Journal articles on the topic 'Anatomical simulator'
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Corte, Giuliano M., Melanie Humpenöder, Marcel Pfützner, Roswitha Merle, Mechthild Wiegard, Katharina Hohlbaum, Ken Richardson, Christa Thöne-Reineke, and Johanna Plendl. "Anatomical Evaluation of Rat and Mouse Simulators for Laboratory Animal Science Courses." Animals 11, no. 12 (December 1, 2021): 3432. http://dx.doi.org/10.3390/ani11123432.
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According to the European Directive 63/2010/EU, education and training involving living rats and mice are classified as an animal experiment and demands the implementation of the 3Rs. Therefore, as a method of refinement, rat and mouse simulators were developed to serve as an initial training device for various techniques, prior to working on living animals. Nevertheless, little is known about the implementation, anatomical correctness, learning efficiency and practical suitability of these simulators. With this in mind, a collaborative research project called “SimulRATor” was initiated to systematically evaluate the existing rat and mouse simulators in a multi-perspective approach. The objective of the study presented here was to identify the anatomical strengths and weaknesses of the available rat and mouse simulators and to determine anatomical requirements for a new anatomically correct rat simulator, specifically adapted to the needs of Laboratory Animal Science (LAS) training courses. Consequently, experts of Veterinary Anatomy and LAS evaluated the anatomy of all currently available rat and mouse simulators. The evaluation showed that compared to the anatomy of living rats and mice, the tails were perceived as the most anatomically realistic body part, followed by the general exterior and the limbs. The heads were rated as the least favored body part.
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Coelho, Giselle, Samuel Zymberg, Marcos Lyra, Nelci Zanon, and Benjamin Warf. "New anatomical simulator for pediatric neuroendoscopic practice." Child's Nervous System 31, no. 2 (September 3, 2014): 213–19. http://dx.doi.org/10.1007/s00381-014-2538-9.
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White, Eoin, Muireann McMahon, Michael Walsh, J. Calvin Coffey, and Leonard O’Sullivan. "Creating Biofidelic Phantom Anatomies of the Colorectal Region for Innovations in Colorectal Surgery." Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care 3, no. 1 (June 2014): 277–82. http://dx.doi.org/10.1177/2327857914031045.
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The aim of this research was to develop a replicated colorectal region for use in laparoscopic instrument innovation.Testing of both surgical skills and laparoscopic surgical instruments takes place in a controlled lab setting. Cadaverous tissue or laparoscopic simulators are the tools of choice for skill testing.However, in the instance of colorectal surgery, porcine intestines remain the gold standard for laparoscopic testing(Lamata et al. 2004). There exists data in current literature which discuss the use of anatomical simulators (also known as simulator boxes) for both researching surgical methods, and testing laparoscopic instruments. There is little focus in the literature on the materials used to create surrogate environments which mimic those of the real world. Simulator boxes exist, and are of high fidelity, but can be quite cumbersome, with some being left in storage areas indefinitely, with some remaining inaccessible for many centers around the world. There are also many peripheral devices which need to accompany these simulators, such as laparoscopes and external monitoring equipment for recording and review. As they are highly specialized pieces of research equipment, in the majority of cases, they are not designed to be portable or readily reconfigurable. These limitations make high end laparoscopic simulators inappropriate choices for early stage HFE (Human Factors Engineering) studies.The authors propose the creation of a laparoscopic simulator which contains anatomically accurate, 3D printed colorectal sections for use in both surgical training and instrument innovation. The colon is modeled from high quality CT data in DICOM format, using the Material Mimics Innovation Suite (Materialise, 2013). By creating virtual models of the internal anatomical structure of the colorectal region, it allows for a more accurate depiction of the anatomy encountered in a surgical setting. A maximum level of realism is required for a simulator to be effective(Lamata et al. 2004).The future application of this work lies in the validation of the 3D printed anatomy which will lead to innovation of new instruments or approaches to laparoscopic surgery.
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Venne, Gabriel, Greg Esau, Ryan T. Bicknell, and J. Tim Bryant. "3D Printed Anatomy-Specific Fixture for Consistent Glenoid Cavity Position in Shoulder Simulator." Journal of Healthcare Engineering 2018 (October 9, 2018): 1–6. http://dx.doi.org/10.1155/2018/2572730.
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Purpose. Fixation methods for consistent anatomical structure positioning in biomechanical testing can be challenging. Image-based 3D printing is an attractive method for fabrication of biomechanical supports of anatomical structure due to its ability to precisely locate anatomical features with respect to the loading system. Method. A case study is presented to provide a design guide for fixation block fabrication. The anatomy of interest was CT scanned and reconstructed in 3D. The model was imported into commercially available CAD software and modified into a solid object and to create the fixture block. The CAD fixture block is standardized such that anatomical features are always in the same position for the testing system by subtracting the anatomy from a base fixture block. Results. This method allowed a strong immobilization of anatomical specimens and a controlled and consistent positioning feature with respect to the testing system. Furthermore, the fixture block can be easily modified and adapted to anatomical structures of interest using CAD software. Conclusion. This approach allows preservation of the bony anatomy integrity and provides a repeatable and consistent anatomical positioning with respect to the testing system. It can be adapted for other anatomical structures in various other biomechanical settings.
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Makic, Mary Beth Flynn, Karen Lovett, and M. Fareedul Azam. "Placement of an Esophageal Temperature Probe by Nurses." AACN Advanced Critical Care 23, no. 1 (January 1, 2012): 24–31. http://dx.doi.org/10.4037/nci.0b013e31823324f3.
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Background Current guidelines support therapeutic hypothermia after cardiac arrest. An esophageal temperature probe (ETP) provides a core temperature assessment; however, accurate placement is necessary. Objectives To demonstrate accurate placement of an ETP and evaluate the effectiveness of high-fidelity simulation with anatomic imaging. Methods Registered nurses (RNs) were educated using 3-dimensional, high-fidelity simulation with VH Dissector technology (Touch of Life Technologies, Aurora, Colorado) to demonstrate ETP placement. The RNs provided survey responses on the effectiveness of simulation before and after using the simulator. Results Thirty-two RNs participated and did not demonstrate difficulties with the skill; however, 53.1% required more than 1 attempt for accurate placement in the distal esophagus. Survey results found that participants had increased confidence and high satisfaction with simulation and 3-dimensional imaging (P < .001). Conclusions Literature is lacking to guide ETP placement. In this study, RNs overestimated the depth for ETP insertion. Accurate temperature readings are highly dependent on accurate anatomical location placement. Providing skill competency training that incorporated anatomical imaging technology enhanced RNs’ awareness for effective skill acquisition.
