To see the other types of publications on this topic, follow the link: Surgical Training Box.
Journal articles on the topic 'Surgical Training Box'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Surgical Training Box.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
MARTINS, João Maximiliano Pedron, Roberto Vanin Pinto RIBEIRO, and Leandro Totti CAVAZZOLA. "WHITE BOX: LOW COST BOX FOR LAPAROSCOPIC TRAINING." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 28, no. 3 (September 2015): 204–6. http://dx.doi.org/10.1590/s0102-67202015000300015.
Full textAbstract:
Background: Laparoscopic surgery is a reality in almost all surgical centers. Although with initial greater technical difficulty for surgeons, the rapid return to activities, less postoperative pain and higher quality aesthetic stimulates surgeons to evolve technically in this area. However, unlike open surgery where learning opportunities are more accessible, the laparoscopic training represents a challenge in surgeon formation. Aim: To present a low cost model for laparoscopic training box. Methods: This model is based in easily accessible materials; the equipment can be easily found based on chrome mini jet and passes rubber thread and a webcam attached to an aluminum handle. Results: It can be finalized in two days costing R$ 280,00 (US$ 90). Conclusion: It is possible to stimulate a larger number of surgeons to have self training in laparoscopy at low cost seeking to improve their surgical skills outside the operating room.
2
Carr, E. R. M., and E. Benjamin. "‘Surgical skills box’: a new training aid for surgical trainees." Journal of Laryngology & Otology 120, no. 2 (February 2006): 133–34. http://dx.doi.org/10.1017/s0022215105000150.
Full textAbstract:
Introduction: Surgical trainees now receive less operating experience with the reduction in junior doctor hours.Design: We designed a simple, portable, versatile ‘surgical skills box’ which allowed surgical trainees to practise vascular anastomosis, suturing, tonsil ties, hand ties and grommet insertion.Discussion: With surgical trainees now receiving reduced operating experience it is more important than ever for them to practise their surgical skills outside the operating theatre environment.
3
Phillips, AW, and AE Jones. "The validity and reliability of workplacebased assessments in surgical training." Bulletin of the Royal College of Surgeons of England 97, no. 3 (March 2015): e19-e23. http://dx.doi.org/10.1308/147363515x14134529301147.
Full text
4
Fernandes, Carla Ferreira Kikuchi, José Maria Cordeiro Ruano, Lea Mina Kati, Alberto Sinhiti Noguti, Manoel João Batista Castello Girão, and Marair Gracio Ferreira Sartori. "Assessment of laparoscopic skills of Gynecology and Obstetrics residents after a training program." Einstein (São Paulo) 14, no. 4 (December 2016): 468–72. http://dx.doi.org/10.1590/s1679-45082016ao3752.
Full textAbstract:
ABSTRACT Objective To evaluate laparoscopic skills of third-year Gynecology and Obstetrics residents after training at a training and surgical experimentation center. Methods Use of a prospective questionnaire analyzing demographic data, medical residency, skills, competences, and training in a box trainer and in pigs. Results After the training, there was significant improvement in laparoscopic skills according to the residents (before 1.3/after 2.7; p=0.000) and preceptors (before 2.1/after 4.8; p=0.000). There was also significant improvement in the feeling of competence in surgeries with level 1 and 2 of difficulty. All residents approved the training. Conclusion The training was distributed into 12 hours in the box trainer and 20 hours in animals, and led to better laparoscopic skills and a feeling of more surgical competence in laparoscopic surgery levels 1 and 2.
5
Loukas, Constantinos. "Surgical Simulation Training Systems: Box Trainers, Virtual Reality and Augmented Reality Simulators." International Journal of Advanced Robotics and Automation 1, no. 2 (July 11, 2016): 1–9. http://dx.doi.org/10.15226/2473-3032/1/2/00109.
Full text
6
Österberg, Johanna, Arestis Sokratous, Konstantinos Georgiou, and Lars Enochsson. "Can 3D Vision Improve Laparoscopic Performance in Box Simulation Training when Compared to Conventional 2D Vision?" Folia Medica 61, no. 4 (December 31, 2019): 491–99. http://dx.doi.org/10.3897/folmed.61.e47958.
Full textAbstract:
Introduction: Three-dimensional (3D) imaging systems have been introduced in laparoscopic surgery to facilitate binocular vision and dexterity to improve surgical performance and safety. Several studies have shown the benefits of 3D imaging in laparoscopy, but until now only a few studies have assessed the outcome by using objective variables. Box trainers are affordable alternatives to virtual laparoscopic surgical training, and the possibility of using real surgical instruments makes them more realistic to use. However, the data and feedback by a virtual simulator have not, until now, been able to assess. Simball Box®, equipped with G-coder sensors®, registers the instrument movements during training and gives the same feedback like a virtual simulator.Aim: The aim of this study was to objectively evaluate the laparoscopic performance in 3D compared to conventional 2D vision by using a box simulation trainer.Materials and methods: Thirty surgeons, residents and consultants, participated in the study. Eighteen had no, or minimal, laparoscopic experience (novices) whereas 12 were experts. They all performed three standard box training exercises (rope race, precision cutting, and basic suturing) in Simball Box. The participants were randomized and started with either 3D HD or traditional 2D HD cameras. The exercises were instructed and supervised. All instrument movements were registered. Variations in time, linear distance, average speed, and motion smoothness were analyzed.Results: The parameters time, distance, speed, and motion smoothness were significantly better when the 3D camera was used.Conclusion: All individuals of both subgroups achieved significantly higher speed and better motion smoothness when using 3D.
7
Nebbia, Martina, Paulo Gustavo Kotze, and Antonino Spinelli. "Training on Minimally Invasive Colorectal Surgery during Surgical Residency: Integrating Surgical Education and Advanced Techniques." Clinics in Colon and Rectal Surgery 34, no. 03 (March 29, 2021): 194–200. http://dx.doi.org/10.1055/s-0041-1722843.
Full textAbstract:
AbstractSurgery is an ever-evolving discipline and continually incorporates new technologies that have improved the ability of the operating room surgeon to perform. The next generation of minimally invasive surgery includes laparoscopic and robotic-assisted procedures. Graduating residents may be expected to have the skills to perform common colorectal procedures using these technologies, and residency programs are developing curriculums to teach these skills. Minimally invasive techniques are challenging and learning only by observation and practice alone is difficult. This requires dedicated training and mentoring.New simulation methods have been conceived specifically for minimally invasive procedures, and these embrace a combination of virtual reality simulators and box trainers, with animal and human tissue, as well as synthetic materials. The aim of this review is to provide an overview of training in minimally invasive colorectal surgery with a focus on different types of simulators that build the basis to develop and include a multistep training approach in a structured training curriculum for minimally invasive colorectal procedures.
8
Kanno, K., M. Andou, T. Hada, A. Shirane, S. Yanai, S. Nakajima, K. Ebisawa, S. Kurotsuchi, and H. Ota. "Direct Vision Box Training for Surgical Trainees with Little or No Prior Laparoscopic Experience." Journal of Minimally Invasive Gynecology 23, no. 7 (November 2016): S151. http://dx.doi.org/10.1016/j.jmig.2016.08.495.
Full text
9
Khan, Khurram Shahzad, Rona Keay, Morag McLellan, and Sajid Mahmud. "Impact of the COVID-19 pandemic on core surgical training." Scottish Medical Journal 65, no. 4 (August 9, 2020): 133–37. http://dx.doi.org/10.1177/0036933020949217.
Full textAbstract:
Background and aims COVID-19 pandemic has caused significant disruption in training which is even more pronounced in the surgical specialties. We aim to assess the impact of COVID-19 pandemic on core surgical training. Methods All core surgical and improving surgical trainees in West of Scotland region were invited to participate in an online voluntary anonymous survey via SurveyMonkey. Results 28 of 44 (63.6%) trainees responded, 15 (53.6%) were CT1/ST1. 14 (50.0%) working in teaching hospital and 15 (53.6%) working in general surgery. 20 (71.4%) felt that due to the pandemic they have less opportunity to operate as the primary surgeon. 21 (75.0%) have not attended any outpatient clinics. 8 (28.6%) did not have any form of access to the laparoscopic box-trainer. 20 (71.4%) felt their level of confidence in preforming surgical skills has been negatively impacted. 18 (64.3%) found it difficult to demonstrate progress in portfolio. 21 (75.0%) trainees have not attended any teaching. 10 (35.7%) trainees have been off-sick. 8 (28.6%) trainees have felt slightly or significantly more stressed. Conclusion COVID-19 pandemic has an unprecedented negative impact on all aspects of core surgical training. The long term impact on the current cohort of trainees is yet to be seen.
10
Stewart, Lygia, and Elizabeth De La Rosa. "Creation of a High Fidelity, Cost Effective, Real World Surgical Simulation for Surgical Education." Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care 10, no. 1 (June 2021): 147. http://dx.doi.org/10.1177/2327857921101081.
