318 research outputs found
Laparoscopic resection of colon cancer. Consensus of European Association of Endoscopic Surgery (E.A.E.S.).
No full textErgonomics in the operating room: transition from open to image-based surgery
No full textAt several specializations, more often minimal invasive procedures are performed instead of open surgery. Laparoscopy is a minimal invasive technique, which is carried out in the abdominal cavity. In spite of the fact that surgical principles are the same for open and laparoscopic procedures, laparoscopy has changed the way of interaction between the surgical team and the operating field in many ways. These changes however have not led to the required adaptations in the operation room to improve the surgical quality and to optimize the work conditions of the surgical team. In this respect, ergonomics can play a role to fit the work environment to the user and improve the surgical quality accordingly. The aim of this thesis is to improve the surgical quality by applying ergonomics (physical, sensory and cognitive) in the operating room. This thesis discusses different studies. The current situation in the Dutch hospitals concerning ergonomics and the aptitude of the operating rooms for laparoscopy is mapped out. Furthermore, in the field of physical ergonomics a product solution, which reduces the physical complaints and the discomfort that the surgical team experiences during procedures, is proposed and evaluated. Subsequently, the sensorial and cognitive aspects of laparoscopic procedures and in particular the image quality during laparoscopic surgery are assessed. This study consists of objective and subjective measurements in thirty-six Dutch hospitals. At last, the results are translated into solutions and methods, which can be applied both by the designers and by the surgical team.Industrial Design Engineerin
Hand-eye coordination in minimally invasive surgery: Theory, surgical practice & training
No full textMechanical Maritime and Materials Engineerin
Changing patterns in the management of gastric volvulus over 14 years - Authors' reply
No full textAbstract
Changing patterns in the management of gastric volvulus over 14 years
Authors' reply : D. I. Watson, P. G. Devitt, Department of Surgery, The University of Adelaide, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula
P. K Amid, Lichtenstein Hernia Institute, 9201 Sunset Boulevard, Suite 505, Los Angeles, CA 90069, USA
Authors' reply : W. W. Vrijland, H. J. Bonjer, Department of General Surgery, University Hospital Rotterdam-Dijkzigt, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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The value of force and torque measurements in transanal total mesorectal excision (TaTME)
No full textBackground: Transanal total mesorectal excision (TaTME) is associated with a relatively long learning curve. Force, motion, and time parameters are increasingly used for objective assessment of skills to enhance laparoscopic training efficacy. The aim of this study was to identify relevant metrics for accurate skill assessment in more complex transanal purse-string suturing. Methods: A box trainer was designed for TaTME and equipped with two custom made multi-DOF force/torque sensors. These sensors measured the applied forces in the axial direction of the instruments (Fz), instrument load orientation expressed in torque (Mx and My) on the entrance port, and the full tissue interaction force (Fft) at the intestine fixation point. In a construct validity study, novices for TaTME performed a purse-string suture to investigate which parameters can be used best to identify meaningful events during tissue manipulation and instrument handling. Results: Significant differences exist between pre- and post-training assessment for the mean axial force at the entrance port Fz (p = 0.01), mean torque in the entrance port Mx (p = 0.03) and mean force on the intestine during suturing Fft (p = 0.05). Furthermore, force levels during suturing exceed safety threshold values, potentially leading to dangerous complications such as rupture of the rectum. Conclusions: Forces and torque measured at the entrance port, and the tissue interaction force signatures provide detailed insight into instrument handling, instrument loading, and tissue handling during purse-string suturing in a TaTME training setup. This newly developed training setup for single-port laparoscopy that enables objective feedback has the potential to enhance surgical training in TaTME.Medical Instruments & Bio-Inspired Technolog
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