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Tai, Bruce L., Deborah Rooney, Francesca Stephenson, Peng-Siang Liao, Oren Sagher, Albert J. Shih, and Luis E. Savastano. "Development of a 3D-printed external ventricular drain placement simulator: technical note." Journal of Neurosurgery 123, no. 4 (October 2015): 1070–76. http://dx.doi.org/10.3171/2014.12.jns141867.
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In this paper, the authors present a physical model developed to simulate accurate external ventricular drain (EVD) placement with realistic haptic and visual feedbacks to serve as a platform for complete procedural training. Insertion of an EVD via ventriculostomy is a common neurosurgical procedure used to monitor intracranial pressures and/or drain CSF. Currently, realistic training tools are scarce and mainly limited to virtual reality simulation systems. The use of 3D printing technology enables the development of realistic anatomical structures and customized design for physical simulators. In this study, the authors used the advantages of 3D printing to directly build the model geometry from stealth head CT scans and build a phantom brain mold based on 3D scans of a plastinated human brain. The resultant simulator provides realistic haptic feedback during a procedure, with visualization of catheter trajectory and fluid drainage. A multiinstitutional survey was also used to prove content validity of the simulator. With minor refinement, this simulator is expected to be a cost-effective tool for training neurosurgical residents in EVD placement.
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Robberecht, L., F. Chai, M. Dehurtevent, P. Marchandise, T. Bécavin, J. C. Hornez, and E. Deveaux. "A novel anatomical ceramic root canal simulator for endodontic training." European Journal of Dental Education 21, no. 4 (May 5, 2016): e1-e6. http://dx.doi.org/10.1111/eje.12207.
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Breimer, Gerben E., Vivek Bodani, Thomas Looi, and James M. Drake. "Design and evaluation of a new synthetic brain simulator for endoscopic third ventriculostomy." Journal of Neurosurgery: Pediatrics 15, no. 1 (January 2015): 82–88. http://dx.doi.org/10.3171/2014.9.peds1447.
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OBJECT Endoscopic third ventriculostomy (ETV) is an effective but technically demanding procedure with significant risk. Current simulators, including human cadavers, animal models, and virtual reality systems, are expensive, relatively inaccessible, and can lack realistic sensory feedback. The purpose of this study was to construct a realistic, low-cost, reusable brain simulator for ETV and evaluate its fidelity. METHODS A brain silicone replica mimicking normal mechanical properties of a 4-month-old child with hydrocephalus was constructed, encased in the replicated skull, and immersed in water. Realistic intraventricular landmarks included the choroid plexus, veins, mammillary bodies, infundibular recess, and basilar artery. The thinned-out third ventricle floor, which dissects appropriately, is quickly replaceable. Standard neuroendoscopic equipment including irrigation is used. Bleeding scenarios are also incorporated. A total of 16 neurosurgical trainees (Postgraduate Years 1–6) and 9 pediatric and adult neurosurgeons tested the simulator. All participants filled out questionnaires (5-point Likert-type items) to rate the simulator for face and content validity. RESULTS The simulator is portable, robust, and sets up in minutes. More than 95% of participants agreed or strongly agreed that the simulator's anatomical features, tissue properties, and bleeding scenarios were a realistic representation of that seen during an ETV. Participants stated that the simulator helped develop the required hand-eye coordination and camera skills, and the training exercise was valuable. CONCLUSIONS A low-cost, reusable, silicone-based ETV simulator realistically represents the surgical procedure to trainees and neurosurgeons. It can help them develop the technical and cognitive skills for ETV including dealing with complications.
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Panova, I. A., E. A. Rokotyanskaya, L. A. Sytova, and L. M. Salakhova. "Effectiveness of Using a Uterine Trainer for Teaching Surgical Hemostasis Skills." Virtual Technologies in Medicine 1, no. 3 (September 17, 2021): 161–62. http://dx.doi.org/10.46594/2687-0037_2021_3_1360.
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The use of the uterus simulator for teaching the surgical skills of performing surgery in case of ingrown placenta and surgical hemostasis in postpartum hemorrhage (patent No. 198996), which is a model of the uterus with anatomical landmarks and simulates a severe complication of pregnancy — ingrowth of the placenta, allows to increase the self-esteem of obstetricians-gynecologists in performing skills of surgical hemostasis.
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Lindquist, Nathan R., Matthew Leach, Matthew C. Simpson, and Jastin L. Antisdel. "Evaluating Simulator-Based Teaching Methods for Endoscopic Sinus Surgery." Ear, Nose & Throat Journal 98, no. 8 (April 24, 2019): 490–95. http://dx.doi.org/10.1177/0145561319844742.
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A multitude of simulator systems for endoscopic sinus surgery (ESS) are available as training tools for residents preparing to enter the operating room. These include human cadavers, virtual reality, realistic anatomic models, and low-fidelity gelatin molds. While these models have been validated and evaluated as independent tools for surgical trainees, no study has performed direct comparison of their outcomes. To address this deficiency, we aimed to evaluate the utility of high-fidelity and low-fidelity trainers as compared to a traditional control (no simulator exposure) for novice trainees acquiring basic ESS skills. Thirty-four first-year medical students were randomized to 3 groups and taught basic sinus anatomy and instrumentation. Two groups received training with either the high-fidelity or low-fidelity trainer, while 1 group served as control. These groups were then tested with cadaveric specimens. These sessions were recorded and graded by an expert. There was no statistical difference in performance between the 3 study groups with regard to identification of anatomy, endoscopic competency, or completion of basic tasks. When the high-fidelity and low-fidelity arms were grouped into a single “trained” cohort, they demonstrated significantly improved time to completion for basic anatomy ( P = .043) and total time ( P = .041). This is the first study to perform a direct comparison of performance between high-fidelity and low-fidelity ESS simulators and controls. Although we found no difference in performance of novice trainees with regard to basic anatomical identification or procedural tasks associated with ESS, the use of ESS simulators may improve time to completion.
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Condino, Sara, Giuseppe Turini, Paolo D. Parchi, Rosanna M. Viglialoro, Nicola Piolanti, Marco Gesi, Mauro Ferrari, and Vincenzo Ferrari. "How to Build a Patient-Specific Hybrid Simulator for Orthopaedic Open Surgery: Benefits and Limits of Mixed-Reality Using the Microsoft HoloLens." Journal of Healthcare Engineering 2018 (November 1, 2018): 1–12. http://dx.doi.org/10.1155/2018/5435097.
