Quality-based assessment of camera navigation skills for laparoscopic fundoplication

2020 ◽  
Vol 33 (11) ◽  
Author(s):  
Florentine Huettl ◽  
Hauke Lang ◽  
Markus Paschold ◽  
Fabian Bartsch ◽  
Sebastian Hiller ◽  
...  
Keyword(s):  
Hiatus Hernia ◽  
Surgical Procedure ◽  
Laparoscopic Fundoplication ◽  
Statistical Significance ◽  
Intraclass Correlation ◽  
Operation Time ◽  
Surgical Performance ◽  
Upper Gi ◽  
Camera Navigation ◽  
Surgical Teams

Summary Laparoscopic fundoplication is considered the gold standard surgical procedure for the treatment of symptomatic hiatus hernia. Studies on surgical performance in minimally invasive hiatus hernia repair have neglected the role of the camera assistant so far. The current study was designed to assess the applicability of the structured assessment of laparoscopic assistance skills (SALAS) score to laparoscopic fundoplication as an advanced and commonly performed laparoscopic upper GI procedure. Randomly selected laparoscopic fundoplications (n = 20) at a single institute were evaluated. Four trained reviewers independently assigned SALAS scoring based on synchronized video and voice recordings. The SALAS score (5–25 points) consists of five key aspects of laparoscopic camera navigation as previously described. Experience in camera assistance was defined as at least 100 assistances in complex laparoscopic procedures. Nine different surgical teams, consisting of five surgical residents, three fellows, and two attending physicians, were included. Experienced and inexperienced camera assistants were equally distributed (10/10). Construct validity was proven with a significant discrimination between experienced and inexperienced camera assistants for all reviewers (P < 0.05). The intraclass correlation coefficient of 0.897 demonstrates the score’s low interrater variability. The total operation time decreases with increasing SALAS score, not reaching statistical significance. The applied SALAS score proves effective by discriminating between experienced and inexperienced camera assistants in an upper GI surgical procedure. This study demonstrates the applicability of the SALAS score to a more advanced laparoscopic procedure such as fundoplication enabling future investigations on the influence of camera navigation on surgical performance and operative outcome.

scholarly journals Reproducibility of 24-h post-exercise changes in energy intake in overweight and obese women using current methodology

2011 ◽  
Vol 108 (2) ◽  
pp. 191-194 ◽  
Author(s):  
Gemma L. Brown ◽  
Michael E. Lean ◽  
Catherine R. Hankey
Keyword(s):  
Energy Intake ◽  
Exercise Intervention ◽  
Statistical Significance ◽  
Intraclass Correlation ◽  
Large Degree ◽  
Exercise Session ◽  
Fat Intake ◽  
Obese Women ◽  
Short Term ◽  
Post Exercise

Direct observation(s) of energy intake (EI) via buffet meals served in the laboratory are often carried out within short-term exercise intervention studies. The reproducibility of values obtained has not been assessed either under resting control conditions or post-exercise, in overweight and obese females. A total of fourteen sedentary, pre-menopausal females (BMI 30·0 (sd5·1) kg/m2) completed four trials; two exercise and two control. Each trial lasted 24 h spanning over 2 d; conducted from afternoon on day 1 and morning on day 2. An exercise session to expend 1·65 MJ was completed on day 1 of exercise trials, and three buffet meals were served during each trial. Reproducibility of post-exercise changes in energy and macronutrient intakes was assessed at each individual buffet meal by intraclass correlation coefficient (ri). Only therivalues for post-exercise changes in energy (ri0·44 (95 % CI − 0·03, 0·77),P = 0·03) and fat intake (ri0·51 (95 % CI 0·04, 0·81),P = 0·02) at the lunch buffet meal achieved statistical significance; however, theserivalues were weak and had large associated 95 % CI, which indicates a large degree of variability associated with these measurements. Energy and macronutrient intakes at the breakfast and evening buffet meals were not reproducible. This study concludes that the frequently used laboratory-based buffet meal method of assessing EI does not produce reliable, reproducible post-exercise changes in EI in overweight and obese women.

scholarly journals Comparison of 1-Repetition-Maximum Performance Across 3 Weightlifting Overhead Pressing Exercises and Sport Groups

