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Lucchino N, Pialat JB, Marquette C, Courtial E, Erhard L, Voulliaume D, Mojallal A, Gazarian A. 3D MODEL of an anatomically inert human hand: feasibility study. HAND SURGERY & REHABILITATION 2024:101709. [PMID: 38685316 DOI: 10.1016/j.hansur.2024.101709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES Surgery for congenital malformation of the hand is complex and protocols are not available. Simulation could help optimize results. The objective of the present study was to design, produce and assess a 3D-printed anatomical support, to improve success in rare and complex surgeries of the hand. MATERIAL AND METHODS We acquired MRI imaging of the right hand of a 30 year-old subject, then analyzed and split the various skin layers for segmentation. Thus we created the prototype of a healthy hand, using 3D multi-material and silicone printing devices, and drew up a printing protocol suitable for all patients. We printed a base comprising bones, muscles and tendons, with a multi-material 3D printer, then used a 3D silicone printer for skin and subcutaneous fatty cell tissues in a glove-like shape. To evaluate the characteristics of the prototype, we performed a series of dissections on the synthetic hand and on a cadaveric hand in the anatomy lab, comparing realism, ease of handling and the final result of the two supports, and evaluated their respective advantages in surgical and training contexts. A grading form was given to each surgeon to establish a global score. RESULTS This evaluation highlighted the positive and negative features of the model. The model avoided intrinsic problems of cadavers, such as muscle rigidity or tissue fragility and atrophy, and enables the anatomy of a specific patient to be rigorously respected. On the other hand, vascular and nervous networks, with their potential anatomical variants, are lacking. This preliminary phase highlighted the advantages and inconveniences of the prototype, to optimize the design and printing of future models. It is an indispensable prerequisite before performing studies in eligible pediatric patients with congenital hand malformation. CONCLUSION The validation of 3D-printed anatomical model of a human hand opens a large field of applications in the area of preoperative surgical planning. The postoperative esthetic and functional benefit of such pre-intervention supports in complex surgery needs assessing.
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Affiliation(s)
- Noé Lucchino
- Service de Chirurgie Plastique, Reconstructrice et Esthétique, Hôpital Saint Joseph Saint Luc, 20 Quai Claude Bernard, 69007 Lyon, France.
| | - Jean-Baptiste Pialat
- Department of Radiology, Groupement Hospitalier Sud, Hospices Civils de Lyon, CREATIS Université Lyon 1, CREATIS-LRMN, 69495 Pierre-Bénite, France
| | - Christophe Marquette
- 3D.FAB, Université Lyon, Université Lyon1, CNRS, INSA, CPE-Lyon, ICBMS, UMR 5246, 43, Bd du 11 Novembre 1918, 69622, Villeurbanne Cedex, France, CNRS/UMR/5220-INSERM U630, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Edwin Courtial
- 3D.FAB, Université Lyon, Université Lyon1, CNRS, INSA, CPE-Lyon, ICBMS, UMR 5246, 43, Bd du 11 Novembre 1918, 69622, Villeurbanne Cedex, France, CNRS/UMR/5220-INSERM U630, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Lionel Erhard
- Institut Chirurgical de la Main et du Membre Supérieur, 17 Avenue Condorcet 69100 Villeurbanne, France
| | - Delphine Voulliaume
- Service de Chirurgie Plastique, Reconstructrice et Esthétique, Hôpital Saint Joseph Saint Luc, 20 Quai Claude Bernard, 69007 Lyon, France
| | - Ali Mojallal
- Department of Plastic Reconstructive and Aesthetic Surgery, University of Lyon, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France
| | - Aram Gazarian
- Chirurgie de la Main et du Membre Supérieur, Polyclinique Orthopédique de Lyon, Lyon, France
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Hendrycks RJ, Reed ER, Graham EM, Patel NK, Rosales M, Mendenhall SD. Learning Curve of Wrist-level Tendon Repairs Using a Novel Tendon Stapler versus Traditional Suture Methods. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5167. [PMID: 37577245 PMCID: PMC10419657 DOI: 10.1097/gox.0000000000005167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/23/2023] [Indexed: 08/15/2023]
Abstract