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Orthopaedic simulators are popular in innovative surgical training programs, where trainees gain procedural experience in a safe and controlled environment. Recent studies suggest that an ideal simulator should combine haptic, visual, and audio technology to create an immersive training environment. This article explores the potentialities of mixed-reality using the HoloLens to develop a hybrid training system for orthopaedic open surgery. Hip arthroplasty, one of the most common orthopaedic procedures, was chosen as a benchmark to evaluate the proposed system. Patient-specific anatomical 3D models were extracted from a patient computed tomography to implement the virtual content and to fabricate the physical components of the simulator. Rapid prototyping was used to create synthetic bones. The Vuforia SDK was utilized to register virtual and physical contents. The Unity3D game engine was employed to develop the software allowing interactions with the virtual content using head movements, gestures, and voice commands. Quantitative tests were performed to estimate the accuracy of the system by evaluating the perceived position of augmented reality targets. Mean and maximum errors matched the requirements of the target application. Qualitative tests were carried out to evaluate workload and usability of the HoloLens for our orthopaedic simulator, considering visual and audio perception and interaction and ergonomics issues. The perceived overall workload was low, and the self-assessed performance was considered satisfactory. Visual and audio perception and gesture and voice interactions obtained a positive feedback. Postural discomfort and visual fatigue obtained a nonnegative evaluation for a simulation session of 40 minutes. These results encourage using mixed-reality to implement a hybrid simulator for orthopaedic open surgery. An optimal design of the simulation tasks and equipment setup is required to minimize the user discomfort. Future works will include Face Validity, Content Validity, and Construct Validity to complete the assessment of the hip arthroplasty simulator.
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Licci, Maria, Florian M. Thieringer, Raphael Guzman, and Jehuda Soleman. "Development and validation of a synthetic 3D-printed simulator for training in neuroendoscopic ventricular lesion removal." Neurosurgical Focus 48, no. 3 (March 2020): E18. http://dx.doi.org/10.3171/2019.12.focus19841.
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OBJECTIVENeuroendoscopic surgery using an ultrasonic aspirator represents a valid tool with which to perform the safe resection of deep-seated ventricular lesions, but the handling of neuroendoscopic instruments is technically challenging, requiring extensive training to achieve a steep learning curve. Simulation-based methods are increasingly used to improve surgical skills, allowing neurosurgical trainees to practice in a risk-free, reproducible environment. The authors introduce a synthetic, patient-specific simulator that enables trainees to develop skills for endoscopic ventricular tumor removal, and they evaluate the model’s validity as a training instrument with regard to realism, mechanical proprieties, procedural content, and handling.METHODSThe authors developed a synthetic simulator based on a patient-specific CT data set. The anatomical features were segmented, and several realistic 1:1 skull models with all relevant ventricular structures were fabricated by a 3D printer. Vascular structures and the choroid plexus were included. A tumor model, composed of polyvinyl alcohol, mimicking a soft-consistency lesion, was secured in different spots of the frontal horn and within the third ventricle. Neurosurgical trainees participating in a neuroendoscopic workshop qualitatively assessed, by means of a feedback survey, the properties of the simulator as a training model that teaches neuroendoscopic ultrasonic ventricular tumor surgery; the trainees rated 10 items according to a 5-point Likert scale.RESULTSParticipants appreciated the model as a valid hands-on training tool for neuroendoscopic ultrasonic aspirator tumor removal, highly rating the procedural content. Furthermore, they mostly agreed on its comparably realistic anatomical and mechanical properties. By the model’s first application, the authors were able to recognize possible improvement measures, such as the development of different tumor model textures and the possibility, for the user, of creating a realistic surgical skull approach and neuroendoscopic trajectory.CONCLUSIONSA low-cost, patient-specific, reusable 3D-printed simulator for the training of neuroendoscopic ultrasonic aspirator tumor removal was successfully developed. The simulator is a useful tool for teaching neuroendoscopic techniques and provides support in the development of the required surgical skills.
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Etami, Helvina Vika, Rochmi Isnaini Rismawanti, Vita Arfiana Nur Hanifah, Herianto Herianto, Yarabisa Yanuar, Djoko Kuswanto, Dyah Wulan Anggrahini, and Putrika Prastuti Ratna Gharini. "CT-Derived 3D Printing for Coronary Artery Cannulation Simulator Design Manufacturing." Bioengineering 9, no. 8 (July 25, 2022): 338. http://dx.doi.org/10.3390/bioengineering9080338.
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Mastering coronary angiography requires practice. Cadavers and animals do not accurately represent the human anatomical body, and practicing with actual patients has medical safety issues. Simulation offers safe and realistic conditions for cardiology intervention training. In this study, we propose a novel 3D printed simulator that contains physically realistic anatomy and has four access points. It increases safety for patients and students, and production is low-cost. We aimed to make and validate this simulator design as a prototype for coronary cannulation training. It was designed using computed tomography (CT) scan data of aorta, coronary, and heart models, and was printed by 3D printing with resin materials consisting of 75% or 85% clear resin and 25% or 15% flexible resin additive. The simulator was constructed with a camera above the simulator with a degree of LAO of 30°/0°, a display table, and an acrylic box. Twelve validators were interviewed for their expert opinions and analyzed by a qualitative method. They scored the simulator’s suitability on a four-point Likert scale questionnaire. They described the simulator as having admirable values for all aspects (85.8%), curriculum suitability (92%), educational importance (94%), accuracy (83%), efficiency (78%), safety (87.5%), endurance (81.2%), aesthetics (80.7%), storage (85.4%), and affordability (85.8%).
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Dandıl, Emre, Zafer Serin, and Yeşim Şenol. "SABAS: A Smartphone-Aided Training Simulator based on Virtual and Augmented Reality for Brain Anatomy Assessment." BRAIN. Broad Research in Artificial Intelligence and Neuroscience 13, no. 3 (September 30, 2022): 252–76. http://dx.doi.org/10.18662/brain/13.3/366.
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Many application areas for augmented reality (AR) and virtual reality (VR) emerged with the technological advances. These technologies, which initially appeared in sectors such as entertainment and games, are now widely used in the field of health care. In this study, a traditional simulator named SABAS is designed with its all components to be used in the training of brain anatomy. The designed simulator is equipped with AR and VR supported innovative e-learning technologies in order to examine and learn the structure of the human brain, whose anatomical structure and functioning is complex, using 3D models in anatomy education. This smartphone-aided application is achieved a high level of success in examination of brain anatomy with the additional features such as interface design and application usability. After the cornerstones of this designed prototype application are presented, the required suggestions are obtained from experts and healthcare professionals and it is observed that the application worked with maximum efficiency. In the study, the effectiveness of the VR and AR aided SABAS mobile application simulator, developed to teach the anatomical structure of the brain, is evaluated based on the experiences of 30 participants who wanted to voluntarily participate in the study.
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Bigsby, R. J. A., C. S. Hardaker, and J. Fisher. "Wear of ultra-high molecular weight polyethylene acetabular cups in a physiological hip joint simulator in the anatomical position using bovine serum as a lubricant." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 211, no. 3 (March 1, 1997): 265–69. http://dx.doi.org/10.1243/0954411971534377.
