Harnessing Technology for Evidence Based Education and Training in Minimally Invasive Surgery. Addendum

2006 ◽  
Author(s):  
C. D. Smith
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Education And Training ◽  
Evidence Based ◽  
And Training

scholarly journals An evidence-based review of enhanced recovery interventions in knee replacement surgery

2013 ◽  
Vol 95 (6) ◽  
pp. 386-389 ◽  
Author(s):  
MS Ibrahim ◽  
S Alazzawi ◽  
I Nizam ◽  
FS Haddad
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Knee Replacement ◽  
Invasive Surgery ◽  
Enhanced Recovery ◽  
Surgical Techniques ◽  
Cochrane Library ◽  
Computer Assisted ◽  
Evidence Based ◽  
Healthcare Budget

Introduction Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient’s postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. Methods A thorough literature search of the electronic healthcare databases (MEDLINE®, Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. Results A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Conclusions Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements.

A Sensorized Instrument for Skills Assessment and Training in Minimally Invasive Surgery

2009 ◽  
Vol 3 (4) ◽  
Author(s):  
A. L. Trejos ◽  
R. V. Patel ◽  
M. D. Naish ◽  
A. C. Lyle ◽  
C. M. Schlachta
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Tracking System ◽  
The Body ◽  
Skills Assessment ◽  
Training Methods ◽  
Laparoscopic Instrument ◽  
Rms Error ◽  
And Training

Minimally invasive surgery (MIS) is carried out using long, narrow instruments and significantly reduces trauma to the body, postoperative pain, and recovery time. Unfortunately, the restricted access conditions, limited instrument motion, and degraded sense of touch inherent in MIS result in new perceptual-motor relationships, which are unfamiliar to the surgeon and require training to overcome. Current training methods do not adequately address the needs of surgeons interested in acquiring these skills. Although a significant amount of research has been focused on the development of sensorized systems for surgery, there is still a need for a system that can be used in any training scenario (laparoscopic trainer, animal laboratories, or real surgery) for the purpose of skills assessment and training. A sensorized laparoscopic instrument has been designed that is capable of noninvasively measuring its interaction with tissue in the form of forces or torques acting in all five degrees-of-freedom (DOFs) available during MIS. Strain gauges attached to concentric shafts within the instrument allow the forces acting in different directions to be isolated. An electromagnetic tracking system is used for position tracking. Two prototypes of the sensorized instrument were constructed. Position calibration shows a maximum root mean square (RMS) error of 1.3 mm. The results of the force calibration show a maximum RMS error of 0.35 N for the actuation force, 0.07 N in the x and y directions, and 1.5 N mm for the torque calibration with good repeatability and low hysteresis. Axial measurements were significantly affected by drift, noise, and coupling leading to high errors in the readings. Novel sensorized instruments for skills assessment and training have been developed and a patent has been filed for the design and operation. The instruments measure forces and torques acting at the tip of the instrument corresponding to all five DOFs available during MIS and provide position feedback in six DOFs. The instruments are similar in shape, size, and weight to traditional laparoscopic instruments allowing them to be used in any training environment. Furthermore, replaceable tips and handles allow the instruments to be used for a variety of different tasks.

scholarly journals Minimally Invasive Surgery for Hepatocellular Carcinoma; Latest Advances

2021 ◽  
Author(s):  
Alexandros Giakoustidis ◽  
Apostolos Koffas ◽  
Dimitrios Giakoustidis ◽  
Vasileios N. Papadopoulos
Keyword(s):  
Hepatocellular Carcinoma ◽  
Minimally Invasive Surgery ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Gold Standard ◽  
Operative Care ◽  
And Training ◽  
Selection Of Patients ◽  
Selection Of

Surgical resection is the gold standard for hepatocellular carcinoma management for early stages of the disease. With advances in technology and techniques, minimally invasive surgery provides a great number of advantages for these patients during their surgery and for their post-operative care. The selection of patients following a multi-disciplinary approach is of paramount importance. Adding to this, the developments in laparoscopic instruments and training, as well as the promising advantages of robotic surgery along with other forms of technology, increase the pool of patients that can undergo operation safely and with good results worldwide. We review results from great centres worldwide and delineate the accurate multi-disciplinary approach for this.

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