Full textAbstract:
Background How do surgical residents learn to operate? What is a surgical plane? How does one learn to see and dissect the plane? How do surgical residents learn tissue handling and suturing (sewing)? One method to learn and practice performing surgery is through the use of simulation training. Surgical training models include laparoscopic box trainers (a plastic box with holes for instruments) with synthetic materials inside to simulate tissues, or computer-based virtual reality simulation for laparoscopic, endoscopic, and robotic techniques. These methods, however, do not use real tissues. They lack the haptic and kinesthetic feedback of real tissue. These simulations fail to recreate the fidelity of soft tissues, do not foster the ability to accurately see surgical planes, do not accurately mimic the act of dissecting surgical planes, do not allow for complex surgical procedures, and do not provide accurate experience to learn tissue handling and suturing. Despite their poor performance, these plastic and virtual trainers are extremely costly to purchase, maintain, and keep up to date - with prices starting at $700 for basic plastic training boxes to thousands of dollars for virtual simulation. Also, there are additional costs of maintenance and software curriculum. Despite the cost of software, virtual simulators do not include a simulation for every surgery. Our aim was to create a life-like surgical simulation as close to real world as possible that allows trainees to learn how to see and dissect surgical planes, learn how soft tissues move, and learn the dynamics of soft tissue manipulation. We created a laparoscopic simulator using porcine tissues for gallbladder removal, acid reflux surgery, and surgery to treat swallowing difficulties (cholecystectomy, Nissen fundoplication, and Heller myotomy, respectively). Second year general surgery residents were able to practice these procedures on real tissues, enabling them to learn the steps of each procedure, increase manual dexterity, improve use of laparoscopic equipment, all while maintaining life-like haptic, soft-tissue feedback and enabling them to develop the ability to see real surgical planes. Methods The abdomen was recreated by purchasing intact porcine liver, gallbladder, (Cholecystectomy simulation) and intact esophagus, stomach, and diaphragm (Nissen and Heller simulation) from a packing supplier. Each organ system was placed into a laparoscopic trainer box with the ability to re-create laparoscopic ports. Surgical residents were then able to perform the procedures using real laparoscopic instruments, laparoscopic camera/video imaging, and real-time electrocautery. The simulation included all critical steps of each procedure such as obtaining the critical view of safety and removing the gallbladder from the liver bed (cholecystectomy), wrapping the stomach around the esophagus and laparoscopic suturing (Nissen fundoplication), and dissecting the muscular portion of the esophageal wall (Heller myotomy). Because these porcine tissues were readily available, several stations were set-up to teach multiple residents during each session (10-12 residents / session). Discussion Surgeons develop haptic perception of soft tissues by cutaneous or tactile feedback and kinesthetic feedback (Okamura, 2009). Kinesthetic feedback is the force and pressure transmitted by the soft tissues along the shaft of the laparoscopic instruments (Okamura, 2009). This soft tissue simulation re-creates the ability to experience what soft tissue feedback feels like, outside a normal operative environment. Real tissue learning allows trainees to learn how to see surgical planes, learn how soft tissues feel and move, develop proficiency in surgical dissection, and learn how to suture laparoscopically. This is the only model that recreates the movement of soft tissues and visualization of dissection planes outside the operative environment. Because this model utilizes the laparoscopic instruments used in the operating room, residents also develop familiarity with laparoscopic instruments, thus, flattening another learning curve. A literature review found that this is the only real tissue simulation being performed for foregut procedures used specifically for resident training. By building a realistic, anatomical model with inherent accurate soft tissue surgical planes, surgical trainees can have a more realistic surgical experience and develop skills in a safe, low pressure environment without sacrificing the hepatic learning and surgical visualization that is critical to performing safe laparoscopic surgery. All residents that participated in the stimulation reported positive feedback and felt that is contributed to their surgical education.
11
Palter, Vanessa N. "Comprehensive Training Curricula for Minimally Invasive Surgery." Journal of Graduate Medical Education 3, no. 3 (September 1, 2011): 293–98. http://dx.doi.org/10.4300/jgme-d-11-00091.1.
Full textAbstract:
Abstract Background The unique skill set required for minimally invasive surgery has in part contributed to a certain portion of surgical residency training transitioning from the operating room to the surgical skills laboratory. Simulation lends itself well as a method to shorten the learning curve for minimally invasive surgery by allowing trainees to practice the unique motor skills required for this type of surgery in a safe, structured environment. Although a significant amount of important work has been done to validate simulators as viable systems for teaching technical skills outside the operating room, the next step is to integrate simulation training into a comprehensive curriculum. Objectives This narrative review aims to synthesize the evidence and educational theories underlining curricula development for technical skills both in a broad context and specifically as it pertains to minimally invasive surgery. Findings The review highlights the critical aspects of simulation training, such as the effective provision of feedback, deliberate practice, training to proficiency, the opportunity to practice at varying levels of difficulty, and the inclusion of both cognitive teaching and hands-on training. In addition, frameworks for integrating simulation training into a comprehensive curriculum are described. Finally, existing curricula on both laparoscopic box trainers and virtual reality simulators are critically evaluated.
12
Thimmegowda, Prashanth Annayyanapalya, Krish Lakshman, Rajashekara Reddy, Sachin Nale, and Ravishanka Ravishanka. "Objective Measurement of Impact of Bench Laparoscopic Training in Novices." Annals of African Surgery 18, no. 3 (July 20, 2021): 170–75. http://dx.doi.org/10.4314/aas.v18i3.8.
Full textAbstract:
Background: We are currently in the era of laparoscopic surgery. It has gained popularity in the last few decades because of its well- known advantages. Laparoscopy requires different skills from those of open surgery. In a paradigm shift, learning basic surgical skills is now performed more in the skills laboratory than in the operation theater. However, there is a lack of reliable training and assessment tools for laparoscopic surgical skills. This study aimed to objectively assess the effect of bench laparoscopic training in novices.
Methods: This prospective study was conducted at the Clinical Skills Centre of Bangalore Medical College and Research Institute (BMCRI) in Bangalore, India. Sixty interns with no previous experience in laparoscopy were included. They underwent supervised training on the box trainer for 3 days, 2 hours a day, in basic surgical tasks, including pointing dots, joining straight lines, joining curved lines, picking objects, peg transfer, and circle cut. All participants were assessed objectively in a virtual reality (VR) simulator before and after training. The objective outcomes measured were time taken, distance traveled, and error scores given by the VR simulator metrics.
Results: The novices showed statistically significant improvement in all the tasks after the training compared with their skill levels before the training.
Conclusion: Structured short-term training significantly improves basic laparoscopic surgery skills.
13
Sugand, Kanchan, Swapnil Palod, Kalu Olua, Satyajit Saha, Asim Naeem, Samina Matin, and Mary Howlett. "Systematic review of workplace-based assessments in psychiatry: surgical dissection and recommendations for improvement." Psychiatrist 35, no. 11 (November 2011): 419–24. http://dx.doi.org/10.1192/pb.bp.110.032011.
Full textAbstract:
SummaryRecent surveys have highlighted widespread criticisms of the use of workplace-based assessments (WPBAs) in psychiatric training. We describe our systematic review of psychiatric WPBAs, including a ‘surgical dissection’ of their format and process. From our review, we identified seven overarching WPBA themes, and have drawn on these to make further recommendations to strengthen the wider acceptability of WPBAs in psychiatric settings. We hope this will encourage further debate on ways of improving these tools, rather than them becoming side-lined as ‘top-down’ tick-box exercises.
14
Egedovo, Alfred, Yik-Hong Ho, Sarah Larkins, and Chrispen Mushuya. "A SYSTEMATIC REVIEW TO ASSESS THE EFFECTIVENESS OF WEB BASED TRAINING VIDEO FOR LAPAROSCOPY SURGERY." International Journal of Research -GRANTHAALAYAH 5, no. 10 (October 31, 2017): 270–89. http://dx.doi.org/10.29121/granthaalayah.v5.i10.2017.2304.
Full textAbstract:
Background: Surgical training for generations has followed the example of an apprenticeship model propagated by William Halsted; teaching method of “see one, do one, teach one”. 1-3Teaching of surgical trainee is time consuming and costly in the operating room when it involves a procedure,4, 5 and the surgical skills acquired from operating room are of variable effectiveness because of the learning curve.6, 7
The objective of this review is to determine if web-based training video (WBTV) is effective to supplement and /or replace the standard surgical training model (SLT). However, the value of this modality for trainees with or no laparoscopic experience is unknown.
Study Hypothesis: Multimedia or Web-based training video (WBTV) learning is equivalent to conventional teaching (Standard surgical training-SLT) in improving scores in cognitive surgical skills.
Search Method:Randomized clinical trials addressing this issue were identified from The Cochrane Library trials register, Medline, Embase, Science Citation Index Expanded, grey literature and reference lists and other databases. The Cochrane Central Register of Controlled Trials: search was narrowed to Issue of 6 of 12, June 2014. Included studies were randomized controlled trials (RCTs) assessing any training technique using at least some elements of surgical simulation, which reported measures of surgical task performance. The Cochrane search yielded one relevant article.8 In the MEDLINE search, the medical Subject Heading (MeSH) was used to search for; Surgical stimulation, surgical training, “Web-based training” and “online education or teaching, training, internet, multimedia teaching” (retrieved articles 78, relevant articles 50) and the headings “Laparoscopy” and “education” (retrieved 103, relevant 91) other provisional abstract (review 3). I focused the search on articles published from 1990 onwards, and I limited it to articles published in English. I did not include case reports and data from abstracts in data synthesis. All of the identified articles were examined for relevance. Retrieved studies were screened for duplication, and additional studies were identified using a manual search of the reference list of the relevant included articles. Since my review focused on Web-based training video effectiveness for teaching laparoscopic surgery techniques, my search strategies was limited to identifying articles focusing on surgical education.
