Introducing New Technology/Surgical Techniques in Orthopaedics

OrthoMedia ◽  
2021 ◽  
Keyword(s):  
New Technology ◽  
Surgical Techniques

scholarly journals Femto Laser-Assisted Cataract Surgery

2020 ◽  
Author(s):  
Clemence Bonnet ◽  
Saba Al-Hashimi ◽  
Antoine P. Brézin ◽  
Dominique Monnet
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
New Technology ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Current Method ◽  
Cataract Extraction ◽  
Scientific Data ◽  
Conventional Surgery ◽  
Lens Fragmentation

Cataract is a leading cause of blindness in the world, and cataract extraction is one of the most commonly performed surgeries. Preferred surgical techniques have changed over the past decades with associated improvements in outcomes and safety. Phacoemulsification is a highly successful technique first introduced over 40 years ago. It is the current method of cataract surgery, with a very low reported rate of major complications and a frequency of overall intraoperative complications of less than 2%. Application of the femtosecond laser evolved to now assist in cataract surgery and has been termed FLACS (femtosecond laser-assisted cataract surgery) and occurs in three steps: corneal incisions (including optional limbal relaxing incisions to reduce astigmatism), anterior capsulotomy, and lens fragmentation. The remaining surgical steps still require the surgeon’s hands. The FLACS technique may have some advantages compared with conventional phacoemulsification. It remains however unclear whether FLACS is globally more efficient and safer than conventional surgery. The popularity of FLACS may also be limited by its higher cost compared with conventional surgery. The potential advantages of laser-assisted surgery are yet to be determined as FLACS technology is relatively new and in continuous evolution. This chapter reports scientific data as well as our own experience with this new technology. All the platforms currently available are described.

Incorporating New Technology Into a Surgical Technique: The Learning Curve of a Single Surgeon's Stereo-Electroencephalography Experience

Neurosurgery ◽  
2019 ◽  
Vol 86 (3) ◽  
pp. E281-E289 ◽  
Author(s):  
Robert A McGovern ◽  
Robert S Butler ◽  
James Bena ◽  
Jorge Gonzalez-Martinez
Keyword(s):  
Surgical Technique ◽  
Learning Curve ◽  
Clinical Experience ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
New Technology ◽  
Surgical Techniques ◽  
Vascular Imaging ◽  
New Paradigm ◽  
Cusum Analysis

Abstract BACKGROUND Technological improvements frequently outpace the publication of randomized, controlled trials in surgical patients. This makes the application of new surgical techniques difficult as surgeons solely use clinical experience to guide changes in their practice. OBJECTIVE To quantitatively examine the learning curve of incorporating new technology into a surgical technique and discuss the clinical significance of incorporating this new technology into daily practice. To identify areas of improvement for operative efficiency and safety. METHODS A retrospective observational study examining quantitative measures of operative efficiency and safety from 2009 to 2017 in 454 consecutive patients undergoing stereo-electroencephalography depth electrode implantations. RESULTS The transition to a new robotic technique significantly improved operative times (196 min [95% CI 173-219] vs 115 min [95% CI 111-118], P < .0001). Cumulative sum (CUSUM) analysis demonstrated that mastery of the robotic technique took much longer than the frame-based technique (operative time peak at case 75 vs case 25, plateau of 150 vs 10 cases). Although hemorrhage rates using different vascular imaging techniques did not appear to differ using traditional statistical analysis (magnetic resonance imaging, MRI 22.3%, computed tomography angiography, CTA 17.9%, angiogram 18.1%, likelihood ratio χ2 = 4.84, P = .30), CUSUM analysis suggested MRI as the vascular imaging modality leading to higher hemorrhage and symptomatic hemorrhage rates at our center. CONCLUSION This experience demonstrates an improvement in operative efficiency through a series of changes made using clinical experience and intuition while transitioning to a completely new paradigm. CUSUM analysis identified potential areas for improvement in both operative efficiency and safety if used in a prospective manner.

scholarly journals Recent advances in urologic surgical techniques for pyeloplasty