Numerous effective techniques for primary tendon coaptations exist. However, these techniques are complex and require a substantial amount of training to become proficient. Recently, a novel tendon stapler device (TSD) was developed that could potentially diminish the discrepancies among surgeons of varying levels of training. We hypothesized that the TSD would be easier to learn and would demonstrate improved learning curve efficiencies across participants of differing tendon repair experience compared with traditional suture methods. Participants included a novice, intermediate, and expert in tendon repairs. Comparisons were performed on wrist-level flexors and extensors from human donor arms. The suture repairs were performed with a modified Kessler with a horizontal mattress and were performed in one session on two donor arms by each participant. In a second session, each participant performed the TSD repairs on the matched, contralateral donor arms. Scatterplots fitted with Loess curves, one-way analysis of variance, Tukey pairwise comparisons, two-sided independent samples t test, and Fisher exact test were used to analyze findings. Results of our study showed that TSD repair times did not vary significantly by experience level. Suture repairs reached a stable "learned" level around repair #30, whereas the TSD repairs showed a more efficient curve that stabilized around repair #23. The TSD required less educational time, demonstrated a more efficient learning curve, and showed less variability across participants and repair order. Overall, the TSD is easy to adopt and may carry positive implications for surgeons and patients.
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Affiliation(s)
- Russell J. Hendrycks
- From the Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Evelyn R. Reed
- From the Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Emily M. Graham
- From the Division of Plastic Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Niki K. Patel
- Division of Plastic, Reconstructive, and Oral Surgery, Division of Orthopaedic Surgery, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa
| | - Megan Rosales
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Shaun D. Mendenhall
- Division of Plastic, Reconstructive, and Oral Surgery, Division of Orthopaedic Surgery, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa
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Khoong YM, Luo S, Huang X, Li M, Gu S, Jiang T, Liang H, Liu Y, Zan T. The application of augmented reality in plastic surgery training and education: A narrative review. J Plast Reconstr Aesthet Surg 2023; 82:255-263. [PMID: 37207439 DOI: 10.1016/j.bjps.2023.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/29/2023] [Accepted: 04/08/2023] [Indexed: 05/21/2023]
Abstract
Continuing problems with fewer training opportunities and a greater awareness of patient safety have led to a constant search for an alternative technique to bridge the existing theory-practice gap in plastic surgery training and education. The current COVID-19 epidemic has aggravated the situation, making it urgent to implement breakthrough technological initiatives currently underway to improve surgical education. The cutting edge of technological development, augmented reality (AR), has already been applied in numerous facets of plastic surgery training, and it is capable of realizing the aims of education and training in this field. In this article, we will take a look at some of the most important ways that AR is now being used in plastic surgery education and training, as well as offer an exciting glimpse into the potential future of this field thanks to technological advancements.
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Affiliation(s)
- Yi Min Khoong
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Shenying Luo
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Xin Huang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Minxiong Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Shuchen Gu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Taoran Jiang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Hsin Liang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Yunhan Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China
| | - Tao Zan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, PR China.