Selection Criteria:I included all randomised clinical trials comparing Web-based model trainers versus other forms of training including standard laparoscopic training and supplementary animal model training use for teaching surgical trainees with or no laparoscopic experience. I also included trials comparing different methods of simulation surgical training.
Results: Thirty RCTs with 831 participants were included, although the quality of the RCTs was often poor. The Web-based training video (WBTV) had one RCTs, the RCT had four intervention groups, they were groups multimedia(WBTV) training, Practical Training (Standard training, Multimedia (WBTV) plus practical training and none of the trainings had different skills but all participants were homogeneous with the same basic skills on laparoscopic cholecystectomy. The result was that multimedia –based (WBTV) training improved surgical performance of Laparoscopic cholecystectomy in a pelvic –trainer significantly when used alone or as combination training. While Virtual reality simulation had shown better results than no training at all, but had no evidence of superiority over standard training practised. When it is done purposefully or video box simulation based on operative performance. Video simulation did not show consistently better results than groups with no training at all, and there were not enough data to determine if video simulation was better than standard training or the use of models. Model simulation may have been better than standard training. Two trials (mostly with a high risk of bias) involving 110 participants were included in this review. In trainees without surgical experience, WBTV training decreased the time taken to complete a task, increased accuracy and decreased errors compared with no training. In the same participants, WBTV training was more accurate than Standard practical training. In participants with laparoscopic experience practical training plus Web-based video training, WBTV training resulted in a greater reduction in operating time, error and unnecessary movements than standard laparoscopic training. In these participants, the composite performance score was better in the WBTV group than the practical group (standard).
Conclusion: WBTV can supplement standard surgical training. However the quality is poor, It is at least as effective as no standard training in supplementing standard laparoscopic training. While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training.
15
Mann, Jakob, Jens Rolinger, Steffen Axt, Andreas Kirschniak, and Peter Wilhelm. "Novel box trainer for taTME – prospective evaluation among medical students." Innovative Surgical Sciences 4, no. 3 (September 25, 2019): 116–20. http://dx.doi.org/10.1515/iss-2019-0013.
Full textAbstract:
AbstractBackgroundTransanal total mesorectal excision (taTME) has been subject to extensive research and increasing clinical application. It allows further reduction of trauma by accessing via a natural orifice. Manifold platforms and instruments have been introduced and heterogeneity in surgical techniques exists. Because of the technique’s complexity there is a persistent need for dedicated training devices and concepts.Materials and methodsThe key steps of taTME were analyzed and a box trainer with three modules resembling these steps was designed and manufactured. Twenty-one surgically inexperienced medical students performed five repetitions of the three tasks with the new box trainer. Time and error count were analyzed for assessment of a learning curve.ResultsA significant reduction of processing time could be demonstrated for tasks 1–3 (p < 0.001; p < 0.001; p = 0.001). The effect size was high for comparison of repetition 1 and 5 and decreased over the course (task 1: r = 0.88 vs. r = 0.21; task 2: r = 0.86 vs. r = 0.23; task 3: r = 0.74 vs. r = 0.44). Also, a significant reduction of errors was demonstrated for tasks 1 and 2. The decrease of effect size was analogously demonstrated.ConclusionsThe trainer might help to reduce the use of animal models for testing of platforms and instruments as well as gaining first-hand experience in transanal rectal resection.
16
Domhan, Lorenz, Jonas Johannink, Johanna Miller, Volker Steger, Albert Linder, Andreas Kirschniak, and Peter Wilhelm. "TuThor: an innovative new training model for video-assisted thoracic surgery." Interactive CardioVascular and Thoracic Surgery 30, no. 3 (November 28, 2019): 477–82. http://dx.doi.org/10.1093/icvts/ivz270.
Full textAbstract:
Abstract OBJECTIVES Video-assisted thoracic surgery (VATS) is a complex technique requiring dedicated surgical training. Platforms for such training are scarce and often rely on the use of live animals, which raises ethical concerns. The objective of this study was to develop a box trainer that is dedicated for VATS training and able to reproduce bleeding scenarios. METHODS The developed Tuebingen Thorax Trainer comprises 5 components that are mounted on a human anatomy-like thoracic cavity containing a porcine organ complex. Any standard thoracoscopic instrument can be used. The organ complex is attached to a perfusion module. We assessed the applicability of the system in four 1-day VATS training courses at the Tuebingen Surgical Training Center. Assessment was performed using a questionnaire handed out to all participants. RESULTS Forty participants have been trained with the Tuebingen Thorax Trainer at our institution since November 2016. Thirty-five (87.5%) participants stated that the Tuebingen Thorax Trainer is an adequate model for VATS training. The ex vivo organ complex was reported to be realistic with regards to the level of detail and scale (76%). A large proportion of participants (27.5%) were experienced with VATS and reported having performed >50 procedures before taking the training course. CONCLUSIONS This new training device allows realistic training for VATS procedures. ‘Stagnant hydrostatic perfusion’ permits simulation of reproducible bleeding scenarios. The device is low in production costs and offers a strong resemblance to the clinical scenario. It reduces the use of animal models and contributes to the efforts in making surgical skills training for VATS more accessible.
17
Qin, Zhibao, Yonghang Tai, Chengqi Xia, Jun Peng, Xiaoqiao Huang, Zaiqing Chen, Qiong Li, and Junsheng Shi. "Towards Virtual VATS, Face, and Construct Evaluation for Peg Transfer Training of Box, VR, AR, and MR Trainer." Journal of Healthcare Engineering 2019 (January 6, 2019): 1–10. http://dx.doi.org/10.1155/2019/6813719.
Full textAbstract:
The aim of this study is to develop and assess the peg transfer training module face, content and construct validation use of the box, virtual reality (VR), cognitive virtual reality (CVR), augmented reality (AR), and mixed reality (MR) trainer, thereby to compare advantages and disadvantages of these simulators. Training system (VatsSim-XR) design includes customized haptic-enabled thoracoscopic instruments, virtual reality helmet set, endoscope kit with navigation, and the patient-specific corresponding training environment. A cohort of 32 trainees comprising 24 novices and 8 experts underwent the real and virtual simulators that were conducted in the department of thoracic surgery of Yunnan First People’s Hospital. Both subjective and objective evaluations have been developed to explore the visual and haptic potential promotions in peg transfer education. Experiments and evaluation results conducted by both professional and novice thoracic surgeons show that the surgery skills from experts are better than novices overall, AR trainer is able to provide a more balanced training environments on visuohaptic fidelity and accuracy, box trainer and MR trainer demonstrated the best realism 3D perception and surgical immersive performance, respectively, and CVR trainer shows a better clinic effect that the traditional VR trainer. Combining these in a systematic approach, tuned with specific fidelity requirements, medical simulation systems would be able to provide a more immersive and effective training environment.
18
Clevin, Lotte, and Teodor P. Grantcharov. "Does box model training improve surgical dexterity and economy of movement during virtual reality laparoscopy? A randomised triala." Acta Obstetricia et Gynecologica Scandinavica 87, no. 1 (January 2008): 99–103. http://dx.doi.org/10.1080/00016340701789929.
Full text
19
Clevin, Lotte, and Teodor P. Grantcharov. "Does Box Model Training Improve Surgical Dexterity and Economy of Movement During Virtual Reality Laparoscopy? A Randomized Trial." Obstetrical & Gynecological Survey 63, no. 5 (May 2008): 301–3. http://dx.doi.org/10.1097/01.ogx.0000312148.82670.18.
Full text
20
Lipatov, V. A., D. A. Severinov, M. D. Z. Naimzada, and I. S. Dragovoz. "Training of students of higher medical educational institutions in endovideosurgery skills." I.P. Pavlov Russian Medical Biological Herald 28, no. 4 (December 15, 2020): 497–505. http://dx.doi.org/10.23888/pavlovj2020284497-505.
Full textAbstract:
Aim. Evaluation of basic skills in endovideosurgery of students of higher medical educational institutions (HMEI) before and after taking an elective course Basics of Surgical Technique.
Materials and Methods. Basic skills in endovideosurgery were investigated in students of the General Medicine Faculty before and after taking an elective course Basics of Surgical Technique organized on the base of the simulation hall of the experimental surgery and oncology laboratory of Research Institute of Experimental Medicine at Kursk State Medical University. The training course included the following exercises on box trainers: Peg Transfer, Pattern Cut, Intracorporal (single interrupted) Suture. After achievement of satisfactory results, final assessment was conducted in the form of examination in practical skills and abilities on laboratory animals biological models (Wetlab). Manipulations conducted by students were assessed using Global Operative Assessment of Laparoscopic Skill (GOALS).