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The Leeds physiological anatomical (PA) hip joint simulator was developed to apply three axes of loading and a complex three-dimensional motion so that the forces and motions can reproduce exactly the walking cycles defined by Paul. This paper presents the results of a study using the Leeds PA hip joint simulator to determine the wear of 32 mm ultra-high molecular weight polyethylene (UHMWPE) acetabular cups against stainless steel and zirconia ceramic heads, using bovine serum as lubricant. These results have been compared with the results of a previous study that used water as the lubricant, which led to UHMWPE transfer film being formed on the stainless steel head. Comparisons are also made with clinical results and results from other simulators. The study indicates that it is preferable to use bovine serum in simulator studies. In addition, the results indicate that if the surface roughness of the metallic and femoral heads are similar, and they remain undamaged during the tests, the wear rates of the UHMWPE cups are likely to be similar.
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Bing, Eric G., Megan L. Brown, Anthony Cuevas, Richard Sullivan, and Groesbeck P. Parham. "User Experience With Low-Cost Virtual Reality Cancer Surgery Simulation in an African Setting." JCO Global Oncology, no. 7 (March 2021): 435–42. http://dx.doi.org/10.1200/go.20.00510.
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PURPOSE Limited access to adequate cancer surgery training is one of the driving forces behind global inequities in surgical cancer care. Affordable virtual reality (VR) surgical training could enhance surgical skills in low- and middle-income settings, but most VR and augmented reality systems are too expensive and do not teach open surgical techniques commonly practiced in these contexts. New low-cost VR can offer skill development simulations relevant to these settings, but little is known about how knowledge is gained and applied by surgeons training and working in specific resource-constrained settings. This study addresses this gap, exploring gynecologic oncology trainee learning and user experience using a low-cost VR simulator to learn to perform an open radical abdominal hysterectomy in Lusaka, Zambia. METHODS Eleven surgical trainees rotating through the gynecologic oncology service were sequentially recruited from the University Teaching Hospital in Lusaka to participate in a study evaluating a VR radical abdominal hysterectomy training designed to replicate the experience in a Zambian hospital. Six participated in semi-structured interviews following the training. Interviews were analyzed using open and axial coding, informed by grounded theory. RESULTS Simulator participation increased participants' perception of their surgical knowledge, confidence, and skills. Participants believed their skills transferred to other related surgical procedures. Having clear goals and motivation to improve were described as factors that influenced success. CONCLUSION For cancer surgery trainees in lower-resourced settings learning medical and surgical skills, even for those with limited VR experience, low-cost VR simulators may enhance anatomical knowledge and confidence. The VR simulator reinforced anatomical and clinical knowledge acquired through other modalities. VR-enhanced learning may be particularly valuable when mentored learning opportunities are limited.
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Cikla, Ulas, Balkan Sahin, Sahin Hanalioglu, Azam S. Ahmed, David Niemann, and Mustafa K. Baskaya. "A novel, low-cost, reusable, high-fidelity neurosurgical training simulator for cerebrovascular bypass surgery." Journal of Neurosurgery 130, no. 5 (May 2019): 1663–71. http://dx.doi.org/10.3171/2017.11.jns17318.
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OBJECTIVECerebrovascular bypass surgery is a challenging yet important neurosurgical procedure that is performed to restore circulation in the treatment of carotid occlusive diseases, giant/complex aneurysms, and skull base tumors. It requires advanced microsurgical skills and dedicated training in microsurgical techniques. Most available training tools, however, either lack the realism of the actual bypass surgery (e.g., artificial vessel, chicken wing models) or require special facilities and regulations (e.g., cadaver, live animal, placenta models). The aim of the present study was to design a readily accessible, realistic, easy-to-build, reusable, and high-fidelity simulator to train neurosurgeons or trainees on vascular anastomosis techniques even in the operating room.METHODSThe authors used an anatomical skull and brain model, artificial vessels, and a water pump to simulate both extracranial and intracranial circulations. They demonstrated the step-by-step preparation of the bypass simulator using readily available and affordable equipment and consumables.RESULTSAll necessary steps of a superficial temporal artery–middle cerebral artery bypass surgery (from skin opening to skin closure) were performed on the simulator under a surgical microscope. The simulator was used by both experienced neurosurgeons and trainees. Feedback survey results from the participants of the microsurgery course suggested that the model is superior to existing microanastomosis training kits in simulating real surgery conditions (e.g., depth, blood flow, anatomical constraints) and holds promise for widespread use in neurosurgical training.CONCLUSIONSWith no requirement for specialized laboratory facilities and regulations, this novel, low-cost, reusable, high-fidelity simulator can be readily constructed and used for neurosurgical training with various scenarios and modifications.
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Russo, Marco, Markus Koenigshofer, Martin Stoiber, Paul Werner, Christoph Gross, Alfred Kocher, Guenther Laufer, Francesco Moscato, and Martin Andreas. "Advanced three-dimensionally engineered simulation model for aortic valve and proximal aorta procedures." Interactive CardioVascular and Thoracic Surgery 30, no. 6 (April 14, 2020): 887–95. http://dx.doi.org/10.1093/icvts/ivaa026.
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Abstract OBJECTIVES A 3-dimensionally (3D) engineered model for simulation of aortic valve and proximal aortic procedures is a reliable tool both for training young surgeons and for simulating complex cases. To achieve a realistic simulation, the artificial model should reproduce the angles and orientations of the cardiac structures based on the patient’s anatomical condition, reproduce tissue mechanical characteristics and be easy to obtain and easy to use. The goal of the study was the production and validation of realistic training models, based on the patient’s actual anatomical characteristics, to provide training for aortic valve procedures. METHODS An anatomical model was manufactured using 3D printing and silicone casting. The digital anatomical model was obtained by segmenting computed tomography imaging. The segmented geometrical images were processed and a casting mould was designed. The mould was manufactured on a 3D printer. Silicone was cast into the mould; after curing, the finished model was ready. The realistic reproduction was evaluated by mechanical hardness tests and a survey by cardiac surgeons. RESULTS Six 3D silicone models were produced that represented the patient’s anatomy including aortic valve leaflets, aortic root with coronary ostia, ascending aorta and proximal arch. Aortic valve replacement was performed, and 100% of the participants evaluated the model in a survey as perfectly reproducing anatomy and surgical handling. CONCLUSIONS We produced a realistic, cost-effective simulator for training purposes and for simulation of complex surgical cases. The model reproduced the real angulation and orientation of the aortic structures inside the mediastinum, permitting a real-life simulation of the desired procedure. This model offers opportunities to simulate various surgical procedures.
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Sokolowski, John A., Catherine M. Banks, Hector M. Garcia, and William T. Richards. "Developing an Ultrasonography Simulator Training Tool." International Journal of Privacy and Health Information Management 1, no. 2 (July 2013): 17–27. http://dx.doi.org/10.4018/ijphim.2013070102.