2020 ◽  
Vol 15 (6) ◽  
pp. 862-867
Author(s):  
Marcos A. Soriano ◽  
Amador García-Ramos ◽  
Antonio Torres-González ◽  
Joaquín Castillo-Palencia ◽  
Pedro J. Marín ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Assessment Method ◽  
Exercise Group ◽  
Mixed Group ◽  
Training Experience ◽  
Strength And Conditioning ◽  
Repetition Maximum ◽  
Main Effect

Objective: To (1) compare the 1-repetition-maximum (1RM) performance between the push press, push jerk, and split jerk and (2) explore these differences between weightlifters, CrossFit athletes, and a mixed group of athletes. Methods: Forty-six resistance-trained males (age 28.8 [6.4] y; height 180.0 [6.0] cm; body mass 84.1 [10.2] kg; weightlifting training experience 3.64 [3.14] y) participated in this study. The 1RM performance of the push press, push jerk, and split jerk was assessed during the same session in a sequential order (ie, combined 1RM assessment method). Thirty-six participants were retested to determine between-sessions reliability of the 1RM values. Results: Intraclass correlation coefficients (ICCs) and associated 95% confidence intervals (CIs) showed a high between-sessions reliability for the push press (ICC = .98; 95% CI, .95–.99), push jerk (ICC = .99; 95% CI, .98–1.00), and split jerk (ICC = .99; 95% CI, .98–1.00). There was a significant main effect of exercise (η2 = .101) and exercise × group interaction (η2 = .012) on 1RM performance (P < .001), whereas the main effect of group did not reach statistical significance (P = .175). Conclusions: This study provides evidence that the weightlifting overhead press derivatives affect 1RM performance. In addition, the interaction of exercise and sport group was caused by the higher differences in 1RM performance between exercises for weightlifters compared with CrossFit and a mixed group of athletes. Therefore, strength and conditioning professionals should be aware that the differences in 1RM performance between weightlifting overhead-press derivatives may be affected by sport group.

Role of intraoperative neuromonitoring of the recurrent laryngeal nerves during thyroid reoperations of recurrent goiter

2017 ◽  
Vol 89 (3) ◽  
pp. 11-15 ◽  
Author(s):  
Jan Sopiński ◽  
Krzysztof Kuzdak ◽  
Masoud Hedayati ◽  
Krzysztof Kołomecki
Keyword(s):  
At Risk ◽  
Statistical Significance ◽  
Operation Time ◽  
Intraoperative Neuromonitoring ◽  
Number Of Patients ◽  
Recurrent Goiter ◽  
Group A ◽  
Procedure Duration ◽  
Recurrent Laryngeal Nerves ◽  
Group B

Reoperations of the thyroid gland are challenging to any surgeon. Such procedures are technically difficult and involve higher risk of complications than primary procedures. Recurrent laryngeal nerve (RLN) palsy is one of such complications The aim of the study was to evaluate the effectiveness of intraoperative neuromonitoring (IONM) in preventing RLN palsy during recurrent goiter operations. Material and methods. We retrospectively analyzed the results of thyroid reoperation performed at the Department of Endocrine, General and Vascular Surgery of Medical University of Lodz in the period from January 2014 to June 2016. The study included 80 patients, who were divided into 2 groups: group A consisted of 27 patients, who had undergone surgery with the use of IONM, while group B included 53 patients, in whom RLN was identified visually. During statistical analysis we took into account the number of nerves at risk, not the number of patients. There were 47 nerves at risk In group A and 86 in group B. We analyzed whether application of IONM had any effect on the frequency of RLN palsy and procedure duration. Results. The frequency of RLN palsy was 10.64% (5/47) in group A and 15.12% (13/86) in group B (no statistical significance, p=0,47). Mean operation time was shorter in group B 71.29 ± 17.125 minutes vs. 75.75 ± 17.94 minutes in group A (no statistical significance, p=0,377). Conclusion. Use of IONM did not significantly reduce the occurrence of RLN palsy and procedure duration.