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 295 ◽  
Author(s):  
Mikolaj Mendrek ◽  
Thomas Alexander Vögeli ◽  
Christian Bach
Keyword(s):  
New Technology ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Operative Management ◽  
Single Port Surgery ◽  
Recent Advances ◽  
Alternative Techniques ◽  
Open Pyeloplasty ◽  
Three Dimensional Vision ◽  
Made In

Pyeloplasty is one of the most common urological reconstructive interventions. Since the presentation of the first open pyeloplasty by Anderson and Hynes in 1949, the management of ureteropelvic junction obstruction has dramatically developed. The most immense progress was made in the 1990s with the introduction of laparoscopy. A multitude of new minimal surgical techniques have been introduced since then. In the last few years, the innovations were based on refinement of already-existing techniques and technology. With this aim, single-port surgery, three-dimensional vision for laparoscopy, robotic technology, and alternative techniques for creating the anastomosis-like fibrin glue have been introduced. This unsystematic review is timely, and the scientific interest is to present and discuss some of the latest advances in surgical techniques and different approaches for the intra- and post-operative management in pyeloplasty. To the best of our knowledge, this is the only review looking at the recent advances in urological surgical techniques for pyeloplasty during the last few years with a focus on new technology and surgical techniques.

scholarly journals RADIO-FREQUENCY WAVE APPLICATION IN ESTHETIC SURGERY OF HEAD AND NECK

2008 ◽  
Vol 37 (2) ◽  
pp. 137-142
Author(s):  
Vukoje Novak
Keyword(s):  
Head And Neck ◽  
Surgical Procedures ◽  
Soft Tissues ◽  
New Technology ◽  
Surgical Techniques ◽  
Pathological Process ◽  
Wave Form ◽  
Esthetic Surgery ◽  
Frequency Wave ◽  
Radio Frequency Wave

Introduction: Four-megahertz radiowave surgery is a relatively new technology usage of which rapidly expands reaching superior results compared to other surgical techniques. Radiosurgery is an atraumatic metod of cutting and coagulation of soft tissues that uses optimal low heat 4.0 MHz source for numerous plastic,esthetic and cosmetic interventions which reguires surgical precision, penetration control and low temperature. This technology allows us to simultaneously cut and coagulate the tissue with minimal lateral tissue alteration, without burning damage and with better wounds healing.This mode is used by the author in high vascularity anatomical areas and for the deeper tissue of the head and neck. The pure cutting wave-form is ideal for skin excision with otoplasty and blepharoplasty when we expect ideal esthetic result. Coagulation is obviously paramount for any surgeon and can make the difference between a good and poor result. When he coagulates tissues in the head and neck, the surgen is frequently close to significant structures such as nerves and vessels which we must protect. Ellman Sugitron 4.0 offers great advantages. One of the stronges point of the Ellman system is the large array of specialized electrodes. By bending the malleable electrodes we can use them at any angle or even around corners. Material and Methods: The Author has done surgical procedures on over 600 patients using this technique on different esthetic problems with satisfying results. In operative material dominate various skin growths (hemangioma, fibroma, naevus, wart) blepharoplasy, otoplasty, rhinoplasty and other minor surgical procedures. Interventions were done in local anesthesy. The aim of this work is to present our observations about radioablation in heterogenous pathological process on head and neck based of our own experience. Results: Our results show that this technology have great advantage over other techniques (scalpel, electrocouter, laser) from which the most important are simultaneous cutting and coagulation,coagulation in liquid medium, minimal termal damage of latteral tissues, faster healing of wounds with excellent cosmetic results. If we want surgery without cut,cut without scar, Ellman Sugitron is the best choice.

scholarly journals Robots are Coming

2019 ◽  
Vol 6 (3) ◽  
pp. 707-730
Author(s):  
Megan Cloud
Keyword(s):  
Legal Status ◽  
New Technology ◽  
Surgical Techniques ◽  
Surgical Care ◽  
Choice Of Law ◽  
Early Adopters ◽  
Practice Of Medicine ◽  
Care Field ◽  
Rural Access ◽  
Improve Access