Results. The average values of the assessed parameters increased: criteria manipulations with tissues from 2.8 to 4.0 points (42.9%), perception of depth from 2.4 to 3.6 points (50%), movement effectiveness by 54.5% (from 2.2 to 3.4 points), bimanual orientation by 60% (from 2.0 to 3.2 points). Criterion independence increased by 66.7% (from 1.8 to 3.0 points).
Conclusion. After the elective course Basics of Surgical Technique, all average values of the studied parameters increased. The results obtained evidence effectiveness of the methods of training in basics of endovideosurgery within the frames of the elective course, which permits to develop skills in endosurgical technique at the stage of getting higher medical education.
21
Lee, Jiann-Der, Jong-Chih Chien, Yu-Tsung Hsu, and Chieh-Tsai Wu. "Automatic Surgical Instrument Recognition—A Case of Comparison Study between the Faster R-CNN, Mask R-CNN, and Single-Shot Multi-Box Detectors." Applied Sciences 11, no. 17 (August 31, 2021): 8097. http://dx.doi.org/10.3390/app11178097.
Full textAbstract:
In various studies, problems with surgical instruments in the operating room are usually one of the major causes of delays and errors. It would be of great help, in surgery, to quickly and automatically identify and keep count of the surgical instruments in the operating room using only video information. In this study, the recognition rate of fourteen surgical instruments is studied using the Faster R-CNN, Mask R-CNN, and Single Shot Multi-Box Detectors, which are three deep learning networks in recent studies that exhibited near real-time object detection and identification performance. In our experimental studies using screen captures of real surgery video clips for training and testing, this study found that that acceptable accuracy and speed tradeoffs can be achieved by the Mask R-CNN classifier, which exhibited an overall average precision of 98.94% for all the instruments.
22
Soriero, Domenico, Giulia Atzori, Fabio Barra, Davide Pertile, Andrea Massobrio, Luigi Conti, Dario Gusmini, et al. "Development and Validation of a Homemade, Low-Cost Laparoscopic Simulator for Resident Surgeons (LABOT)." International Journal of Environmental Research and Public Health 17, no. 1 (January 2, 2020): 323. http://dx.doi.org/10.3390/ijerph17010323.
Full textAbstract:
Several studies have demonstrated that training with a laparoscopic simulator improves laparoscopic technical skills. We describe how to build a homemade, low-cost laparoscopic training simulator (LABOT) and its validation as a training instrument. First, sixty surgeons filled out a survey characterized by 12 closed-answer questions about realism, ergonomics, and usefulness for surgical training (global scores ranged from 1—very insufficient to 5—very good). The results of the questionnaires showed a mean (±SD) rating score of 4.18 ± 0.65 for all users. Then, 15 students (group S) and 15 residents (group R) completed 3 different tasks (T1, T2, T3), which were repeated twice to evaluate the execution time and the number of users’ procedural errors. For T1, the R group had a lower mean execution time and a lower rate of procedural errors than the S group; for T2, the R and S groups had a similar mean execution time, but the R group had a lower rate of errors; and for T3, the R and S groups had a similar mean execution time and rate of errors. On a second attempt, all the participants tended to improve their results in doing these surgical tasks; nevertheless, after subgroup analysis of the T1 results, the S group had a better improvement of both parameters. Our laparoscopic simulator is simple to build, low-cost, easy to use, and seems to be a suitable resource for improving laparoscopic skills. In the future, further studies should evaluate the potential of this laparoscopic box on long-term surgical training with more complex tasks and simulation attempts.
23
Gravante, Gianpiero, and Dario Venditti. "A Systematic Review on Low-cost Box Models to Achieve Basic and Advanced Laparoscopic Skills During Modern Surgical Training." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 23, no. 2 (April 2013): 109–20. http://dx.doi.org/10.1097/sle.0b013e3182827c29.
Full text
24
Galimov, O. V., V. O. Khanov, A. G. Safargalina, A. R. Kashapova, N. R. Dashdamirova, and R. I. Makhortov. "Learning curve of students of the Bashkir state medical University in the educational process on endovideosimulators." Virtual Technologies in Medicine 1, no. 4 (January 18, 2021): 22–25. http://dx.doi.org/10.46594/2687-0037_2020_4_1270.
Full textAbstract:
The article presents a comparative analysis of the learning curve of 40 students of Bashkir State Medical University on the technique of intracorporeal suture on a box simulator developed at the Department of Surgical diseases and new technologies and the "LapSim" simulator. Students who had different levels of manual skills were divided into two groups: the first - trained on a "box simulator", the second - trained on a "LapSim"simulator. To assess the level of development of practical skills, indicators of time spent on performing manipulation (in minutes) and GOALS (Global Operational Assessment of Laparoscopic Skills) were used. To assess the level of development of practical skills, indicators of time spent on performing manipulation (in minutes) and GOALS scores (Global Operational Assessment of Laparoscopic Skills). During analysis of the results there is a significant reduction of the time of performing manipulation in groups with an increase of the experience of students (in the performance of the second and third attempts). Training on a box simulator subjectively turned out to be easier for students than on a virtual laparoscopy simulator "LapSim".
25
Glybochko, Peter Vitalevich, Leonid Mikhailovich Rapoport, Yuri Gennadevich Alyaev, Eugene Sergeevich Sirota, Eugene Alexeevich Bezrukov, Dmitry Nikolaevich Fiev, Ildar Shamilevich Byadretdinov, Mikhail Dmitrievich Bukatov, Alexander Vasilevich Letunovskiy, and Dmitry Olegovich Korolev. "Multiple application of three-dimensional soft kidney models with localized kidney cancer: A pilot study." Urologia Journal 85, no. 3 (March 27, 2018): 99–105. http://dx.doi.org/10.1177/0391560317749405.
Full textAbstract:
Aim: To evaluate the effectiveness of three-dimensional printing application in urology for localized renal cancer treatment using three-dimensional printed soft models. Materials and methods: The study included five patients with kidney tumors. The patients were treated in the Urology Clinic of I.M. Sechenov First Moscow State Medical University from February 2016 to June 2017. Personalized three-dimensional printed models based on computed tomographic images were created. Five surgeons took part in a survey in which the utility of computed tomographic images versus three-dimensional printed models for presurgical planning was compared. A laparoscopic partial nephrectomy training using the developed three-dimensional printed models was performed by the same surgeons in a surgical training box. Results: The patients underwent endoscopic surgery using laparoscopic access. The average time of surgery was 187 min. All the operations were performed with complete renal artery clamping. The average warm ischemia time was 19.5 min and the average blood loss was 170 mL. No conversions to open surgery or radical nephrectomy, and no postoperative complications and deaths were observed. All the surgical margins were negative. The tumors were morphologically identified as renal cell carcinoma in four cases and as oncocytoma in one case. Conclusion: The developed three-dimensional printed models allow one to evaluate the pathological anatomy of tumors more effectively. High similarity between three-dimensional models and native kidneys contribute to improvement of surgical skills necessary for partial nephrectomy. Training on the three-dimensional models also allows surgeons to facilitate selection of an optimal surgical tactics for each patient.
26
Pandya, Abhilash, Shahab Eslamian, Hao Ying, Matthew Nokleby, and Luke A. Reisner. "A Robotic Recording and Playback Platform for Training Surgeons and Learning Autonomous Behaviors Using the da Vinci Surgical System." Robotics 8, no. 1 (February 6, 2019): 9. http://dx.doi.org/10.3390/robotics8010009.
Full textAbstract:
This paper describes a recording and playback system developed using a da Vinci Standard Surgical System and research kit. The system records stereo laparoscopic videos, robot arm joint angles, and surgeon–console interactions in a synchronized manner. A user can then, on-demand and at adjustable speeds, watch stereo videos and feel recorded movements on the hand controllers of entire procedures or sub procedures. Currently, there is no reported comprehensive ability to capture expert surgeon movements and insights and reproduce them on hardware directly. This system has important applications in several areas: (1) training of surgeons, (2) collection of learning data for the development of advanced control algorithms and intelligent autonomous behaviors, and (3) use as a “black box” for retrospective error analysis. We show a prototype of such an immersive system on a clinically-relevant platform along with its recording and playback fidelity. Lastly, we convey possible research avenues to create better systems for training and assisting robotic surgeons.
27
Supe, Avinash, Ramkrishna Prabhu, Ilene Harris, Steven Downing, and Ara Tekian. "Structured Training on Box Trainers for First Year Surgical Residents: Does It Improve Retention of Laparoscopic Skills? A Randomized Controlled Study." Journal of Surgical Education 69, no. 5 (September 2012): 624–32. http://dx.doi.org/10.1016/j.jsurg.2012.05.002.
Full text
28
Rodrigues Armijo, Priscila, Chun-Kai Huang, Tyson Carlson, Dmitry Oleynikov, and Ka-Chun Siu. "Ergonomics Analysis for Subjective and Objective Fatigue Between Laparoscopic and Robotic Surgical Skills Practice Among Surgeons." Surgical Innovation 27, no. 1 (November 27, 2019): 81–87. http://dx.doi.org/10.1177/1553350619887861.