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This paper presents the development of an Ultrasonography Simulator Training Tool. Ultrasonography is a user-dependent technology; operators must possess both physical and cognitive ultrasonography capability to include mechanical manipulation of the probe, image capture, and interpretation of pathology. There are three major challenges in developing a simulator training tool that provides both the physical (hardware) and cognitive (software-visualization) learning experience: 1) graphical user interface design, 2) hardware utilization and interface, and 3) the integration of software for simulating volume of ultrasound beams and visualization of images (imagery data). This tool is being being developed with educator input from conceptual design to final product validation. The initial output of this effort is a prototype real-time, dynamic ultrasound simulator training tool specific for cardiac interrogation. The tool has been crafted to accommodate a dedicated teaching component that is extendable with additional anatomical imagery and teaching materials to include instructor observation capability.
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Cosson, Philip, and Zenghai Lu. "Geometric validation of a computer simulator used in radiography education." BJR|Open 2, no. 1 (November 2020): 20190027. http://dx.doi.org/10.1259/bjro.20190027.
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Objectives: The radiographical process of projection of a complex human form onto a two-dimensional image plane gives rise to distortions and magnifications. It is important that any simulation used for educational purposes should correctly reproduce these. Images generated using a commercially available computer simulation widely used in radiography education (ProjectionVRTM) were tested for geometric accuracy of projection in all planes. Methods: An anthropomorphic skull phantom was imaged using standard projection radiography techniques and also scanned using axial CT acquisition. The data from the CT was then loaded into the simulator and the same projection radiography techniques simulated. Bony points were identified on both the real radiographs and the digitally reconstructed radiographs (DRRs). Measurements sensitive to rotation and magnification were chosen to check for rotation and distortion errors. Results: The real radiographs and the DRRs were compared by four experienced observers and measurements taken between the identified bony points on each of the images obtained. Analysis of the mean observations shows that the measurement from the DRR matches the real radiograph +1.5 mm/−1.5 mm. The Bland Altman bias was 0.55 (1.26 STD), with 95% limits of agreement 3.01 to −1.91. Conclusions: Agreement between the empirical measurements is within the reported error of cephalometric analysis in all three anatomical planes. The image appearances of both the real radiographs and DRRs compared favourably. Advances in knowledge: The commercial computer simulator under test (ProjectionVRTM) was able to faithfully recreate the image appearances of real radiography techniques, including magnification and distortion. Students using this simulation for training will obtain feedback likely to be useful when lessons are applied to real-world situations.
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Chen, Wen Hao, Shairah Radzi, Li Qi Chiu, Wai Yee Yeong, and Sreenivasulu Reddy Mogali. "Development of a 3-dimensional printed tube thoracostomy task trainer: An improved methodology." Asia Pacific Scholar 6, no. 1 (January 5, 2021): 109–13. http://dx.doi.org/10.29060/taps.2021-6-1/sc2243.
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Introduction: Simulation-based training has become a popular tool for chest tube training, but existing training modalities face inherent limitations. Cadaveric and animal models are limited by access and cost, while commercial models are often too costly for widespread use. Hence, medical educators seek a new modality for simulation-based instruction. 3D printing has seen growing applications in medicine, owing to its advantages in recreating anatomical detail using readily available medical images. Methods: Anonymised computer tomography data of a patient’s thorax was processed using modelling software to create a printable model. Compared to a previous study, 3D printing was applied extensively to this task trainer. A mixture of fused deposition modelling and material jetting technology allowed us to introduce superior haptics while keeping costs low. Given material limitations, the chest wall thickness was reduced to preserve the ease of incision and dissection. Results: The complete thoracostomy task trainer costs approximately SGD$130 (or USD$97), which is significantly cheaper compared to the average commercial task trainer. It requires approximately 118 hours of print time. The complete task trainer simulates the consistencies of ribs, intercostal muscles and skin. Conclusion: By utilising multiple 3D printing technologies, this paper aims to outline an improved methodology to produce a 3D printed chest tube simulator. An accurate evaluation can only be carried out after we improve on the anatomical fidelity of this prototype. A 3D printed task trainer has great potential to provide sustainable simulation-based education in the future.
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Samy, Ravi N., Shanmugam Murugappan, Don Stredney, and Gregory Wiet. "Simulator Enhances Drilling Skills in Inexperienced Surgeons." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (August 2008): P59. http://dx.doi.org/10.1016/j.otohns.2008.05.190.
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Objective 1) Validate whether a PC-based simulation program can be used to enhance temporal bone skills in those without any anatomical knowledge or surgical experience. 2) Understand the complexities of adapting simulator technology to educate novice and experienced temporal bone surgeons. Methods In this prospective, pilot study, individuals performed a craniectomy (measuring approximately 1”x2”) from the squamosa of cadaveric temporal bone specimens using typical otologic drills and instrumentation; the goals were to remove the bone, create straight lines along the edges of the craniectomy, and perform dural decompression without violating the dura. After performing this, the individuals then spent the next 2 weeks performing virtual temporal bone surgery on the OSC/OSU simulator. The individuals then performed the craniectomy a second time. A blinded observer (neurotologist) then assessed performance on the pre- and post-simulation tested bones. Results In all 6 sets of bones (12 bones total), the blinded observer was able to correctly determine which was the presimulation temporal bone and the post-simulation temporal bone. This was based primarily on the objective criteria of adequacy of dural decompression and the avoidance of dural tears. The assessment of linear edges of the craniectomy was not felt to be of sufficient importance. Conclusions The temporal bone simulator was able to improve the surgical skills in individuals with no prior temporal bone surgical experience or anatomy knowledge. The preliminary data from this study will be extended to a larger study group for statistical significance. Additional performance measures will need to be created to improve objective evaluation.
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Capogna, Giorgio, Alessandra Coccoluto, Emanuele Capogna, and Angelica Del Vecchio. "Objective Evaluation of a New Epidural Simulator by the CompuFlo®Epidural Instrument." Anesthesiology Research and Practice 2018 (June 26, 2018): 1–6. http://dx.doi.org/10.1155/2018/4710263.
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Background. In this study, we describe a custom-made new epidural simulator, created by modifying the inner structure of a commercially available one, in the attempt to make it adequately realistic. To validate and evaluate the realism of our device, we used the Computerized Epidural Instrument CompuFlo.Method. The Compuflo CompuFlo curves obtained from 64 experiments on the epidural simulator were compared to 64 curves obtained from a previous human study, from consecutive laboring parturients requesting epidural analgesia.Results. Epidural simulator and human pressure curves were very similar. There was a significant difference between the drop of pressure due to false and true loss of resistance (LOR) in both the groups.Discussion. Our simulator can realistically reproduce the anatomical layers the needle must pass as demonstrated by the similarity between the simulator and human pressure curves and the small differences of pressure values recorded. CompuFlo may be used as an objective tool to create and assess and compare objectively the epidural task trainers.