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Cate G, Barnes CL, Dickinson KJ. Simulation training to retool practicing orthopedic surgeons is rare. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2023; 2:57. [PMID: 38013868 PMCID: PMC10203688 DOI: 10.1007/s44186-023-00136-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/05/2023] [Accepted: 05/14/2023] [Indexed: 11/29/2023]
Abstract
Purpose Modern surgical practice is continuously changing as technology develops. New techniques are often implemented after a surgeon has made the transition to independent clinical practice. There is therefore a need to 'retool' technical skills. Additionally, practicing surgeons must maintain and develop skills such as leadership, communication, critical thinking, teaching, and mentoring. Our aim was to perform a scoping review to assess the current status of simulation education for practicing Orthopedic Surgeons (OS). Methods A 10 year search of PubMed, ERIC, and Web of Science was performed with a medical librarian. Controlled vocabulary Medical Subject Headings terms and natural language were developed with subject matter experts describing simulation, training and OS. Two trained reviewers evaluated all abstracts for inclusion. Exclusion criteria were articles that did not assess simulation education involving practicing OS. Data were extracted from the included full text articles by two reviewers: details of study design, type of participants, type of simulation and role of OS in the educational event. Results Initial search identified 1824 articles of which 443 were duplicates, and 1381 articles were further screened. Of these, 1155 were excluded, 226 full text articles were assessed for eligibility and 80 included in analysis. Most were published in the last 6 years and from the United States. The majority (99%) described technical skill simulations (arthroscopy 56%, screw placement 23%, ligament reconstruction 19%). OS were rarely the only learners with 91% studies also having residents participate. OS were the targeted learner in 6% studies. OS provided content validity for 15 (19%) and construct validity in 59 (74%) studies. Conclusions Simulation training to educate practicing OS is rare. OS are often used to validate work rather than being the center of an educational endeavor. A refocusing is needed to provide adequate training for practicing surgeons to retool skills as new techniques become available.
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Affiliation(s)
- Graham Cate
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
| | - C. Lowry Barnes
- Department of Orthopedic Surgery, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Karen J. Dickinson
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
- Office of Interprofessional Education, University of Arkansas for Medical Sciences, Little Rock, USA
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR USA
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5
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Boere PM, Kachooei AR, Ilyas AM. Orthopaedic Hand Surgical Simulation Training: A Review. J Hand Microsurg 2023. [DOI: 10.1055/s-0043-1762895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
AbstractIn recent years, new orthopaedic surgical simulation and virtual reality (VR) training models have emerged to provide unlimited education medium to an unlimited number of trainees with no time limit, especially in response to trainee work-hour restrictions. Surgical simulators range from simple wooden boxes to animal and cadaver models to three-dimensional-printed and VR simulators. The coronavirus disease 2019 pandemic further highlighted the need for at-home learning tools for orthopaedic surgical trainees. Advancement in simulating shoulder and knee arthroscopies using VR simulators surpasses the other fields in orthopaedic surgery. Despite the high degree of precision needed to operate at a microscopic level involving vessels, nerves, and the small bones of the hand, the simulation tools have limited advancement in the field of orthopaedic hand surgery. This narrative review summarizes the status of surgical simulation and training techniques available to orthopaedic hand surgical trainees, factors affecting their application, and areas in hand surgery that still lag behind their surgical subspecialty counterparts.
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Affiliation(s)
- Payton M. Boere
- Department of Orthopaedics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Amir R. Kachooei
- Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Asif M. Ilyas
- Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
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Lang F, Willuth E, Haney CM, Felinska EA, Wennberg E, Kowalewski KF, Schmidt MW, Wagner M, Müller-Stich BP, Nickel F. Serious gaming and virtual reality in the multimodal training of laparoscopic inguinal hernia repair: a randomized crossover study. Surg Endosc 2023; 37:2050-2061. [PMID: 36289083 PMCID: PMC10017619 DOI: 10.1007/s00464-022-09733-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to assess the transferability of surgical skills for the laparoscopic hernia module between the serious game Touch Surgery™ (TS) and the virtual reality (VR) trainer Lap Mentor™. Furthermore, this study aimed to collect validity evidence and to discuss "sources of validity evidence" for the findings using the laparoscopic inguinal hernia module on TS. METHODS In a randomized crossover study, medical students (n = 40) in their clinical years performed laparoscopic inguinal hernia modules on TS and the VR trainer. TS group started with "Laparoscopic Inguinal Hernia Module" on TS (phase 1: Preparation, phase 2: Port Placement and Hernia Repair), performed the module first in training, then in test mode until proficiency was reached. VR group started with "Inguinal Hernia Module" on the VR trainer (task 1: Anatomy Identification, task 2: Incision and Dissection) and also performed the module until proficiency. Once proficiency reached in the first modality, the groups performed the other training modality until reaching proficiency. Primary endpoint was the number of attempts needed to achieve proficiency for each group for each task/phase. RESULTS Students starting with TS needed significantly less attempts to reach proficiency for task 1 on the VR trainer than students who started with the VR trainer (TS = 2.7 ± 0.6 vs. VR = 3.2 ± 0.7; p = 0.028). No significant differences for task 2 were observed between groups (TS = 2.3 ± 1.1 vs. VR = 2.1 ± 0.8; p = 0.524). For both phases on TS, no significant skill transfer from the VR trainer to TS was observed. Aspects of validity evidence for the module on TS were collected. CONCLUSION The results show that TS brought additional benefit to improve performances on the VR trainer for task 1 but not for task 2. Skill transfer from the VR trainer to TS could not be shown. VR and TS should thus be used in combination with TS first in multimodal training to ensure optimal training conditions.