Which Surgical Procedure for Uncomplicated Hiatus Hernia

JAMA ◽  
1965 ◽  
Vol 192 (2) ◽  
pp. 173
Author(s):  
Beatty H. Ramsay
Keyword(s):  
Hiatus Hernia ◽  
Surgical Procedure

scholarly journals Reproducibility and reliability of three-dimensional soft tissue landmark identification using three-dimensional stereophotogrammetry

2016 ◽  
Vol 86 (6) ◽  
pp. 1004-1009 ◽  
Author(s):  
Asli Baysal ◽  
Ahmet Oguz Sahan ◽  
Mehmet Ali Ozturk ◽  
Tancan Uysal
Keyword(s):  
Soft Tissue ◽  
Statistical Significance ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Intraclass Correlation Coefficients ◽  
Paired Samples ◽  
Landmark Identification ◽  
The Difference ◽  
Intraexaminer Reliability

ABSTRACT Objective: To evaluate the intraexaminer repeatability and interexaminer reproducibility of soft tissue landmarks on three-dimensional (3-D) stereophogrammetric images. Materials and Methods: Thirty-four stereophotogrammetric images were taken and 19 soft tissue points were identified. The images were obtained using the 3-DMD Face (3-DMD TM Ltd, Atlanta, Ga) system. Two examiners marked 34 images manually with a mouse-driven cursor 4 weeks apart. Intraexaminer marking differences were calculated and classified as &lt;0.5 mm, 0.5–1 mm, and &gt;1 mm. Intraclass correlation coefficients were calculated for intraexaminer reliability. A paired-samples t-test was used to evaluate the difference between the examiners. Interexaminer reproducibility was evaluated by kappa analysis. Statistical significance was set at P &lt; .05. Results: Only one landmark (labiale superior) had an intraexaminer marking difference less than 0.5 mm. Existing landmarks had an intraexaminer difference less than 1 mm, but higher than 0.5 mm. The intraclass correlation coefficients (ICCs) indicated good intraexaminer repeatability for both observers. The ICC range for examiners 1 and 2 was 0.986–1.000 and 0.990–1.000, respectively. Kappa scores showed good interexaminer agreement, especially on the z-axis. Conclusions: Except labiale superior, the soft tissue landmarks used in this study were shown to have moderate reproducibility, but the difference between the landmarks was less than 1 mm, and they had clinically acceptable reproducibility.

scholarly journals Accuracy of registration techniques and vascular imaging modalities in fusion imaging for aortic endovascular interventions: a phantom study

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
M. M. Sieren ◽  
C. Schareck ◽  
M. Kaschwich ◽  
M. Horn ◽  
F. Matysiak ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Intraclass Correlation ◽  
Fusion Imaging ◽  
Imaging Modalities ◽  
3D Registration ◽  
Registration Accuracy ◽  
Absolute Deviation ◽  
Infrarenal Aortic Aneurysm ◽  
Vascular Model ◽  
Left Anterior Oblique

Abstract Background This study aimed to assess the error of different registration techniques and imaging modalities for fusion imaging of the aorta in a standardized setting using a anthropomorphic body phantom. Materials and methods A phantom with the 3D printed vasculature of a patient suffering from an infrarenal aortic aneurysm was constructed. Pulsatile flow was generated via an external pump. CTA/MRA of the phantom was performed, and a virtual 3D vascular model was computed. Subsequently, fusion imaging was performed employing 3D-3D and 2D-3D registration techniques. Accuracy of the registration was evaluated from 7 right/left anterior oblique c-arm angulations using the agreement of centerlines and landmarks between the phantom vessels and the virtual 3D virtual vascular model. Differences between imaging modalities were assessed in a head-to-head comparison based on centerline deviation. Statistics included the comparison of means ± standard deviations, student’s t-test, Bland-Altman analysis, and intraclass correlation coefficient for intra- and inter-reader analysis. Results 3D-3D registration was superior to 2D-3D registration, with the highest mean centerline deviation being 1.67 ± 0.24 mm compared to 4.47 ± 0.92 mm. The highest absolute deviation was 3.25 mm for 3D-3D and 6.25 mm for 2D-3D registration. Differences for all angulations between registration techniques reached statistical significance. A decrease in registration accuracy was observed for c-arm angulations beyond 30° right anterior oblique/left anterior oblique. All landmarks (100%) were correctly positioned using 3D-3D registration compared to 81% using 2D-3D registration. Differences in accuracy between CT and MRI were acceptably small. Intra- and inter-reader reliability was excellent. Conclusion In the realm of registration techniques, the 3D-3D method proved more accurate than did the 2D-3D method. Based on our data, the use of 2D-3D registration for interventions with high registration quality requirements (e.g., fenestrated aortic repair procedures) cannot be fully recommended. Regarding imaging modalities, CTA and MRA can be used equivalently.