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Choi, Yong Je, Yoon Ha Joo, Baek-Lok Oh, and Jung Chan Lee. "3D-Printed Ophthalmic-Retrobulbar-Anesthesia Simulator: Mimicking Anatomical Structures and Providing Tactile Sensations." IEEE Journal of Translational Engineering in Health and Medicine 9 (2021): 1–6. http://dx.doi.org/10.1109/jtehm.2021.3099971.
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Santos, Ricardo, Giselle Coelho, Marcos Lyra, Saulo Santos, and Glaydson Godinho. "Board 536 - Technology Innovations Abstract Anatomical Shoulder Simulator for Arthroscopy Training (Submission #831)." Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare 8, no. 6 (December 2013): 627. http://dx.doi.org/10.1097/01.sih.0000441734.56793.63.
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Caselato, Giselle Coelho Resende, Benjamin Warf, Nelci Zanon, and Samuel Zymberg. "Board #301 - Technology Innovation New Anatomical Simulator for Pediatric Neuroendoscopic Training (Submission #9599)." Simulation in Healthcare: Journal of the Society for Simulation in Healthcare 9, no. 6 (December 2014): 480. http://dx.doi.org/10.1097/01.sih.0000459402.89497.d3.
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Zafar, Sobia, Kristina Mladenovic, Sakher AlQahtani, Chaitanya Puranik, and Rasa Mladenovic. "Assessing the Pedological Impact of Local Anesthesia Dental Simulator as Serious Game." Applied Sciences 12, no. 7 (March 23, 2022): 3285. http://dx.doi.org/10.3390/app12073285.
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The aim of our study was to determine the effectiveness of a mobile 3D augmented reality (AR) simulator for local anesthesia training as a serious game. We present a mobile simulator which has three modes for learning: study, 3D simulation, and AR reality. Both pre- and post-training surveys contained open-ended and Likert-scale questions (comprising five response options) on demographics and students’ experiences. The response rate was 90.1%. Of the total participants, 37 subjects were female and 27 were male. The mean age was 20 years. The results of the pre-training survey showed that over 80% of dental students from both universities agreed that they were excited about using the mobile simulator. The results from the post training survey showed that 78.7–88.2% of participants felt comfortable using the mobile application, over 72% agreed that it was user friendly, and over 82.3% of participants agreed that it looked realistic. It was also found that 76.6–88.2% of participants agreed that the 3D anatomical structures improved their understanding of LA administration. A serious game for learning local anesthesia can be a very interesting and valuable learning tool for dental students.
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Knobel, Roxana, Lia Volpato, Liliam Gervasi, Raquel Viergutz, and Alberto Trapani. "A Simple, Reproducible and Low-cost Simulator for Teaching Surgical Techniques to Repair Obstetric Anal Sphincter Injuries." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 40, no. 08 (August 2018): 465–70. http://dx.doi.org/10.1055/s-0038-1668527.
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Objective To describe and evaluate the use of a simple, low-cost, and reproducible simulator for teaching the repair of obstetric anal sphincter injuries (OASIS). Methods Twenty resident doctors in obstetrics and gynecology and four obstetricians participated in the simulation. A fourth-degree tear model was created using low-cost materials (condom simulating the rectal mucosa, cotton tissue simulating the internal anal sphincter, and bovine meat simulating the external anal sphincter). The simulator was initially assembled with the aid of anatomical photos to study the anatomy and meaning of each component of the model. The laceration was created and repaired, using end-to-end or overlapping application techniques. Results The model cost less than R$ 10.00 and was assembled without difficulty, which improved the knowledge of the participants of anatomy and physiology. The sutures of the layers (rectal mucosa, internal sphincter, and external sphincter) were performed in keeping with the surgical technique. All participants were satisfied with the simulation and felt it improved their knowledge and skills. Between 3 and 6 months after the training, 7 participants witnessed severe lacerations in their practice and reported that the simulation was useful for surgical correction. Conclusion The use of a simulator for repair training in OASIS is affordable (low-cost and easy to perform). The simulation seems to improve the knowledge and surgical skills necessary to repair severe lacerations. Further systematized studies should be performed for evaluation.
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Bragdon, C. R., D. O. O'Connor, J. D. Lowenstein, M. Jasty, and W. D. Syniuta. "The Importance of Multidirectional Motion on the Wear of Polyethylene." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 210, no. 3 (September 1996): 157–65. http://dx.doi.org/10.1243/pime_proc_1996_210_408_02.
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The development of a new hip simulator for the study of bearing materials used in total hip replacements has led to several findings which add important new information to the understanding of wear process of ultra-high molecular weight polyethylene, the most commonly used bearing material today for total joint replacements. Using this hip simulator which is capable of applying the physiological motion pathways occurring during gait to total hip components which are held in the correct anatomical position under the complex loading conditions of the hip in gait, the authors have shown that physiological motion pathways produce very different wear rates and morphology of the wear surface than unidirectional reciprocating pathways. Scanning electron microscopy studies show striking differences in the morphology of the wear surfaces of the polyethylene depending upon the relative motions of the components. Wear rates, surface morphology and particle debris generation consistent with clinical and retrieved studies are achieved when physiological conditions are simulated.
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Berry, E., A. Marsden, K. W. Dalgarno, D. Kessel, and D. J. A. Scott. "Flexible tubular replicas of abdominal aortic aneurysms." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 216, no. 3 (March 1, 2002): 211–14. http://dx.doi.org/10.1243/0954411021536423.
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The aim of this study was to manufacture life-size, flexible, tubular replicas of human abdominal aortic aneurysms and the associated vasculature, suitable for use in a training simulator for endovascular procedures. Selective laser sintering was used to create a geometrically correct master model for each of ten anatomical variations. The masters were used to generate flexible latex replicas. The use of the replicas in the training simulator was demonstrated. In total ten silicone rubber models were produced. When connected into the training simulator and perfused at arterial pressure it was possible to deploy an endovascular stent under fluoroscopic control and to perform angiography. The study has shown that conventional rapid prototyping technology can be used to manufacture flexible, radiolucent replicas which provide a realistic training environment for endovascular procedures.
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Perényi, Ádám, Bálint Posta, Linda Szabó, Zoltán Tóbiás, Balázs Dimák, Roland Nagy, Gyöngyi Jónás, et al. "A VOXEL-MAN Tempo 3D virtuálisvalóság-szimulátor alkalmazása a sziklacsont sebészetében." Orvosi Hetilap 162, no. 16 (April 18, 2021): 623–28. http://dx.doi.org/10.1556/650.2021.32053.