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Affiliation(s)
- Franziska Lang
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - E Willuth
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - C M Haney
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - E A Felinska
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - E Wennberg
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - K F Kowalewski
- Department of Urology and Urological Surgery, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany
| | - M W Schmidt
- Department of Gynecology and Obstetrics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - M Wagner
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - B P Müller-Stich
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - F Nickel
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
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Shahid S, Saghir N, Saghir R, Young-Sing Q, Miranda BH. WALANT: A Discussion of Indications, Impact, and Educational Requirements. Arch Plast Surg 2022; 49:531-537. [PMID: 35919552 PMCID: PMC9340192 DOI: 10.1055/s-0042-1748659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.
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Affiliation(s)
- Shahab Shahid
- The Centre for Hand Surgery, St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, United Kingdom
| | - Noman Saghir
- Nightingale Breast Centre, Wythenshawe Hospital, Manchester, United Kingdom
| | - Reyan Saghir
- Department of Cardiology, Calderdale Royal Hospital, Halifax, United Kingdom
| | - Quillan Young-Sing
- The Centre for Hand Surgery, St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, United Kingdom
| | - Benjamin H Miranda
- The Centre for Hand Surgery, St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, United Kingdom.,St Andrew&s Anglia Ruskin (StAAR) Research Group, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, United Kingdom
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Saleem HY, Kaplan JL, Torres-Guzman RA, Avila FR, Forte AJ. Simulation in Hand Surgery: A Literature Review. World J Surg 2022; 46:718-724. [PMID: 34993601 DOI: 10.1007/s00268-021-06400-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Due to duty hour regulations, patient safety and inadequate operative time simulation have become a necessary part of surgical education and training in residency. Currently, there is no formal adoption of simulators for the use of surgical education or assessment in hand surgery. This literature review analyzes that the simulation techniques established thus far in hand surgery. METHODS A comprehensive literature search was performed on PubMed. Search results were filtered by title and abstract to isolate articles that were relevant to simulation in hand surgery. Articles that were nonspecific to the hand, non-English and cadaveric were excluded. Additional articles were identified through references from the initial search. RESULTS A total of 1192 articles were yielded from the initial query. After the application of the inclusion criteria, this was narrowed down to 28 articles. Another 8 additional articles were excluded as they did not pertain to the hand although the simulators could be adapted for hand surgery. A total of 20 articles were included in this study. CONCLUSIONS Surgical simulation is a growing and essential field of surgical education. Simulators in hand surgery are limited and require further research and validation. Like other surgical subspecialties, hand surgery may benefit from the adoption of an official simulation curriculum for the assessment of residents and enhancement of technical skills.