Full textAbstract:
Introduction. Our aim was to determine how self-reported and objectively measured fatigue of upper limb differ between laparoscopic and robotic surgical training environments. Methods. Surgeons at the 2016 SAGES Conference Learning Center and at our institution were enrolled. Two standardized surgical tasks (peg transfer [PT] and needle passing [NP]) were performed twice in each surgical skills practical environments: (1) laparoscopic training-box environment (Fundamentals of Laparoscopic Surgery [FLS]) and (2) Mimic dV-trainer (MIMIC). Muscle activation of upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis, and extensor digitorum were recorded using surface electromyography (EMG; Trigno, Delsys, Inc, Natick, MA). Subjective fatigue was self-reported using Piper Fatigue Scale-12. Analysis was done using SPSS v25.0, α = .05. Results. Demographics were similar between FLS (N = 14) and MIMIC (N = 12). For PT, MIMIC had a significant increase in EMGRMS of UT ( P < .001) and AD ( P < .001). Conversely, FLS led to significant decreased muscle fatigue in UT ( P = .015). For NP, MIMIC had a significant increase in EMGRMS for UT ( P = .034) and AD ( P = .031), but FLS induced more muscle fatigue for AD ( P = .004). There was significant decrease in self-reported fatigue after performing FLS tasks ( P = .030) but not after MIMIC ( P = .663). Conclusion. Our results showed that practice with MIMIC resulted in greater activation of shoulder muscles, while FLS caused more significant muscle fatigue in the same muscles. This could be due to ergonomic disadvantages and nonoptimal ergonomic settings. Further studies are needed to understand the optimal ergonomics and its impact on fatigue and muscle activation during use of both the FLS and MIMIC training systems.
29
Alonso-Silverio, Gustavo A., Fernando Pérez-Escamirosa, Raúl Bruno-Sanchez, José L. Ortiz-Simon, Roberto Muñoz-Guerrero, Arturo Minor-Martinez, and Antonio Alarcón-Paredes. "Development of a Laparoscopic Box Trainer Based on Open Source Hardware and Artificial Intelligence for Objective Assessment of Surgical Psychomotor Skills." Surgical Innovation 25, no. 4 (May 29, 2018): 380–88. http://dx.doi.org/10.1177/1553350618777045.
Full textAbstract:
Background. A trainer for online laparoscopic surgical skills assessment based on the performance of experts and nonexperts is presented. The system uses computer vision, augmented reality, and artificial intelligence algorithms, implemented into a Raspberry Pi board with Python programming language. Methods. Two training tasks were evaluated by the laparoscopic system: transferring and pattern cutting. Computer vision libraries were used to obtain the number of transferred points and simulated pattern cutting trace by means of tracking of the laparoscopic instrument. An artificial neural network (ANN) was trained to learn from experts and nonexperts’ behavior for pattern cutting task, whereas the assessment of transferring task was performed using a preestablished threshold. Four expert surgeons in laparoscopic surgery, from hospital “Raymundo Abarca Alarcón,” constituted the experienced class for the ANN. Sixteen trainees (10 medical students and 6 residents) without laparoscopic surgical skills and limited experience in minimal invasive techniques from School of Medicine at Universidad Autónoma de Guerrero constituted the nonexperienced class. Data from participants performing 5 daily repetitions for each task during 5 days were used to build the ANN. Results. The participants tend to improve their learning curve and dexterity with this laparoscopic training system. The classifier shows mean accuracy and receiver operating characteristic curve of 90.98% and 0.93, respectively. Moreover, the ANN was able to evaluate the psychomotor skills of users into 2 classes: experienced or nonexperienced. Conclusion. We constructed and evaluated an affordable laparoscopic trainer system using computer vision, augmented reality, and an artificial intelligence algorithm. The proposed trainer has the potential to increase the self-confidence of trainees and to be applied to programs with limited resources.
30
Mei, Qipei, Jonathan Chainey, David Asgar-Deen, and Daniel Aalto. "Detection of Suture Needle Using Deep Learning." Journal of Medical Robotics Research 04, no. 03n04 (September 2019): 1942005. http://dx.doi.org/10.1142/s2424905x19420054.
Full textAbstract:
The importance of surgical simulation has increased over the last decade and the majority of medical schools have incorporated simulation into their curriculum. An essential aspect of surgical education is to evaluate how the student performs when compared to an expert surgeon. Another way to evaluate the skill of the student would be by tracking the position of the needle during the procedure, a factor correlating to surgical skill. In this study, we developed deep learning algorithms for needle detection during a video of a surgical procedure. 78 videos of a person doing a running suture on synthetic skin were captured using an HD camera. A total of 3368 images were manually annotated with a VGG annotator tool. Two deep learning algorithms (YOLOv3 and Faster R-CNN) were pretrained on 2219 images extracted from the JIGSAWS dataset, then trained on the 804 images from the training set and finally applied to the 345 images from the evaluation set. The performance of the algorithm was evaluated using the intersection over union (IoU) method as well as by measuring the Euclidean distance between bounding box centroids. These values were compared against the inter-observer reliability among three authors. The best IoU value by deep learning algorithms compared against the ground truth was found to be 0.601 for Faster R-CNN while the average inter-observer value was 0.663. The average Euclidean distances between bounding box centroids for authors and for the Faster R-CNN algorithm were 21.9 pixels and 36.8 pixels, respectively. Through qualitative and quantitative assessment of the algorithm (visually observing the algorithm’s needle annotations), deep learning shows promise for automatically tracking the position of the needle during a suturing operation.
31
Zhang, Yu, Dan Luo, Jia Li, and Jisheng Li. "Study on Collision Detection and Force Feedback Algorithm in Virtual Surgery." Journal of Healthcare Engineering 2021 (February 9, 2021): 1–12. http://dx.doi.org/10.1155/2021/6611196.
Full textAbstract:
The development of virtual reality technology is expected to solve traditional surgical training. The lack of methods has brought revolutionary advances in technology. The virtual surgery system based on collision detection and force feedback can enable the operator to have stronger interaction, which is an exploration of the feature of touch in virtual reality technology. Reality is an important indicator of the virtual surgical system. This article improves the realism of the system from the visual and tactile senses and uses the surrounding ball collision detection and force feedback algorithms to build a realistic surgical platform. In the virtual surgery training system, the introduction of force feedback greatly improves the sense of presence during virtual surgery interaction. The operator can feel the softness and hardness of different tissues and organs through the force feedback device. Virtual reality is an interdisciplinary comprehensive technology that has been widely used in military, film, medical, and gaming fields. Virtual reality can simulate the objective world and display it visually, making people feel immersive. Virtual surgery provides surgeons with a recyclable surgical practice platform and can help doctors perform preoperative rehearsals and predict the results of surgery. The design of collision detection and force feedback algorithms is a prerequisite to ensure the immersion and transparency of the virtual surgical training system. This article mainly introduces the collision detection and force feedback algorithm research in virtual surgery, with the intention of providing some ideas and directions for the development of virtual surgery. This paper proposes two collision detection algorithms, space decomposition method and hierarchical bounding box method, and three force feedback algorithms including spring mass point algorithm, Runge–Kutta method, and Euler method to construct virtual surgery collision detection and force feedback. Experiment with the Overall System Architecture. This paper proves through experimental results that the average collision detection time after the application of the improved collision detection and force feedback algorithm in the virtual surgery system is more than 80.7% less than the traditional method, which greatly improves the detection speed.
32
Mallick, R., F. Odejinmi, M. Sideris, E. Egbase, and M. Kaler. "The impact of COVID-19 on obstetrics and gynaecology trainees; how do we move on?" Facts, Views and Vision in ObGyn 13, no. 1 (March 31, 2021): 7–12. http://dx.doi.org/10.52054/fvvo.13.1.004.
Full textAbstract:
Background: Obstetrics and Gynaecology (O&G) is an evolving specialty that encompasses women’s health at its core. The COVID-19 pandemic has caused significant patient care challenges, however simultaneously it has resulted in the interruption of clinical training and cessation of all elective work. Our primary aim was to assess the impact of the pandemic on the experiences of O&G trainees. Methods: An email invite was sent to all 127 O&G trainees in Kent, Surrey and Sussex (KSS), inviting them to participate in an anonymous 33-question survey. The survey data was collected and analysed over a 4-week period. Results: Of the 127 trainees sent the survey, 87 responded (69%). 39% and 75% of trainees agreed that the pandemic had a negative impact on their overall physical and mental wellbeing respectively. 43% agreed that the COVID-19 pandemic had adversely affected their obstetric training experience whilst almost all trainees stated a significant negative impact on benign gynaecology surgical training. Reassuringly, over 80% were positive they would recover from the negative impacts of COVID-19. Conclusions: It is evident that COVID-19 has impacted O&G trainees in several ways. Whilst we face uncertain times, we must firstly ensure the physical and mental well-being of all trainees. It is encouraging that non-emergency consultations and benign surgery are being restarted nationwide and whilst this will inevitably help with re-booting surgical training, we must also think “outside” the box and utilise other modes of teaching and training to safeguard learning whilst mitigating against the negative impacts of subsequent waves.