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Összefoglaló. Bevezetés: Az emberi sziklacsont a halántékcsont része, egy bonyolult és változatos anatómiai felépítésű struktúra. A sziklacsonton végzett beavatkozások előtt, a műtéti szövődmények megelőzése érdekében, nélkülözhetetlen a biztos anatómiai tudás és kézügyesség megszerzése, valamint az egyes műtéti lépések és mozdulatok begyakorlása. A VOXEL-MAN Tempo 3D fül-orr-gégészeti szimulátor a virtuális valóság és a robotika alkalmazásával nyújt gyakorlási lehetőséget. Célkitűzés: A Szegedi Tudományegyetem 2019-ben VOXEL-MAN fül-orr-gégészeti szimulátort helyezett üzembe az Orvosi Készségfejlesztési Központban. A cikk fül-orr-gégész szakorvos szerzői a VOXEL-MAN Tempo szimulátor megismerését követően bemutatják a készüléket, és megfogalmazzák a szimulátorral végzett beavatkozásokkal szemben támasztott igényüket. Módszer: A szerzők a megfogalmazott szempontoknak megfelelően értékelik a VOXEL-MAN Tempo szimulátort, és meghatározzák, milyen szerepet szánnak neki a gyakorlati képzésben. Eredmények: A szimulátor virtuálisan, mégis valósághűen mutatja meg a sziklacsont anatómiai viszonyait, a fontos anatómiai struktúrák valós térbeli elhelyezkedését és egymástól, illetve a sebészi eszköztől mért távolságát. A rendszer lehetővé teszi a fülműtétek valósághű elvégzését (kétkezes csontmunka fúróval és szívóval, vérzés szimulálása) taktilis visszacsatolással. Az egy- vagy kétkezes feladatokkal fejleszthetjük a sebészi készségeket. A fülműtétek csontmunkája reprodukálható módon elvégezhető valódi beteg halántékcsontjáról készített rutin, nagy felbontású komputertomográfiás vizsgálat anyagából. Következtetés: Tapasztalataink alapján a szimulátor kiválóan alkalmas az egyes műtéti lépesek begyakorlására. A jövőben fontos szerepet szánunk a virtuális rendszernek a fül-orr-gégészeti graduális és a fülsebészeti posztgraduális képzésben. Orv Hetil. 2021; 162(16): 623–628. Summary. Introduction: The pars petrosa of the human temporal bone is a structure of complex and diverse anatomy. Prior to surgical interventions, in order to prevent surgical complications, it is essential to acquire sound anatomical knowledge and dexterity as well as to practice each surgical step and movement. The VOXEL-MAN Tempo 3D simulator uses virtual reality and robotics to provide an opportunity to practice. Objective: In 2019, the University of Szeged installed a VOXEL-MAN Virtual Reality simulator at the Medical Skills Development Center. After learning about the VOXEL-MAN Tempo simulator, the authors present the device and articulate their need for interventions with the simulator. Method: The VOXEL-MAN Tempo simulator is evaluated according to the formulated criteria and the role assigned to it in the practical training is determined. Results: The simulator shows the anatomical structure of the temporal bone virtually, yet realistically, the real spatial location of the important anatomical structures and their distance from each other and from the surgical instrument. The system allows ear surgery to be performed realistically (two-handed bone work with a drill and suction) with tactile (vibration) and visual (bleeding) feedback. One can improve surgical skills with one- or two-handed tasks. Bone work in ear surgeries can be performed in a reproducible manner from routine, high-resolution computer tomography of the temporal bone of a real patient. Conclusion: With reference to our experience, the simulator is excellent for practicing each surgical step. In the future, we intend to use this virtual system in undergraduate and postgraduate training in otolaryngology. Orv Hetil. 2021; 162(16): 623–628.
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Lee, Jong Joo, Junho Ko, Yeomin Yun, Seong-Wook Jang, Yoon Ha, Yoon Sang Kim, and Dong Ah Shin. "Feasibility of the Epiduroscopy Simulator as a Training Tool: A Pilot Study." Pain Research and Management 2020 (April 29, 2020): 1–6. http://dx.doi.org/10.1155/2020/5428170.
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Epiduroscopy is a type of spinal intervention that visualizes the epidural space through the sacral hiatus using a fiberoptic scope. However, it is technically difficult to perform compared to conventional interventions and susceptible to complications. Surgery simulator has been shown to be a promising modality for medical education. To develop the epiduroscopy simulator and prove its usefulness for epiduroscopy training, we performed a case-control study including a total of 20 physicians. The participants were classified as the expert group with more than 30 epiduroscopy experiences and the beginner group with less experience. A virtual simulator (EpiduroSIM™, BioComputing Lab, KOREATECH, Cheonan, Republic of Korea) for epiduroscopy was developed by the authors. The performance of the participants was measured by three items: time to reach a virtual target, training score, and number of times the dura and nerve are violated. The training score was better in the expert group (75.00 vs. 67.50; P<0.01). The number of violations was lower in the expert group (3.50 vs. 4.0; P<0.01). The realism of the epidural simulator was evaluated to be acceptable in 40%. Participants improved their simulator skills through repeated attempts. The epiduroscopy simulator helped participants understand the anatomical structure and actual epiduroscopy.
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Varoquier, M., C. P. Hoffmann, C. Perrenot, N. Tran, and C. Parietti-Winkler. "Construct, Face, and Content Validation on Voxel-Man® Simulator for Otologic Surgical Training." International Journal of Otolaryngology 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/2707690.
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Objective. To assess the face, content, and construct validity of the Voxel-Man TempoSurg Virtual Reality simulator. Participants and Methods. 74 ear, nose, and throat (ENT) surgeons participated. They were assigned to one of two groups according to their level of expertise: the expert group (n=16) and the novice group (n=58). The participants performed four temporal bone dissection tasks on the simulator. Performances were assessed by a global score and then compared to assess the construct validity of the simulator. Finally, the expert group assessed the face and content validity by means of a five-point Likert-type scale. Results. experienced surgeons performed better (p<.01) and faster (p<.001) than the novices. However, the groups did not differ in terms of bone volume removed (p=.11) or number of injuries (p=.37). 93.7% of experienced surgeons stated they would recommend this simulator for anatomical learning. Most (87.5%) also thought that it could be integrated into surgical training. Conclusion. The Voxel-Man TempoSurg Virtual Reality simulator constitutes an interesting complementary tool to traditional teaching methods for training in otologic surgery.
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Garitey, V., T. Gandelheid, J. Fuseri, R. PÉlissier, and R. Rieu. "Ventricular flow Dynamic past Bileaflet Prosthetic Heart Valves." International Journal of Artificial Organs 18, no. 7 (July 1995): 380–91. http://dx.doi.org/10.1177/039139889501800706.
