Surgical instrumentation

This chapter discusses the instrumentation needed to perform minimally invasive sacroiliac joint fusion, a novel treatment for sacroiliac joint pain or chronic sacroiliitis. As in any surgical procedure, access to the appropriate surgical instrumentation is imperative for a safe and successful outcome. Topics covered include patient positioning and preparation for sacroiliac joint fusion; sterile preparation and surgical drapes are used. Nonsurgical items needed during the procedure for planning, administration of local anesthetic, absorption of blood or fluid, infection prevention, and wound dressing are detailed. The surgical instruments used to incise, maintain hemostasis, and close the incision are described. Device manufacturers provide prepacked kits that may contain a guide pin, a series of dilators, broach, screws, implant, and implant delivery system.

Assessing the efficacy of tablet-based simulations for learning pseudo-surgical instrumentation

Nurses and surgeons must identify and handle specialized instruments with high temporal and spatial precision. It is crucial that they are trained effectively. Traditional training methods include supervised practices and text-based study, which may expose patients to undue risk during practice procedures and lack motor/haptic training respectively. Tablet-based simulations have been proposed to mediate some of these limitations. We implemented a learning task that simulates surgical instrumentation nomenclature encountered by novice perioperative nurses. Learning was assessed following training in three distinct conditions: tablet-based simulations, text-based study, and real-world practice. Immediately following a 30-minute training period, instrument identification was performed with comparable accuracy and response times following tablet-based versus text-based training, with both being inferior to real-world practice. Following a week without practice, response times were equivalent between real-world and tablet-based practice. While tablet-based training does not achieve equivalent results in instrument identification accuracy as real-world practice, more practice repetitions in simulated environments may help reduce performance decline. This project has established a technological framework to assess how we can implement simulated educational environments in a maximally beneficial manner.