33
Wataganara, Tuangsit, Sommai Viboonchart, Wangcha Chumthup, Prakong Chuenwattana, Julaporn Pooliam, Katika Nawapun, and Nisarat Phithakwatchara. "Comparison of Mannequin Training Satisfaction with a Conventional Box Trainer and a Low-Fidelity Fetoscopic Surgical Simulator for Selective Fetoscopic Laser Photocoagulation." Fetal Diagnosis and Therapy 47, no. 1 (August 28, 2019): 84–90. http://dx.doi.org/10.1159/000502180.
Full text
34
Jue, Jessica, Neal A. Shah, and Tim Ken Mackey. "An Interdisciplinary Review of Surgical Data Recording Technology Features and Legal Considerations." Surgical Innovation 27, no. 2 (December 6, 2019): 220–28. http://dx.doi.org/10.1177/1553350619891379.
Full textAbstract:
Surgical data recording technology has great promise to generate patient safety and quality data that can be utilized to potentially reduce medical errors. Variations of these systems aim to improve surgical technique, develop better training simulation, and promote adverse event investigation similar to the aims of black box technology utilized in other industries. However, many unknowns remain for surgical data recording utilization in operating rooms and clinical settings in the United States. This includes the need to appropriately design systems so they collect meaningful and useful data that can be discussed by surgical team members in an open and safe environment to optimize clinical care processes. In order to better understand the clinical and regulatory environment for surgical data recording systems, we conducted an interdisciplinary review to identify key technology approaches, and assess legal and regulatory implications associated with this potentially disruptive technology. We found technology ranging from audio and visual data, to systems utilizing mobile applications, and kinematic data capture. The data collected present legal questions over ownership of information and privacy, along with regulatory issues at the federal and state levels. The benefits of these data should be balanced with the need to develop appropriate policies and regulations that protect the interests of both clinicians and patients in order to encourage further innovation and better realize the potential of surgical data recording technology to improve clinical decision making and patient safety outcomes.
35
Aryal, Kamal Raj, Chelise Currow, Sarah Downey, Raaj Praseedom, and Alexander Seager. "Work-Based Assessments in Higher General Surgical Training Program: A Mixed Methods Study Exploring Trainers' and Trainees' Views and Experiences." Surgery Journal 06, no. 01 (January 2020): e49-e61. http://dx.doi.org/10.1055/s-0040-1708062.
Full textAbstract:
Abstract Introduction In the United Kingdom, work-based assessments (WBAs) including procedure-based assessments (PBAs), case-based discussions (CBDs), clinical evaluation exercises (CEXs), and direct observation of procedural skills (DOPS) have been used in Higher General Surgical Training Program (HGSTP) since the introduction of Modernising Medical Careers. Although the Intercollegiate Surgical Curriculum Project states that they should be used for the formative development of trainees using feedback and reflection, there is no study to look at the perception of their usefulness and barriers in using them, particularly in HGSTP. The aim of this study is to investigate trainer's and trainee's perception of their usefulness, barriers in using them, and way forward for their improvement in HGSTP. Methods This was a mixed method study. In phase I, after ethics committee approval, an online survey was sent to 83 trainers and 104 trainees, with a response rate of 33 and 37%, respectively, using Online Surveys (formerly Bristol Online Survey) from July 2018 to December 2018. After analysis of this result, in phase II, semistructured interviews were conducted with five trainees and five trainers who had volunteered to take part from phase I. Thematic analysis was performed to develop overarching themes. Results For professional formative development, 15% of the trainers and 53% of the trainees felt that WBAs had a low value. Among 4 WBAs—CEX, CBD, PBA, and DOPS—PBA was thought to be the most useful WBA by 52% trainers and 74% trainees.More trainers than trainees felt that it was being used as a formative tool (33 vs. 16%). The total number of WBAs thought to be required was between 20 and 40 per year, with 46% of the trainers and 53% of the trainees preferring these numbers.The thematic analysis generated four themes with subthemes in each: theme 1, “factors affecting usefulness,” including the mode of validation, trainer/trainee engagement, and time spent in validating; theme 2, “doubt on utility” due to doubt on validity and being used as a tick-box exercise; theme 3, “pitfalls/difficulties” due to lack of time to validate, late validation, e-mail rather than face-to-face validation, trainer and trainee behavior, variability in feedback given, and emphasis on number than quality; and theme 4, “improvement strategies.” Conclusions The WBAs are not being used in a way they are supposed to be used. The perception of educational impact (Kirkpatrick levels 1 and 2) by trainers was more optimistic than by trainees. Improvements can be made by giving/finding more time, trainer training, more face-to-face validation, and better trainer trainee interactions.
36
Gorki, Hagen, Nirav C. Patel, Christian Liewald, Stephen Wildhirt, Valavanur A. Subramanian, and Andreas Liebold. "A Step toward Nonrobotic Total Endoscopic Coronary Bypass Grafting: 40 Coronary Anastomoses in a Biomechanical Beating Heart Model." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 7, no. 5 (September 2012): 359–67. http://dx.doi.org/10.1097/imi.0b013e31827cd52b.
Full textAbstract:
Objective Nonrobotic total endoscopic coronary bypass grafting is commonly considered as technically too difficult. After endoscopic practicing in a simple box model, we questioned this statement in a more sophisticated training model. Methods In a handmade chest model containing a mechanically actuated porcine heart, anastomoses between homologous vein and shunted anterior coronary artery were performed using Prolene 7–0 sutures or U-clips in 20 anastomoses each. Commercially available endoscopic instruments and exclusive two-dimensional endoscopic vision were used. As quality control, the procedures were recorded, flow was measured, indocyanine green dye angiograms were performed, vinylpolysiloxane endocasts were produced, and finally the anastomoses were assessed from the endothelial side. Three-dimensional computed tomographic reconstruction was explored for cast measuring. Results All anastomoses were completed successfully in a time of 51 ± 14 minutes (Prolene) and 48 ± 10 minutes (U-clips). Despite suboptimal equipment, a reproducible sequence of the procedure was established and documented. Improving surgical performance was reflected in a reduction in anastomotic leakage and time requirement. The quality assessment protocol showed a learning curve and problems itself, which are briefly discussed. Conclusions A beating heart model is an adamant requirement of training for the technically demanding procedure of nonrobotic total endoscopic coronary bypass grafting. Refinement of the model and quality assessment as well as expansion of training to other regions of the heart should prepare for a cost-effective, broad-based clinical application of nonrobotic endoscopic techniques in coronary surgery. Available high-definition three-dimensional vision systems and the development of appropriate (articulating) instruments will make the procedure safer and quicker and will cut the learning curve.
37
Mansour, Sami, Nizar Din, Kumaran Ratnasingham, Shashidhar Irukulla, George Vasilikostas, Marcus Reddy, and Andrew Wan. "Objective Assessment of the Core Laparoscopic Skills Course." Minimally Invasive Surgery 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/379625.
Full textAbstract:
Objective.The demand for laparoscopic surgery has led to the core laparoscopic skills course (CLSC) becoming mandatory for trainees in UK. Virtual reality simulation (VR) has a great potential as a training and assessment tool of laparoscopic skills. The aim of this study was to determine the role of the CLSC in developing laparoscopic skills using the VR.Design.Prospective study. Doctors were given teaching to explain how to perform PEG transfer and clipping skills using the VR. They carried out these skills before and after the course. During the course they were trained using the Box Trainer (BT). Certain parameters assessed.Setting.Between 2008 and 2010, doctors attending the CLSC at St Georges Hospital.Participants.All doctors with minimal laparoscopic experience attending the CLSC.Results. Forty eight doctors were included. The time taken for the PEG skill improved by 52%, total left hand and right hand length by 41% and 48%. The total time in the clipping skill improved by 57%. Improvement in clips applied in the marked area was 38% and 45% in maximum vessel stretch.Conclusions.This study demonstrated that CLSC improved some aspects of the laparoscopic surgical skills. It addresses Practice-based Learning and patient care.
38
Stoddart, Michael Thomas, and Lucy Mary Frances Rolt. "Using video calling to simulate arthroscopic surgery in a resource-poor setting." BMJ Simulation and Technology Enhanced Learning 7, no. 1 (May 15, 2020): 41–43. http://dx.doi.org/10.1136/bmjstel-2019-000569.
Full textAbstract:
There is high demand for arthroscopic procedures in the developing world. Simulation allows trainees to develop basic arthroscopic skills away from theatre, where there may be reduced surgical exposure compared with centres with established arthroscopic practice. Smartphones are widely available and accessible throughout the world. We propose a method to create a low-cost, low-fidelity arthroscopic simulator that can be used at home by using the video call function of smartphones. We used readily available materials from a local market. An adequately sized cardboard box was used to house exercises, LED head torch as a light source, bamboo skewers as probes and a smartphone with video call function allowed visualisation without the need to purchase additional equipment. The whole simulator was constructed using less than 50 ZAR (US$3) of new materials. The arthroscopic simulator can be built simply and is easily portable. Established training exercises can be practised and allow development of basic arthroscopic skills. Our home-made simulator is inexpensive, simple to construct and does not require additional hardware (or software) purchases by the trainee. It is a perfect solution for individuals who want to practise their arthroscopic skills, either at home or at the workplace.