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Affiliation(s)
- Humza Y Saleem
- Department of Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Jamie L Kaplan
- Department of Surgery, Mayo Clinic, Jacksonville, FL, USA
| | | | - Francisco R Avila
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
| | - Antonio J Forte
- Division of Plastic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
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Dionisi S, Giannetta N, Di Simone E, Ricciardi F, Liquori G, De Leo A, Moretti L, Napoli C, Di Muzio M, Orsi GB. The Use of mHealth in Orthopedic Surgery: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12549. [PMID: 34886274 PMCID: PMC8657184 DOI: 10.3390/ijerph182312549] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 01/25/2023]
Abstract
(1) Background: It is well known that the success of surgical procedures is related to optimal postoperative management and follow-up. In this regard, mHealth technologies could potentially improve perioperative care. Based on these considerations, the objective of this scoping review is to evaluate the current status and use of mHealth interventions designed to provide perioperative care in orthopedic surgery. (2) Methods: This scoping review was conducted in accordance with the PRISMA statement (Extension for Scoping Review) and follows the framework of Arskey and O'Malley. (3) Results: The use of mHealth in the surgical setting is mainly oriented towards the development of applications for monitoring post-operative pain and optimizing communication between the various health professionals involved in patient care. (4) Conclusions: The mHealth systems can have a positive impact both on patient participation in the therapeutic process and on the communication between health professionals, increasing the quality of care.
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Affiliation(s)
- Sara Dionisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.D.); (G.L.); (A.D.L.)
| | - Noemi Giannetta
- Faculty of Philosophy, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Emanuele Di Simone
- Nursing, Technical, Rehabilitation, Assistance and Research Department, IRCCS Istituti Fisioterapici Ospitalieri—IFO, 00144 Rome, Italy;
| | - Francesco Ricciardi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (F.R.); (M.D.M.)
| | - Gloria Liquori
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.D.); (G.L.); (A.D.L.)
| | - Aurora De Leo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.D.); (G.L.); (A.D.L.)
| | - Lorenzo Moretti
- Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy;
| | - Christian Napoli
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy;
| | - Marco Di Muzio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (F.R.); (M.D.M.)
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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Hardy NP, Cahill RA. Digital surgery for gastroenterological diseases. World J Gastroenterol 2021; 27:7240-7246. [PMID: 34876786 PMCID: PMC8611203 DOI: 10.3748/wjg.v27.i42.7240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/27/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023] Open
Abstract
Advances in machine learning, computer vision and artificial intelligence methods, in combination with those in processing and cloud computing capability, portend the advent of true decision support during interventions in real-time and soon perhaps in automated surgical steps. Such capability, deployed alongside technology intraoperatively, is termed digital surgery and can be delivered without the need for high-end capital robotic investment. An area close to clinical usefulness right now harnesses advances in near infrared endolaparoscopy and fluorescence guidance for tissue characterisation through the use of biophysics-inspired algorithms. This represents a potential synergistic methodology for the deep learning methods currently advancing in ophthalmology, radiology, and recently gastroenterology via colonoscopy. As databanks of more general surgical videos are created, greater analytic insights can be derived across the operative spectrum of gastroenterological disease and operations (including instrumentation and operative step sequencing and recognition, followed over time by surgeon and instrument performance assessment) and linked to value-based outcomes. However, issues of legality, ethics and even morality need consideration, as do the limiting effects of monopolies, cartels and isolated data silos. Furthermore, the role of the surgeon, surgical societies and healthcare institutions in this evolving field needs active deliberation, as the default risks relegation to bystander or passive recipient. This editorial provides insight into this accelerating field by illuminating the near-future and next decade evolutionary steps towards widespread clinical integration for patient and societal benefit.
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Affiliation(s)
- Niall Philip Hardy
- UCD Centre for Precision Surgery, University College Dublin, Dublin D07 Y9AW, Ireland
| | - Ronan Ambrose Cahill
- UCD Centre for Precision Surgery, University College Dublin, Dublin D07 Y9AW, Ireland
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Harsten R, Papavasiliou T, Uppal L. Simulation training in hand surgery - where are we now and where should we be? EUROPEAN JOURNAL OF PLASTIC SURGERY 2021; 44:853-854. [PMID: 34539082 PMCID: PMC8441041 DOI: 10.1007/s00238-021-01887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/06/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Rebecca Harsten
- Department of Plastic Surgery, Royal London Hospital, Whitechapel Rd, Whitechapel, London, E1 1FR UK
| | - Theodora Papavasiliou
- Department of Plastic Surgery, Guys' and St' Thomas' Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
| | - Lauren Uppal
- Department of Plastic Surgery, Guys' and St' Thomas' Hospitals, Westminster Bridge Rd, Lambeth, London, SE1 7EH UK
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12
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Impact of the internet on veterinary surgery. Vet Anim Sci 2020; 11:100161. [PMID: 33511303 PMCID: PMC7816005 DOI: 10.1016/j.vas.2020.100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 11/20/2022] Open
Abstract
The advent of the internet, and the technological innovations associated with it, have driven significant advances in surgical teaching and learning. The ease of access to information and the variety of online resources allow rapid sharing of surgical knowledge, promoting new teaching and learning patterns. Educational content from online platforms adds theoretical and practical knowledge to accelerate the learning curve and continuing education of surgeons. This study reviews how the advent of the Internet has influenced the teaching and dissemination of knowledge in veterinary surgery.
