Transferability of Simulation-Based Training in Laparoscopic Surgeries: A Systematic Review

Objective. The implementation of simulation-based training in residency programs has been increased, but the transferability of surgical skills in the real operating room is not well documented. In our survey, the role of simulation in surgical training will be evaluated. Study Design. In this systemic review, randomized control trials, which assessed the transferability of acquired skills through simulation in the real operating setting, were included. A systematic search strategy was undertaken using a predetermined protocol. Results. Eighteen randomized clinical trials were included in this survey. Two studies investigated inguinal hernia repair, six laparoscopic cholecystectomy, five gynecologic procedures, two laparoscopic suturing, and two camera navigation during laparoscopic procedures. Simulation-trained participants showed superiority in surgical performance in comparison with untrained surgeons. The operation time, accuracy, incidence of intraoperative errors, and postoperative complications were statistically better in the simulation-trained group in comparison with the conventional-trained group. Conclusion. Simulation provides a safe, effective, and ethical way for residents to acquire surgical skills before entering the operating room.

Quality-based assessment of camera navigation skills for laparoscopic fundoplication

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.

An Investigation Tool for Mounting Sustainable Practice

Smart mobile devices of the present era offer many services i.e. SMS, gaming, a camera, navigation, the Internet, television, etc., and their utilization has significantly risen during the last decades. Today, individuals are addicted to mobiles and cannot think of living without using them. Conversely, these mobiles become obsolete due to certain shortcomings and are eventually replaced with new ones and thus create e-waste, which are alarmed as threat to the society. In this work, the authors describe mobiles and e-waste in a closed loop structure for supporting green issues. The work has rooted generalized interval-valued trapezoidal fuzzy numbers (GIVTFNs) with a degree of similarity measure approach to model the rationale and to furnish decision results. The authors developed a decision support system to prevent e-waste by defining significant inadequacy liable for the larger alteration of working mobiles. The present study demonstrates the technical model under an Indian context to verify its applicability, but it can be used it under any regional or worldwide scenario.

Descent trajectory reconstruction and landing site positioning of Chang’E-4 on the lunar farside

Chang’E-4 (CE-4) was the first mission to accomplish the goal of a successful soft landing on the lunar farside. The landing trajectory and the location of the landing site can be effectively reconstructed and determined using series of images obtained during descent when there were no Earth-based radio tracking and the telemetry data. Here we reconstructed the powered descent trajectory of CE-4 using photogrammetrically processed images of the CE-4 landing camera, navigation camera, and terrain data of Chang’E-2. We confirmed that the precise location of the landing site is 177.5991°E, 45.4446°S with an elevation of −5935 m. The landing location was accurately identified with lunar imagery and terrain data with spatial resolutions of 7 m/p, 5 m/p, 1 m/p, 10 cm/p and 5 cm/p. These results will provide geodetic data for the study of lunar control points, high-precision lunar mapping, and subsequent lunar exploration, such as by the Yutu-2 rover.