, 0.7 ± 1.2 mm along the dorsal/ventral axis, and 0.5 ± 2.4 mm in the rostral/caudal axis. Conclusions Despite its limits (temperature, vascularization), the human cadaver model is effective for studying the accuracy of MRgHIFU brain therapy. With the 1-MHz system investigated here, there is millimetric accuracy.

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A nanomaterial-based breath test for short-term follow-up after lung tumor resection

Nanomedicine Nanotechnology Biology and Medicine ◽

10.1016/j.nano.2012.07.009 ◽

2013 ◽

Vol 9 (1) ◽

pp. 15-21 ◽

Cited By ~ 69

Author(s):

Yoav Y. Broza ◽

Ran Kremer ◽

Ulrike Tisch ◽

Arsen Gevorkyan ◽

Ala Shiban ◽

...

Keyword(s):

Breath Test ◽

Lung Tumor ◽

Tumor Resection ◽

Short Term

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Robot Guided Sheaths (RoGS) for Percutaneous Access to the Pediatric Kidney: Patient-Specific Design and Preliminary Results

Volume 1: Aerial Vehicles; Aerospace Control; Alternative Energy; Automotive Control Systems; Battery Systems; Beams and Flexible Structures; Biologically-Inspired Control and its Applications; Bio-Medical and Bio-Mechanical Systems; Biomedical Robots and Rehab; Bipeds and Locomotion; Control Design Methods for Adv. Powertrain Systems and Components; Control of Adv. Combustion Engines, Building Energy Systems, Mechanical Systems; Control, Monitoring, and Energy Harvesting of Vibratory Systems ◽

10.1115/dscc2013-3917 ◽

2013 ◽

Cited By ~ 3

Author(s):

Tania K. Morimoto ◽

Michael H. Hsieh ◽

Allison M. Okamura

Keyword(s):

Three Dimensional ◽

The Body ◽

Surrounding Tissue ◽

Patient Specific ◽

Three Dimensional Model ◽

Specific Design ◽

Surgical Access ◽

Minimally Invasive Surgical ◽

Area Of Interest ◽

Ct Data

Robot-guided sheaths consisting of pre-curved tubes and steerable needles are proposed to provide surgical access to locations deep within the body. In comparison to current minimally invasive surgical robotic instruments, these sheaths are thinner, can move along more highly curved paths, and are potentially less expensive. This paper presents the patient-specific design of the pre-curved tube portion of a robot-guided sheath for access to a kidney stone; such a device could be used for delivery of an endoscope to fragment and remove the stone in a pediatric patient. First, feasible two-dimensional paths were determined considering workspace limitations, including avoidance of the ribs and lung, and minimizing collateral damage to surrounding tissue by leveraging the curvatures of the sheaths. Second, building on prior work in concentric-tube robot mechanics, the mechanical interaction of a two-element sheath was modeled and the resulting kinematics was demonstrated to achieve a feasible path in simulation. In addition, as a first step toward three-dimensional planning, patient-specific CT data was used to reconstruct a three-dimensional model of the area of interest.

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Perioperative outcomes of combined heart surgery and lung tumor resection: a systematic review and meta-analysis

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01607-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Shizhao Cheng ◽