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McKnight RR, Pean CA, Buck JS, Hwang JS, Hsu JR, Pierrie SN. Virtual Reality and Augmented Reality-Translating Surgical Training into Surgical Technique. Curr Rev Musculoskelet Med 2020; 13:663-674. [PMID: 32779019 PMCID: PMC7661680 DOI: 10.1007/s12178-020-09667-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW As immersive learning outside of the operating room is increasingly recognized as a valuable method of surgical training, virtual reality (VR) and augmented reality (AR) are increasingly utilized in orthopedic surgical training. This article reviews the evolving nature of these training tools and provides examples of their use and efficacy. The practical and ethical implications of incorporating this technology and its impact on both orthopedic surgeons and their patients are also discussed. RECENT FINDINGS Head-mounted displays (HMDs) represent a possible adjunct to surgical accuracy and education. While the hardware is advanced, there is still much work to be done in developing software that allows for seamless, reliable, useful integration into clinical practice and training. Surgical training is changing: AR and VR will become mainstays of future training efforts. More evidence is needed to determine which training technology translates to improved clinical performance. Volatility within the HMD industry will likely delay advances in surgical training.
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Affiliation(s)
- R Randall McKnight
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1001 Blythe Blvd, Charlotte, NC, 28203, USA.
| | - Christian A Pean
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA
| | - J Stewart Buck
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1001 Blythe Blvd, Charlotte, NC, 28203, USA
| | - John S Hwang
- Department of Orthopedic Surgery, Mount Carmel, Columbus, OH, USA
- Department of Orthopedic Surgery, Orthopedic ONE, Columbus, OH, USA
| | - Joseph R Hsu
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 1001 Blythe Blvd, Charlotte, NC, 28203, USA
| | - Sarah N Pierrie
- Department of Orthopaedics and Center for the Intrepid, San Antonio Military Medical Center, Fort Sam Houston, TX, USA
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Dickinson KJ, Bass BL. A Systematic Review of Educational Mobile-Applications (Apps) for Surgery Residents: Simulation and Beyond. JOURNAL OF SURGICAL EDUCATION 2020; 77:1244-1256. [PMID: 32307244 DOI: 10.1016/j.jsurg.2020.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/29/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The number of mobile-applications (Apps) increases daily. The regulation of App content is minimal yet surgical residents use these in daily educational practice. Surgical educators must be aware of the quality, efficacy, and validity of Apps available to effectively educate residents. The aim of this review was to determine the quality, efficacy, and validity evidence for educational Apps used by surgical residents. MATERIALS AND METHODS We searched PubMed, Embase, and ERIC for articles published before September 1, 2019. Controlled vocabulary and natural language describing Apps/surgical residents were used. Two reviewers evaluated abstracts for inclusion. INCLUSION CRITERIA studies measuring the quality, efficacy, or validity of educational Apps for surgical residents. Data was extracted from full text of included articles: study design, participants, App investigated, App development, evidence for efficacy, or validity of App. RESULTS Initial search identified 278 articles. 64 articles were duplicates and 214 articles were screened. A further 156 were excluded with 58 full text articles assessed for eligibility. Forty-five were included in analysis. Simulation (9/45) and Feedback (15/45) Apps were the most commonly studied in surgical residents. These were the main Apps that provided validity evidence for their use in education. CONCLUSION Surgical education is evolving as educational technology becomes more prevalent. To be effective as surgical educators we must understand and appropriately use available tools. Of the educational Apps studied (21 Apps in 8 categories), only 3 categories reported validity evidence. Future studies should take care to measure validity and efficacy of educational Apps for surgical education to ensure quality control.