scholarly journals A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application

2020 ◽  
Author(s):  
Fuming Wang ◽  
Haolan Xiong ◽  
Xiaotao Long ◽  
Yang Li ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Procedure ◽  
Evaluation Criteria ◽  
Operation Time ◽  
Tension Band ◽  
Standard Position ◽  
Patella Fractures ◽  
Intraoperative Fluoroscopy ◽  
Significant Difference ◽  
K Wires

Abstract Background Traditionally, the technique of modified tension band wires (MTBW) has been the most commonly used surgical procedure. The purpose of this study is to design a precise navigation device that can obtain a standard position of K-wires for (MTBW), and to compare the precise MTBW (P-MTBW) by a navigation device with the conventional MTBW (C-MTBW) by hands in a retrospective study.Methods The device is designed by solidworks2012 software (USA), which can provide a precise guidance for obtaining a parallel K-wires. In addition, it can set the distance between two k-wires and the level of k-wires below patellar anterior surface. From June 2014 to August 2018, a total of 112 patients are employed in this retrospective study. The patients are divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We need to record and analyze the operation time and the number of fluoroscopy, postoperative internal fixation imaging, knee function and complications.Results There were 54 patients in P-MTBW group and 58 patients in C-MTBW group. There were statistically significant differences(P＜0.001) in the operation time between P-MTBW group (39.5±4.7; range, 32–49 minutes) and C-MTBW group (53.7±6.8; range, 42–71 minutes). The number of intraoperative fluoroscopy was significantly less (P＜0.001) in P-MTBW group(4.2±1.4) versus that of C-MTBW group (8.3±2.7). According to Iowa knee score, there was no significant difference (P=0.268) in function between the two groups. According to our own evaluation criteria for MTBW, anyone in the P-MTBW group was excellent and 26 patients were excellent, 20 patients were good and 2 patients were fair in the C-MTBW group.Conclusion The navigation device can reduce operation time and intraoperative fluoroscopy frequency. P-MTBW fixation is an accurate and effective surgical procedure for patella fractures.

scholarly journals Outdoor circuit test: construction and validation of an instrument for the prediction of cardiorespiratory capacity for older adults

2020 ◽  
Vol 23 (6) ◽  
Author(s):  
Gabriela Rezende de Oliveira Venturini ◽  
Paulo de Tarso Veras Farinatti ◽  
Nádia Souza Lima da Silva
Keyword(s):  
Older Adults ◽  
Heart Rate ◽  
Execution Time ◽  
Statistical Significance ◽  
Intraclass Correlation ◽  
Positive Association ◽  
Test Construction ◽  
Subjective Perception ◽  
Validity And Reliability ◽  
Predictive Capacity

Abstract Objective: the present study aimed to construct, validate and verify the reliability of a protocol for assessing the cardiorespiratory capacity of older adults attending the Rio ao Ar Livre (Open Air Rio, or RAL) project entitled the “Outdoor Circuit Test” (OCT). Method: validity and reliability tests were carried out to assess the accuracy of the OCT, with 50 older adults (70.6 ± 6.3 years) of both sexes who regularly attended the RAL. Validity was tested by collecting VO2max data under maximal cardiopulmonary exercise test conditions, and the OCT variables: a) Circuit Execution Time; b) Heart Rate; c) Subjective Perception of Exertion; d) Average Heart Rate (HRméd). Reliability was tested through the reproducibility of the measurements of the OCT variables, expressed by the Intraclass Correlation Coefficient (ICC). The predictive capacity of VO2max was given by multiple linear regression and the final stability of the model by the analysis of the residues and the calculation of Cook’s distances, with a value of P≤ 0.05 adopted for statistical significance. Results: the predictive model based on age, sex, waist circumference, BMI and circuit execution time explained 41% of VO2max variance, with a standard error of estimate of 18.5%. Conclusion: the OCT exhibited satisfactory reproducibility (0.62 to 0.93), and proved to be valid, reliable, and specific for predicting the cardiorespiratory fitness of older adults attending RAL, demonstrating adequate reproducibility and a positive association with the physical fitness of older adults.

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