Yiyao Jiang ◽

Xin Li ◽

Xike Lu ◽

Xun Zhang ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Heart Surgery ◽

Lung Tumor ◽

Meta Analysis ◽

Tumor Resection ◽

Perioperative Outcomes ◽

Complication Rates ◽

Off Pump ◽

Pump Cabg

Abstract Objective The prevalence of patients with concomitant heart and lung lesions requiring surgical intervention is increasing. Simultaneous cardiac surgery and pulmonary resection avoids the need for a second operation. However, there are concerns regarding the potentially increased mortality and complication rates of simultaneous surgery and the adequacy of lung exposure during heart surgery. Therefore, we performed a meta-analysis to evaluate the perioperative mortality and complication rates of combined heart surgery and lung tumor resection. Methods A comprehensive literature search was performed in July 2020. The PubMed, Embase, and Web of Science databases were searched to identify studies that reported the perioperative outcomes of combined heart surgery and lung tumor resection. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias of included studies. Pooled proportions and 95% confidence intervals (95% CI) were calculated by R version 3.6.1 using the meta package. Results A total of 536 patients from 29 studies were included. Overall, the pooled proportion of operative mortality was 0.01 (95% CI: 0.00, 0.03) and the pooled proportion of postoperative complications was 0.40 (95% CI: 0.24, 0.57) for patients who underwent combined cardiothoracic surgery. Subgroup analysis by lung pathology revealed that, for patients with lung cancer, the pooled proportion of anatomical lung resection was 0.99 (95% CI: 0.95, 1.00) and the pooled proportion of systematic lymph node dissection or sampling was 1.00 (95% CI: 1.00, 1.00). Subgroup analysis by heart surgery procedure found that the pooled proportion of postoperative complications of patients who underwent coronary artery bypass grafting (CABG) patients using the off-pump method was 0.17 (95% CI: 0.01, 0.43), while the pooled proportion of complications after CABG using the on-pump method was 0.61 (95% CI: 0.38, 0.82). Conclusion Combined heart surgery and lung tumor resection had a low mortality rate and an acceptable complication rate. Subgroup analyses revealed that most patients with lung cancer underwent uncompromised anatomical resection and mediastinal lymph node sampling or dissection during combined cardiothoracic surgery, and showed off-pump CABG may reduce the complication rate compared with on-pump CABG. Further researches are still needed to verify these findings.

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Neuro Deficit Caused by Vertebral Hemangioma Enneking Stage 3: Incidence, Treatment Options and One Extraordinary Serious Case

Medical Research Archives ◽

10.18103/mra.v9i4.2379 ◽

2021 ◽

Vol 9 (4) ◽

Author(s):

Andreas Reinke ◽

Gordian Schmid ◽

Ehab Shiban ◽

Alexander Wild

Keyword(s):

Surgical Treatment ◽

Spinal Canal ◽

Tumor Resection ◽

Complete Recovery ◽

Neurological Symptoms ◽

Surrounding Tissue ◽

Vertebral Hemangioma ◽

Institutional Experience ◽

Enneking Stage ◽

Vertebral Hemangiomas

Objective Aggressive Vertebral Hemangiomas (VH) are very rare lesions that may present with compression fractures or bony expansion and erosion into the epidural space resulting in neurological symptoms. Especially in these patients a surgical treatment is essential. We illustrate our institutional experience and discuss the relevant literature. Method Our database was searched for cases with vertebral hemangioma and the appearance of a neurological deficit between 2015 and 2020. We were able to identify one very extraordinary case which showed a very aggressive nature and resulted in paraparesis twice in the patient. Furthermore a Medline analysis was performed to identify data of this rare illness (aggressive VH, Enneking stage 3, S3) to assess the incidence and therapeutic options for this so called benign vascular tumor. Results One patient was identified in the database with an extraordinary course which resulted in paraparesis twice. A 54-year-old man presented with an acute onset of paraparesis of the legs. Contrast-enhanced magnetic resonance imaging (MRI) revealed a hypervascular tumor of the entire L3 vertebral body and the surrounding tissue with subtotal compression of the spinal canal (Enneking stage 3). After decompression and spinal stabilization a complete recovery of the paraparesis was seen. Two weeks after the initial presentation a recurrence of the paraparesis was noted. The subsequent MRI demonstrated a recurrent increase in the tumor size with spinal canal compression. After endovascular embolization, a gross total tumor resection with a vertebral replacement was performed. The patient was noted to have a complete recovery. Conclusion The number of cases with aggressive vertebral hemangiomas (Enneking Stage 3) is limited. However, despite limited treatment algorithms for these rare cases due to the lack of data, surgical treatment should be recommended, especially in the presence of neurological symptoms. That can be underlined by our institutional experience.

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