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Affiliation(s)
| | - Barbara L Bass
- Department of Surgery, Houston Methodist Hospital, Houston, Texas
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Lap Nicholas Tsang C, Cao J, Sugand K, Chiu J, Casper Pretorius F. Face, content, construct validity and training effect of touch surgery™ as a surgical decision-making trainer for novices in open appendicectomy. Int J Surg Protoc 2020; 22:19-23. [PMID: 32671311 PMCID: PMC7348480 DOI: 10.1016/j.isjp.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/25/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Laparoscopic surgery has become the gold standard for many operations with significant benefits in morbidity and hospital recovery time. One such procedure is appendicectomy, which is overwhelmingly performed using the laparoscopic approach in the modern era. This has also meant that the number of cases involving traditional open appendicectomy has declined despite surgeons being expected to be able to convert to the open technique if required. One method to rehearse for theatre is the use of software applications. This paper investigates the validity of Touch Surgery™ as an education tool for surgical decision-making for novices, as well as its training effect in open appendicectomy. METHOD 70 participants will be recruited, consisting of 60 medical students (novices) and 10 surgical consultants (experts). For face, content, and construct validity, first attempt scores on the Touch Surgery™ Open Appendicectomy Test Module will be compared between novices and experts. For the training effect and knowledge decline elements of the study, novices will be further randomised into either the low intervention (control) group who will complete the simulation once, or to the high intervention group who will complete the simulation six times, with both novice groups asked to repeat the test one week later. All participants will also be requested to complete questionnaires regarding the stimulation.
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Affiliation(s)
| | - Jerry Cao
- Department of Surgery, Wollongong Hospital, NSW, Australia
| | - Kapil Sugand
- Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, United Kingdom
| | - Jacqui Chiu
- Faculty of Medicine, University of Queensland, QLD, Australia
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Abstract
Hand trauma surgical treatment and perioperative therapy are often lacking in low- and middle-income countries resulting in high rates of patient morbidity following injury. Providing education through a multifaceted approach including in-person teaching, written resources, videos, and Internet and social media platforms and facilitating skill acquisition through simulation permits local providers to gain expertise in hand trauma care and thus benefits patients. This article outlines challenges faced by low- and middle-income countries in caring for hand trauma patients and possible implementable solutions.
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Affiliation(s)
- Kate Elzinga
- Section of Plastic Surgery, University of Calgary, South Health Campus, 4448 Front St SE, Calgary, Alberta T3M 1M4, Canada.
| | - Kevin C Chung
- Section of Plastic Surgery, The University of Michigan Medical School, The University of Michigan Health System, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-0340, USA
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Al-Obaidi B, Babu S, Al-Hadithy N. Smartphones in orthopaedics: a decade of innovation. Br J Hosp Med (Lond) 2019; 80:274-277. [DOI: 10.12968/hmed.2019.80.5.274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Smartphones have become a mainstream feature in medicine since the introduction of the Apple iPhone in 2007. Over the last decade they have taken on increasing prominence with multiple uses in daily practice. They have long been used for group messaging and accessing patient's electronic records while mobile. More recently, however, smartphones have allowed clinicians to improve patient assessment in clinic and manage follow-up appointments remotely. Furthermore they have been used to aid procedural tasks in surgery and provide a medium for simulation training for junior doctors. The role of smartphones in the future is predicted to increase exponentially and there will no doubt be countless further roles for them in the ever-expanding field of orthopaedics.
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Affiliation(s)
- Bilal Al-Obaidi
- Orthopaedic Registrar, Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, London
| | - Satish Babu
- Orthopaedic Registrar, Department of Trauma and Orthopaedics, Frimley Park Hospital, Camberley GU16 7UJ
| | - Nawfal Al-Hadithy
- Upper Limb Fellow, Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge
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