New technology frequently emerges that challenges the legal status quo. Early adopters must then grapple with uncertainty over how the law will apply to novel legal quandaries. There is no better example of this than in medicine; however, the health care field is notoriously risk averse. Despite this, the practice of medicine stands to gain tremendously from these technological advancements. One such advancement is the relatively new ability to perform robotic surgery in which the surgeon is remote from the patient. Widespread use of this technology would improve rural access to surgical care, as well as improve access to more advanced surgical techniques. But problems may arise concerning choice-of-law when the laws of jurisdictions that the patient and surgeon are located in conflict. This Comment will explore the choice-of-law dilemma using Texas as a point of reference to discuss the likely choice-of-law analysis that would take place in a telesurgical malpractice case.

scholarly journals Where Do We Stand with The Ever Evolving Technology?

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Yehia Salah Eldin Mostafa
Keyword(s):  
Refractive Surgery ◽  
New Technology ◽  
Surgical Techniques ◽  
Albert Einstein ◽  
Well Being ◽  
Technological Innovations ◽  
Corneal Surface ◽  
The Road ◽  
Surgical Field ◽  
Fast Evolution

"Imagination is more important than knowledge. For knowledge is limited, whereas imagination embraces the entire world, stimulating progress, giving birth to evolution." Albert Einstein. “Once a new technology rolls over you, if you're not part of the steamroller, you're part of the road”. Stewart Brand. The developments in the field of ophthalmology have gone through tremendous and fast evolution over the last 40 years. The purpose of this evolution is the well being of our patients. In the surgical field we aim at efficiency, safety and predictability. Technological innovations are always aimed to improve a surgical need or a patient outcome. For example with the development of modern phacoemulsification machines and techniques it became possible to aspirate the hardest of nuclei through a tiny incision down to 1.8 mm, which was not possible manually. So innovations in surgical techniques have evolved rapidly to improve the use of the technology. Another example is the introduction of excimer laser technology in refractive surgery which gave us the opportunity of precision in carving the corneal surface to attain the desired refractive result which was not possible with any previous technique.

The impact of failed novel technology and technical errors on the revision burden in total hip arthroplasty: what percentage of revision hip arthroplasty was potentially avoidable?

2021 ◽  
pp. 112070002199665
Author(s):  
Matthew L Brown ◽  
Justin M Dunn ◽  
Samuel Early ◽  
Sravya Challa ◽  
Kace A Ezzet
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
New Technology ◽  
Surgical Techniques ◽  
Unintended Consequences ◽  
Novel Technologies ◽  
Total Hip ◽  
Technical Errors ◽  
The Impact

Background: Despite the high success rate of total hip arthroplasty (THA), new implant technologies continue to be developed. Although potentially useful, such novel developments may result in unintended consequences, leading to revision surgery, often prematurely. In several instances, new technology that appeared promising was later found to be inferior to existing technology and resulting in early revision surgery. Additionally, technical surgical errors may also lead to early revisions. Some have argued that revisions related to such phenomena are potentially avoidable. The present analysis investigates to what extent the contribution of “failed new technology” and “technical errors” contributes to the revision burden and to the need for premature revision arthroplasty. Methods: We retrospectively analysed 432 revision THAs and categorised them as either “late revisions” based on survivorship of 10 years or “premature revisions”. Among both cohorts, we determined what percentage of revisions were potentially avoidable and due to failed novel technologies and technical errors, and what percent were “unavoidable”. Results: Of the 432 revisions, 267 (62%) were considered premature and 38% were considered late. Of the premature revisions, 108 were considered potentially avoidable (81 failed novel technologies, 27 technical errors). Conclusions: Our data demonstrates that new technology and surgical techniques can result in premature failure of THA. Surgeons should take caution when incorporating new implant technology or surgical techniques into their practice.

