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Misadventures in General Surgery
Published in Marilyn Sue Bogner, Misadventures in Health Care, 2003
Surgeons train in residency programs based on a mentorship system for a period of 5 to 6 years. Residency training consists of an intensive exposure to diseases that require surgery for treatment and provides technical training in performing these operations and caring for the patients before and after surgery (“National surgical work patterns as a basis for residency training plans: the response of a panel of surgeons,” 1977). Residents’ work schedules are frequently 80 to 120 hours per week and are justified by the argument that this exposure maximizes the intensity of the learning and accustoms the residents to overcoming fatigue when dealing with serious illness. In other words, residents are trained to always place the necessities of patients’ care above their own comfort and needs (Bunch, Dvonch, Storr, Baldwin, & Hughes, 1992).
Virtual and Augmented Reality in Medicine
Published in John G Webster, Minimally Invasive Medical Technology, 2016
In surgical planning, the surgeon reviews the accessible patient information and develops a plan for the surgical procedure. As discussed earlier, advanced visualization techniques can support the mental task of understanding complex anatomical data. Potentially, additional information from different examinations or generic data sets can be combined for the virtual patient model. Based on such a model, optimal corridors, for example neurosurgery, can be identified. These trajectories can consider the location of vessels, nerves, specific brain regions and other critical anatomy, and landmarks can be set for them when image-guided surgery is used.
Mechanical testing
Published in C M Langton, C F Njeh, The Physical Measurement of Bone, 2016
Christopher F Njeh, Patrick H Nicholson, Jae-Young Rho
There are many reasons why the study of the mechanical properties of bone is important, and the breadth of reasons is evidenced by the varied backgrounds of those interested and active in this study of these properties. These include orthopaedic surgeons, trauma surgeons, orthodontists, prothodontists, radiologists, practitioners of general medicine, medical physicists and biomedical engineers. A good knowledge of these properties can help predict how bones can be expected to behave in the body. For example, ‘the loads they can and cannot bear or the amount of energy they will absorb before fracturing’ [34]. This knowledge can also be used as a predictor of the effects of ageing and disease on bone behaviour.Mechanical tests provide input for computational models of bone mechanics, adaptation and repairs.Knowledge of the material properties of cancellous bone has a twofold implication for bone implantation. Firstly, if other materials are to be substituted for bone, their mechanical properties must be compatible with those of bone to ensure a viable system. Secondly, the whole process of fracture fixation-implant design and implant insertion depend upon the internal distribution of the material properties [35]. This is more so when the prostheses are predominantly surrounded by cancellous bone and accordingly rely on cancellous bone for fixation. An example is the total hip-joint replacement, in which one part of the artificial joint occupies the medullary canal of the femur, the other part occupying the acetabular region of the pelvis [36].Data on the strength characteristics and other mechanical properties of bone might also be useful in the selection of sites for obtaining bone grafts.The ability of the human body to withstand acceleration and deceleration forces of various magnitude without severe trauma is of major importance to the safety engineer who must design the automobile, airplane cockpit or space vehicle to protect the occupant as much as possible from the effect of these forces.Some knowledge of these limits of tolerance is likewise of practical significance to the designers and manufacturers of protective clothing and equipment used in sports such as football, skiing and motor vehicle racing. Other researchers like anatomists, zoologists, physiologists, anthropologists, physicists, crystallographers and bio-engineers are also interested in the mechanical properties of bone.
The role of robotic technology in minimally invasive surgery for mitral valve disease
Published in Expert Review of Medical Devices, 2021
Johannes Bonatti, Bob Kiaii, Cem Alhan, Stepan Cerny, Gianluca Torregrossa, Gianluigi Bisleri, Caroline Komlo, T. Sloane Guy
For robotic mitral valve surgery, the lead surgeon should have the appropriate certification in cardiac surgery by the certifying institution in the country where she or he practices cardiac surgery. The console surgeon should have experience with all aspects of mitral valve surgery and be very versatile in repair techniques, since the robotic procedures will be longer than the conventional operations, especially during the learning curve. Training in the so called mini-mitral using conventional videoscopy is also beneficial but not an absolute prerequisite. The lead surgeon along with the entire team should enroll in different courses offered by the different societies on robotic mitral valve surgery. These courses should include both formal didactic and hands-on-courses to demonstrate the basic skills required to perform robotic cardiac operations. The team’s institution should arrange and facilitate the acquisition of virtual simulators and ‘wet labs’ to allow the team to practice in a simulation environment, the choreography and the entire procedure before the surgery in their first 8–10 cases. The team should also have the ability to practice anytime in the future on a regular basis. For a program to be proficient in robotic mitral valve surgery, they need to be performing at a minimum 20 robotic cases per year. The entire team need to continue to obtain extra expertise through accredited continuing education programs [55].
Patient-specific guides improve hip arthroplasty surgical accuracy
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Adeel Aqil, Sanya Patel, Anatole Wiik, Gareth Jones, Alex Bridle, Justin P. Cobb
Femurs were first mounted in a 3D printed customized block (Embody Orthopaedic Ltd, London, U.K.), at a standard distance from the top of the greater trochanter ready for preparation. A PS cutting guide was used in one group, while routinely available osteotomy cutting guides were used in the conventional group (Figure 1). The rapid prototyped PS guide directed the proximal femoral osteotomy cut level and orientation as well as directing the entry point of the femoral rasp (Figure 1). Femurs were rasped up to the desired size as dictated by the ‘feel for the implant fit’ (as is under normal clinical circumstances). A single, senior orthopaedic surgeon performed the surgery. The two different stems used in the study (Furlong HAC and Furlong Evolution, Joint Replacement Instruments Ltd, U.K.) varied greatly in their proximal geometry, surface coating, and length, but were both uncemented and collared in design (Figure 2).
Soft medical robotics: clinical and biomedical applications, challenges, and future directions
Published in Advanced Robotics, 2019
Jen-Hsuan Hsiao, Jen-Yuan (James) Chang, Chao-Min Cheng
Furthermore, for successful cardiac surgery, heart stabilization is crucial for the surgeon to have a clear and steady view. Stabilization may be achieved by advancing biocompatible soft robotics technology to explore and exploit material stiffness characteristics that can provide stability and adjust to the beating of the heart [24]. This technology could be used to develop additional soft medical devices that must navigate around and operate on beating hearts [25].