39
Flores-Funes, Diego, Enrique Pellicer-Franco, Benito Flores-Pastor, Matilde Moreno-Cascales, Miguel Ángel Fernández-Villacañas-Marín, and José Luis Aguayo-Albasini. "Una experiencia de integración de la Formación Sanitaria Especializada con la Universitaria de Posgrado: Entrenamiento por etapas en cirugía laparoscópica." Revista Española de Educación Médica 1, no. 2 (November 27, 2020): 82–89. http://dx.doi.org/10.6018/edumed.454671.
Full textAbstract:
Antecedentes: Diseño de un modelo de simulación para formación en cirugía laparoscópica. Métodos: Dentro del Máster Anatomía Aplicada a la Clínica se implementaron tres etapas de formación progresiva en médicos residentes. La etapa 1 se realizó en simulador con material no biológico: manejo de objetos, disección con pinza y tijera, y sutura laparoscópica. La etapa 2 utilizó material biológico (tubo digestivo en fresco) en simulador, para la práctica de sección intestinal y anastomosis intracorpórea. En la etapa 3 se realizaron técnicas laparoscópicas en cadáver en fresco (apendicectomía, colecistectomía, apertura de la transcavidad epiploica, hemicolectomías derecha e izquierda). Se añadió una encuesta de satisfacción a los participantes de la actividad. Resultados: El programa se impartió a 6 residentes de Cirugía General. Todos completaron los ejercicios de las etapas 1 y 2. En la etapa 3 se pudo realizar el neumoperitoneo sin dificultad y los tejidos presentaron una textura adecuada. Los residentes de primer año completaron la apendicectomía y la colecistectomía, pero procedimientos más complejos requirieron residentes con más experiencia. Los participantes encuestados reflejaron que el programa es adecuado y útil para el entrenamiento en laparoscopia. Conclusiones: El modelo propuesto es reproducible y adecuado en adquisición de competencias básicas en cirugía laparoscópica. Background: Design of a simulation model training in laparoscopic surgery for surgical residents. Methods: Three stages of progressive training were programmed within a Postgraduate Degree in Clinical Anatomy. Stage 1 was performed in a box-trainer with synthetic materials: managing small objects, dissection with clamp and scissors, and laparoscopic intracorporeal suture. Stage 2 used biological material (fresh digestive tract from a human corpse) in box-trainer, practicing section and intracorporeal anastomosis. In stage 3, laparoscopy was performed on a fresh corpse (appendectomy, cholecystectomy, lesser sac opening, right and left colectomy). A satisfaction survey was carried out to the participants. Results: Some six General and Digestive Surgery residents took the program. All of them completed the stage 1 and 2 exercises. In stage 3, the pneumoperitoneum could be performed without any complications, and tissues presented an adequate texture. First-year residents completed appendectomy and cholecystectomy, but more complex procedures required more experienced residents. The participants reflected that the program is adequate and useful to gain basic skills in laparoscopy. Conclusions: The proposed model is reproducible and adequate in acquisition of basic skills in laparoscopic surgery.
40
Oussi, Ninos, Konstantinos Georgiou, Andreas Larentzakis, Dimitrios Thanasas, Markus Castegren, Evangelos Georgiou, and Lars Enochsson. "Validation of a Novel Needle Holder to Train Advanced Laparoscopy Skills to Novices in a Simulator Environment." Surgical Innovation 27, no. 2 (February 1, 2020): 211–19. http://dx.doi.org/10.1177/1553350619901222.
Full textAbstract:
Background. Our aim was to determine if a newly designed Najar needle holder (NNH) shortens the time for novices to improve advanced laparoscopy (AL) techniques (suturing/knot tying), compared with a conventional macro needle holder (MNH) in a simulator. Furthermore, we aimed to validate a new video scoring system determining AL skills. Methods. Forty-six medical students performed identical surgical tasks in a prospective, crossover study evaluating AL skills (NNH vs MNH). All subjects performed a double-throw knot, 2 single-throw knots following 3 running sutures in the Simball Box (SB) simulator. After resting, subjects switched needle holders. All tasks were videotaped and analyzed using SB software and by 2 independent reviewers using the Objective Video Evaluation Scoring Table (OVEST). Trial performance expressed as SB Overall Score (SBOS) and OVEST. Results. In the group starting with NNH (followed by MNH) OVEST was consistently high during both trials (median = 12.5, range = 6.5-18.0, and median = 13.5, range = 6.5-21.0; P = .2360). However, in the group starting with MNH, OVEST improved significantly when the participants changed to NNH (median = 10.0, range = 2.5-19.5, vs median = 14.5, range = 4.5-18.0; P = .0003); an improvement was also found with SBOS (median = 37%, range = 27% to 92%, vs median = 48%, range = 34% to 70%; P = .0289). In both trials, both independent reviewers’ OVEST measures correlated well: Trial 1: β = 0.97, P < .0001; and Trial 2: β = 0.95, P < .0001. A correlation also existed between SBOS and OVEST in both trials (β = 2.1, P < .0001; and β = 1.9, P = .0002). Conclusions. This study indicates a significantly higher improvement in laparoscopic suturing skills in novices training AL skills using NNH compared with MNH. Starting early, AL training in novices using NNH is a feasible option. Furthermore, OVEST used in experimental settings as an evaluation tool is comparable with the validated SBOS.
41
De, Suvranu, Dhannanjay Deo, Ganesh Sankaranarayanan, and Venkata S. Arikatla. "A Physics-Driven Neural Networks-Based Simulation System (PhyNNeSS) for Multimodal Interactive Virtual Environments Involving Nonlinear Deformable Objects." Presence: Teleoperators and Virtual Environments 20, no. 4 (August 1, 2011): 289–308. http://dx.doi.org/10.1162/pres_a_00054.
Full textAbstract:
While an update rate of 30 Hz is considered adequate for real-time graphics, a much higher update rate of about 1 kHz is necessary for haptics. Physics-based modeling of deformable objects, especially when large nonlinear deformations and complex nonlinear material properties are involved, at these very high rates is one of the most challenging tasks in the development of real-time simulation systems. While some specialized solutions exist, there is no general solution for arbitrary nonlinearities. In this work we present PhyNNeSS—a Physics-driven Neural Networks-based Simulation System—to address this long-standing technical challenge. The first step is an offline precomputation step in which a database is generated by applying carefully prescribed displacements to each node of the finite element models of the deformable objects. In the next step, the data is condensed into a set of coefficients describing neurons of a Radial Basis Function Network (RBFN). During real-time computation, these neural networks are used to reconstruct the deformation fields as well as the interaction forces. We present realistic simulation examples from interactive surgical simulation with real-time force feedback. As an example, we have developed a deformable human stomach model and a Penrose drain model used in the Fundamentals of Laparoscopic Surgery (FLS) training tool box. A unique computational modeling system has been developed that is capable of simulating the response of nonlinear deformable objects in real time. The method distinguishes itself from previous efforts in that a systematic physics-based precomputational step allows training of neural networks which may be used in real-time simulations. We show, through careful error analysis, that the scheme is scalable, with the accuracy being controlled by the number of neurons used in the simulation. PhyNNeSS has been integrated into SoFMIS (Software Framework for Multimodal Interactive Simulation) for general use.
42
Asadi, Sara, Parvin Farzanegi, and Mohammad Ali Azarbayjani. "Combined therapies with exercise, ozone and mesenchymal stem cells improve the expression of HIF1 and SOX9 in the cartilage tissue of rats with knee osteoarthritis." Physiology International 107, no. 2 (June 2020): 231–42. http://dx.doi.org/10.1556/2060.2020.00024.
Full textAbstract:
AbstractPurposeKnee osteoarthritis (OA) is a common type of degenerative joint disease which decreases the quality of life. Sex-determining region Y box 9 (SOX9) and hypoxia-inducible factor-1 (HIF1) are considered as the key regulators of OA. We investigated the effect of combined therapies with mesenchymal stem cells (MSCs), ozone (O3) and exercise training on SOX9 and HIF1 expression in the cartilage of rats with knee OA.MethodsKnee OA was induced by surgical method. OA rats were divided into model, MSCs, ozone, exercise, MSCs + ozone, MSCs + exercise, ozone + exercise and MSCs + ozone + exercise groups. Rats in the MSCs group received intraarticular injection of 1 × 106 cells/kg. Rats in the ozone group received O3 at the concentration of 20 μg/mL, once weekly for 3 weeks. Rats in the exercise group were trained on rodent treadmill three times per week. 48 hours after the programs, cartilage tissues were isolated and the expression of SOX9 and HIF1 was determined using Real-Time PCR.ResultsSignificant differences were found in the expression of SOX9 and HIF1 between groups (P < 0.0001). Although combined therapies with exercise, MSCs and O3 significantly increased the expression of SOX9 and HIF1 in the cartilage tissue of rats with knee OA, combination of exercise with O3 was significantly more effective compared to the other combined therapies (P < 0.001).ConclusionsCombined therapy with exercise, MSCs and O3 significantly increased the expression of SOX9 and HIF1 genes in the cartilage of rats with knee OA; however, exercise + O3 was significantly more effective.