Microfabrication research at the National Submicron Facility

1983 ◽  
Vol 41 ◽  
pp. 86-89
Author(s):  
E.D. Wolf
Keyword(s):  
Integrated Circuits ◽  
Particle Physics ◽  
High Speed ◽  
New Technology ◽  
High Energy ◽  
High Energy Particle ◽  
New Science ◽  
Wide Range ◽  
Intermediate Domain ◽  
Circuit Function

Most microelectronics devices and circuits operate faster, consume less power, execute more functions and cost less per circuit function when the feature-sizes internal to the devices and circuits are made smaller. This is part of the stimulus for the Very High-Speed Integrated Circuits (VHSIC) program. There is also a need for smaller, more sensitive sensors in a wide range of disciplines that includes electrochemistry, neurophysiology and ultra-high pressure solid state research. There is often fundamental new science (and sometimes new technology) to be revealed (and used) when a basic parameter such as size is extended to new dimensions, as is evident at the two extremes of smallness and largeness, high energy particle physics and cosmology, respectively. However, there is also a very important intermediate domain of size that spans from the diameter of a small cluster of atoms up to near one micrometer which may also have just as profound effects on society as “big” physics.

Characterization of RF Sputtered ZnO Piezoelectric Films Using Transmission Electron Microscope

1975 ◽  
Vol 33 ◽  
pp. 86-87
Author(s):  
Kemining W. Yeh ◽  
Richard S. Muller ◽  
Wei-Kuo Wu ◽  
Jack Washburn
Keyword(s):  
Integrated Circuit ◽  
Acoustic Waves ◽  
New Technology ◽  
Surface Acoustic Waves ◽  
Electromechanical Properties ◽  
Leading Role ◽  
Saw Devices ◽  
Transmission Electron ◽  
High Degree

Considerable and continuing interest has been shown in the thin film transducer fabrication for surface acoustic waves (SAW) in the past few years. Due to the high degree of miniaturization, compatibility with silicon integrated circuit technology, simplicity and ease of design, this new technology has played an important role in the design of new devices for communications and signal processing. Among the commonly used piezoelectric thin films, ZnO generally yields superior electromechanical properties and is expected to play a leading role in the development of SAW devices.

Gut microbiome a promising target for management of respiratory diseases

2020 ◽  
Vol 477 (14) ◽  
pp. 2679-2696
Author(s):  
Riddhi Trivedi ◽  
Kalyani Barve
Keyword(s):  
Respiratory Diseases ◽  
New Technology ◽  
Bacterial Flora ◽  
Systemic Circulation ◽  
The Body ◽  
Lung Pathology ◽  
Promising Target ◽  
Current Therapies ◽  
Intestinal Microbial Flora ◽  
On Chip

The intestinal microbial flora has risen to be one of the important etiological factors in the development of diseases like colorectal cancer, obesity, diabetes, inflammatory bowel disease, anxiety and Parkinson's. The emergence of the association between bacterial flora and lungs led to the discovery of the gut–lung axis. Dysbiosis of several species of colonic bacteria such as Firmicutes and Bacteroidetes and transfer of these bacteria from gut to lungs via lymphatic and systemic circulation are associated with several respiratory diseases such as lung cancer, asthma, tuberculosis, cystic fibrosis, etc. Current therapies for dysbiosis include use of probiotics, prebiotics and synbiotics to restore the balance between various species of beneficial bacteria. Various approaches like nanotechnology and microencapsulation have been explored to increase the permeability and viability of probiotics in the body. The need of the day is comprehensive study of mechanisms behind dysbiosis, translocation of microbiota from gut to lung through various channels and new technology for evaluating treatment to correct this dysbiosis which in turn can be used to manage various respiratory diseases. Microfluidics and organ on chip model are emerging technologies that can satisfy these needs. This review gives an overview of colonic commensals in lung pathology and novel systems that help in alleviating symptoms of lung diseases. We have also hypothesized new models to help in understanding bacterial pathways involved in the gut–lung axis as well as act as a futuristic approach in finding treatment of respiratory diseases caused by dysbiosis.

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