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Surgery Simulator (surgery + simulator)
Selected AbstractsPorcine Sebaceous Cyst Model: An Inexpensive, Reproducible Skin Surgery SimulatorDERMATOLOGIC SURGERY, Issue 8 2005Jonathan Bowling MBChB background. Surgical simulators are an established part of surgical training and are regularly used as part of the objective structured assessment of technical skills. Specific artificial skin models representing cutaneous pathology are available, although they are expensive when compared with pigskin. The limitations of artificial skin models include their difficulty in representing lifelike cutaneous pathology. objective. Our aim was to devise an inexpensive, reproducible surgical simulator that provides the most lifelike representation of the sebaceous cyst. materials and methods. Pigskin, either pig's feet/trotters or pork belly, was incised, and a paintball was inserted subcutaneously and fixed with cyanoacrylic glue. results. This model has regularly been used in cutaneous surgical courses that we have organized. Either adding more cyanoacrylic glue or allowing more time for the paint ball to absorb fluid from surrounding tissue can also adjust the degree of difficulty. conclusions. The degree of correlation with lifelike cutaneous pathology is such that we recommend that all courses involved in basic skin surgery should consider using the porcine sebaceous cyst model when teaching excision of sebaceous cysts. [source] Improving realism of a surgery simulator: linear anisotropic elasticity, complex interactions and force extrapolationCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 3 2002Guillaume Picinbono Abstract In this article, we describe the latest developments of the minimally invasive hepatic surgery simulator prototype developed at INRIA. The goal of this simulator is to provide a realistic training test bed to perform laparoscopic procedures. Therefore, its main functionality is to simulate the action of virtual laparoscopic surgical instruments for deforming and cutting tridimensional anatomical models. Throughout this paper, we present the general features of this simulator including the implementation of several biomechanical models and the integration of two force-feedback devices in the simulation platform. More precisely, we describe three new important developments that improve the overall realism of our simulator. First, we have developed biomechanical models, based on linear elasticity and finite element theory, that include the notion of anisotropic deformation. Indeed, we have generalized the linear elastic behaviour of anatomical models to ,transversally isotropic' materials, i.e. materials having a different behaviour in a given direction. We have also added to the volumetric model an external elastic membrane representing the ,liver capsule', a rather stiff skin surrounding the liver, which creates a kind of ,surface anisotropy'. Second, we have developed new contact models between surgical instruments and soft tissue models. For instance, after detecting a contact with an instrument, we define specific boundary constraints on deformable models to represent various forms of interactions with a surgical tool, such as sliding, gripping, cutting or burning. In addition, we compute the reaction forces that should be felt by the user manipulating the force-feedback devices. The last improvement is related to the problem of haptic rendering. Currently, we are able to achieve a simulation frequency of 25,Hz (visual real time) with anatomical models of complex geometry and behaviour. But to achieve a good haptic feedback requires a frequency update of applied forces typically above 300,Hz (haptic real time). Thus, we propose a force extrapolation algorithm in order to reach haptic real time. Copyright © 2002 John Wiley & Sons, Ltd. [source] Effects of alternative instrumentation strategies in adolescent idiopathic scoliosis: A biomechanical analysisJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2009Martin Robitaille Abstract The recent advent of modern instrumentation systems has improved the correction of scoliosis, but complicated the surgical decision-making process, especially with the introduction of diverse spinal fixation devices, new preoperative corrective maneuvers, and the reevaluation of many rules concerning the selection of fusion levels and other guidelines for surgical correction. Our objective was to assess the biomechanical effects of different instrumentation strategies for the same scoliotic cases. Several instrumentation strategies suggested by a group of 32 experienced senior surgeons for five cases were individually simulated using a validated computer model implemented in a spine surgery simulator. The resulting geometric indices varied among the five cases (e.g., range of main thoracic Cobb angles: 5,17°, 16,29°, 25,44°, 15,34°, 16,32°; kyphosis: 22,33°, 20,54°, 33,55°, 24,49°, 29,46°; and lordosis: 10,52°, 24,38°, 26,54°, 8,28°, 34,53°). The average correction was better with pedicle screws (71%) than with hooks (51%) and hybrid constructs (67%). For the first time, to our knowledge, the effect of different instrumentation strategies was compared on the same patients, which is possible only with a surgery simulator. A large variability of instrumentation strategies existed among experienced surgeons and produced rather different results. This study questions the criteria for optimal configuration and standards to design the best surgical construct. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:104,113, 2009 [source] The Utility of Simulation in Medical Education: What Is the Evidence?MOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 4 2009Yasuharu Okuda MD Abstract Medical schools and residencies are currently facing a shift in their teaching paradigm. The increasing amount of medical information and research makes it difficult for medical education to stay current in its curriculum. As patients become increasingly concerned that students and residents are "practicing" on them, clinical medicine is becoming focused more on patient safety and quality than on bedside teaching and education. Educators have faced these challenges by restructuring curricula, developing small-group sessions, and increasing self-directed learning and independent research. Nevertheless, a disconnect still exists between the classroom and the clinical environment. Many students feel that they are inadequately trained in history taking, physical examination, diagnosis, and management. Medical simulation has been proposed as a technique to bridge this educational gap. This article reviews the evidence for the utility of simulation in medical education. We conducted a MEDLINE search of original articles and review articles related to simulation in education with key words such as simulation, mannequin simulator, partial task simulator, graduate medical education, undergraduate medical education, and continuing medical education. Articles, related to undergraduate medical education, graduate medical education, and continuing medical education were used in the review. One hundred thirteen articles were included in this review. Simulation-based training was demonstrated to lead to clinical improvement in 2 areas of simulation research. Residents trained on laparoscopic surgery simulators showed improvement in procedural performance in the operating room. The other study showed that residents trained on simulators were more likely to adhere to the advanced cardiac life support protocol than those who received standard training for cardiac arrest patients. In other areas of medical training, simulation has been demonstrated to lead to improvements in medical knowledge, comfort in procedures, and improvements in performance during retesting in simulated scenarios. Simulation has also been shown to be a reliable tool for assessing learners and for teaching topics such as teamwork and communication. Only a few studies have shown direct improvements in clinical outcomes from the use of simulation for training. Multiple studies have demonstrated the effectiveness of simulation in the teaching of basic science and clinical knowledge, procedural skills, teamwork, and communication as well as assessment at the undergraduate and graduate medical education levels. As simulation becomes increasingly prevalent in medical school and resident education, more studies are needed to see if simulation training improves patient outcomes. Mt Sinai J Med 76:330,343, 2009. © 2008 Mount Sinai School of Medicine [source] | ||||||||||