43
Ribeiro, Igo B., and Marc Ruel. "Right Anterior Minithoracotomy for Aortic Valve Replacement: A Widely Applicable, Simple, and Stepwise Approach." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 14, no. 4 (May 14, 2019): 321–29. http://dx.doi.org/10.1177/1556984519844745.
Full textAbstract:
Objective A stepwise approach for right anterior minithoracotomy aortic valve replacement (RAT-AVR), without sutureless valves, special instruments, or preoperative imaging, was developed. We report our experience with this widely applicable, simplified approach. Methods Patients with a history of previous chest surgery, documented PVD, severe COPD, LVOT size <2.0 cm, and root size <2.8 cm were excluded. Chest CT was not mandatory. The stepwise surgical approach consists of 1) tolerability of single-lung ventilation; 2) 5-cm long incision on third right anterior ICS; 3) small pericardial opening to localize the aortic valve annular plane by digital palpation; 4) shingling of the correct rib to create a box field; 5) optimizing exposure with stay sutures; 6) femoral or central cannulation with right superior pulmonary vein venting and usual antegrade cardioplegia; 7) performing a standard AVR without adjunct instruments; and 8) reconstructing 1 costochondral cartilage. Results Fifty-five patients were operated. The mean age was 68.5 years (SD 10.4); 29.1% were female. Median STS PROM was 1.18 (0.4 to 6.6). Pump and cross-clamp times were 104.8 minutes (SD 27.9) and 73.2 minutes (SD 22.8), respectively. There was no need for a knot pusher. There was 1 conversion, 1 reopening for bleeding, and 1 pacemaker insertion. No patient had a stroke, MI, or death at 30 days. The median LOS was 6 days (3 to 19). Conclusion RAT-AVR can be applicable and performed safely in a wide range of patients by adopting a simple, stepwise approach with intraoperative assessment, without the need for special imaging, instrumentation, or advanced training.
44
Nousiainen, Markku T., Daniel M. Omoto, Patrick O. Zingg, Yoram A. Weil, Sami W. Mardam-Bey, and William C. Eward. "Training Femoral Neck Screw Insertion Skills to Surgical Trainees." Journal of Orthopaedic Trauma 27, no. 2 (February 2013): 87–92. http://dx.doi.org/10.1097/bot.0b013e3182604b49.
Full text
45
Kheiran, Amin, Purnajyoti Banerjee, and Philip Stott. "Consenting Operative Orthopaedic Trauma Patients: Challenges and Solutions." ISRN Surgery 2014 (February 6, 2014): 1–5. http://dx.doi.org/10.1155/2014/354239.
Full textAbstract:
Guidelines exist to obtain informed consent before any operative procedure. We completed an audit cycle starting with retrospective review of 50 orthopaedic trauma procedures (Phase 1 over three months to determine the quality of consenting documentation). The results were conveyed and adequate training of the staff was arranged according to guidelines from BOA, DoH, and GMC. Compliance in filling consent forms was then prospectively assessed on 50 consecutive trauma surgeries over further three months (Phase 2). Use of abbreviations was significantly reduced (P=0.03) in Phase 2 (none) compared to 10 (20%) in Phase 1 with odds ratio of 0.04. Initially, allocation of patient’s copy was dispensed in three (6% in Phase 1) cases compared to 100% in Phase 2, when appropriate. Senior doctors (registrars or consultant) filled most consent forms. However, 7 (14%) consent forms in Phase 1 and eleven (22%) in Phase 2 were signed by Core Surgical Trainees year 2, which reflects the difference in seniority amongst junior doctors. The requirement for blood transfusion was addressed in 40% of cases where relevant and 100% cases in Phase 2. Consenting patients for trauma surgery improved in Phase 2. Regular audit is essential to maintain expected national standards.
46
Oliveira, Emannuella Araújo de, and Lenilda Austrilino. "Método inovador de ensino para a prática de suturas de pele." Revista Pesquisa Qualitativa 7, no. 14 (July 31, 2019): 282. http://dx.doi.org/10.33361/rpq.2019.v.7.n.14.261.
Full textAbstract:
Resumo: Este trabalho tem como objetivo mostrar potencialidades de um método inovador de ensino, para prática de sutura de pele, usando materiais orgânicos e sintéticos. Trata-se de um estudo de caso com discentes de medicina, participantes de oficina realizada aplicando técnicas básicas de sutura de pele, com treinamento simulado em três consistências de tecidos. Os dados coletados com questionários e observações avaliando desempenho discente e efetividade do método. As suturas realizadas em EVA, berinjela e língua de boi utilizando ponto simples, simples invertido, Donatti, U horizontal, sutura contínua e intradérmica, compuseram seis estações de avaliação. Após a prática na bancada, os discentes vivenciaram situação real em ambiente ambulatorial. Os discentes foram avaliados com conceitos bom e regular, inclusive na prática ambulatorial, mostra que o método de sutura em consistências diferentes favorece a aprendizagem. A estratégia utilizando material com diversas texturas mostrou-se efetivo para desenvolver habilidades e aquisição de competências para prática de sutura de pele. A oficina despertou interesse para especialidade cirúrgica.Palavras-chave: Educação Médica; Materiais de Ensino; Modelos Educacionais; Cirurgia Técnicas de Sutura; Procedimentos Cirúrgicos Ambulatoriais. Innovative teaching model for the practice of skin suturingAbstract: The objective shows the potentialities of a bench model using organic and synthetic materials, designed to development and skill acquisition in skin suturing. Method: Case study with students of the medical school. A workshop was held to practice skin sutures, providing basic suture techniques with simulated training in three tissue consistencies. Data were collected from the application of questionnaires and observation. After practicing in this bench model, the students had the opportunity to experience real situation in an outpatient setting. Results: On the workbench the sutures were made in the following materials EVA, eggplant and ox tongue, using simple point, simple inverted, Donatti, U horizontal, continuous and intradermal suture. The results show that practice in different consistencies favors learning. Conclusion: The teaching strategy proved effective for the development of skills and acquisition of skills necessary for the practice of skin suture. The workshop aroused interest for the surgical specialty.Keywords: Medical Education; Surgery; Suturing Techniques; Outpatient Surgical; Educational Model.
47
Hiyoshi, Yukiharu, Yuji Miyamoto, Takahiko Akiyama, Nobuya Daitoku, Yuki Sakamoto, Ryuma Tokunaga, Kojiro Eto, et al. "Time trial of dry box laparoscopic surgical training improves laparoscopic surgical skills and surgical outcomes." Asian Journal of Endoscopic Surgery, October 20, 2020. http://dx.doi.org/10.1111/ases.12871.
Full text
48
Gurusamy, Kurinchi Selvan, Myura Nagendran, Clare D. Toon, and Brian R. Davidson. "Laparoscopic surgical box model training for surgical trainees with limited prior laparoscopic experience." Cochrane Database of Systematic Reviews, March 1, 2014. http://dx.doi.org/10.1002/14651858.cd010478.pub2.
Full text
49
Nagendran, Myura, Clare D. Toon, Brian R. Davidson, and Kurinchi Selvan Gurusamy. "Laparoscopic surgical box model training for surgical trainees with no prior laparoscopic experience." Cochrane Database of Systematic Reviews, January 17, 2014. http://dx.doi.org/10.1002/14651858.cd010479.pub2.
Full text
50
"Evaluation of Hybrid-Training Box for Laparoscopic Cholecystectomy." Journal of the Medical Association of Thailand 103, no. 9 (September 15, 2020): 864–68. http://dx.doi.org/10.35755/jmedassocthai.2020.09.10405.
Full textAbstract:
Background: The training box is a simple tool for practice, but it does not use real tissue. The Hybrid-Training box for laparoscopic cholecystectomy simulator (LCS) was used in the laparoscopic cholecystectomy (LC) training. Objective: To evaluate its face validity and construct validity. Materials and Methods: Between January 2017 and December 2017, 30 participants were divided into two groups, an experienced group (EG) and a novice group (NV). There were 15 participants in each group, and each was asked to perform LC using the LCS. Face validity was evaluated after task completion using a questionnaire with scores ranging from one (very bad or unrealistic) to five (excellent or very realistic) on a five-point Likert scale. Operative time and accidental tearing of the gallbladder were used to evaluate construct validity. Results: The participants in the EG were staff working in general surgery, and subjects in the NV were third- and fourth-year surgical residents. Face validity showed no significant difference on the Likert scale in terms of resembling reality or haptic feedback from tissue (23.6±2.8, 21.7±3.8, p=0.13). The mean operative time of the EG was 15±2.4 minutes while that of the NV was 32±4.1 minutes (p<0.01), and more errors in the form of accidental perforation of gallbladder during LC were found in the NV (67%, 13%, p<0.001). Conclusion: The LCS is an all-in-one simulator that provides effective skill training for LC. The frozen pig gallbladder added realism and was convenient to use. Keywords: Simulator, Laparoscopic cholecystectomy, Training model