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To characterise hydrodynamic properties of prosthetic heart valves in mitral position, ultrasonic velocity measurements were performed using a cardiovascular simulator. A Duromedics and a Saint-Jude Medical bileaflet heart valve were tested. The Saint-Jude valve was oriented first in an anatomical position, i.e. the tilt axis parallel to the septal wall, and then in an anti-anatomical position. In the anti-anatomical position, from mid diastole to mid systole, two contrarotative vortices are generated in the ventricle by the interaction between the flow directed by the leaflets downstream from the lateral orifices and the ventricular wall motions. In the anatomical position, the mitral flow penetrates the ventricle principally through the lateral orifice proximal to the septal wall, due to the vortex in the atrial chamber. The mitral inflow then circulates along the septal wall to the apex, and produces a large ventricular vortex during systole. In the anatomical position, the Saint-Jude thus provides a better ventricular washout during this phase. The mitral inflow through the Duromedics in the anti-anatomical position produces two contrarotative vortices in the ventricle, but in the opposite sense than downstream the Saint-Jude valve; the flows that penetrate through the lateral orifices are directed to the ventricular walls and then recirculate to the centre of the ventricle, providing a very fluctuating flow near the apex. Thus, a slight difference in valve design produces a significant difference in the ventricular flow fields.
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WIŚNIEWSKI, Tomasz, Adrian MRÓZ, Janusz MAGDA, and Agnieszka WIELOWIEJSKA-GIERTUGA. "STAND FOR TRIBOLOGICAL TESTING OF HIP ENDOPROSTHESES." Tribologia 270, no. 6 (December 31, 2016): 167–77. http://dx.doi.org/10.5604/01.3001.0010.6936.
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The paper presents a new construction of hip-joint simulator. The SBT-01.2 simulator is designed for conducting tribological testing of hip endoprostheses based on ISO 14242-1, which specifies the requirements for the range of motion and load characteristics of the friction pair (femoral head vs. acetabular cup) during one test cycle. The construction of the simulator is based on the anatomical structure of the human hip joint. The prosthesis acetabulum is mounted in the upper part of the mounting head while maintaining the inclination angle relative to the axis of the socket to the direction of the loading force. The head of the prosthesis is mounted on a pin embedded in the bottom, movable base. After placing a special sleeve on the lower base, liquid lubricant is applied on the head-cup tribological system. The employed software enables continuous control, online visualization, and data recording. During testing, parameters such as lubricant temperature, instantaneous loading force, friction torque, and the number of cycles are recorded.
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Frascio, M., M. Sguanci, M. Minuto, M. Casaccia, and F. Mandolfino. "Efficacy of a Domestic Simulator for Training in Laparoscopic Surgery." International Journal of Privacy and Health Information Management 5, no. 1 (January 2017): 76–91. http://dx.doi.org/10.4018/ijphim.2017010105.
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To present the University of Genoa Advanced Simulation Center (SimAv) and the project of a trainer (eLap4D) that would achieve the equivalent goals of the fundamentals of laparoscopic surgery trainer at an economical cost. The validation process is going to be shown too. METHODS. The laparoscopic trainer is a physical low-cost laparoscopic training platform that reproduces the tactile feedback (eLaparo4d) integrated with a software for virtual anatomical realistic scenarios (Unity3D V 4.1). A sample of 20 students was selected, divided into 2 homogeneous groups with respect to the level of confidence with the use of video games, consoles, smartphones (this has been possible thanks to the use of a questionnaire, administered before the practical phase of training). The groups participated in a training program based on 5 basic laparoscopic skills (laparoscopic focusing and navigation, hand – eye – coordination and grasp coordination). So, a second and a third study sample was chosen, consisting of 20 post graduate students (intermediate group) and 20 experienced surgeons; for these groups a training program was provided, identical to the previous group as well as their subdivision into 2 group. The face validity was used for an ergonomic analysis of the simulator, the construct to test the system's ability to differentiate potential expert users (experienced surgeons) from non-experts (student without experience in laparoscopic surgery). The authors analyzed the results of the three samples obtained by comparing variables such as score, % of fulfillment, panality and time. At the same time, the students' improvements have been monitored, developing a customized learning curve for each user. To evaluate the structural characteristics of the simulator a specific questionnaire has been used. The results were encouraging. The simulator is ergonomically satisfactory and its structural features are adapted to the training. The system was able to differentiate the level of experience and also has therefore met the requirements of “construct validity”. laparoscopic simulators can be constructed at an economical cost.
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Monteiro dos Santos, Ricardo Barreto, Glaydson Godinho, Marcos Lyra, and Giselle Coelho Resende Caselato. "Board #317 - Technology Innovation Anatomical Shoulder Simulator for Open Surgery and Arthroscopy Training (Submission #9584)." Simulation in Healthcare: Journal of the Society for Simulation in Healthcare 9, no. 6 (December 2014): 491. http://dx.doi.org/10.1097/01.sih.0000459418.63055.c2.
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Piromchai, P., I. Ioannou, S. Wijewickrema, P. Kasemsiri, J. Lodge, G. Kennedy, and S. O'Leary. "Effects of anatomical variation on trainee performance in a virtual reality temporal bone surgery simulator." Journal of Laryngology & Otology 131, S1 (October 28, 2016): S29—S35. http://dx.doi.org/10.1017/s0022215116009233.
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AbstractObjective:To investigate the importance of anatomical variation in acquiring skills in virtual reality cochlear implant surgery.Methods:Eleven otolaryngology residents participated in this study. They were randomly allocated to practice cochlear implant surgery on the same specimen or on different specimens for four weeks. They were then tested on two new specimens, one standard and one challenging. Videos of their performance were de-identified and reviewed independently, by two blinded consultant otolaryngologists, using a validated assessment scale. The scores were compared between groups.Results:On the standard specimen, the round window preparation score was 2.7 ± 0.4 for the experimental group and 1.7 ± 0.6 for the control group (p = 0.01). On the challenging specimen, instrument handling and facial nerve preservation scores of the experimental group were 3.0 ± 0.4 and 3.5 ± 0.7 respectively, while the control group received scores of 2.1 ± 0.8 and 2.4 ± 0.9 respectively (p < 0.05).Conclusion:Training on temporal bones with differing anatomies is beneficial in the development of expertise.
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Condino, Sara, Fabrizio Cutolo, Nadia Cattari, Simone Colangeli, Paolo Domenico Parchi, Roberta Piazza, Alfio Damiano Ruinato, Rodolfo Capanna, and Vincenzo Ferrari. "Hybrid Simulation and Planning Platform for Cryosurgery with Microsoft HoloLens." Sensors 21, no. 13 (June 29, 2021): 4450. http://dx.doi.org/10.3390/s21134450.
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Cryosurgery is a technique of growing popularity involving tissue ablation under controlled freezing. Technological advancement of devices along with surgical technique improvements have turned cryosurgery from an experimental to an established option for treating several diseases. However, cryosurgery is still limited by inaccurate planning based primarily on 2D visualization of the patient’s preoperative images. Several works have been aimed at modelling cryoablation through heat transfer simulations; however, most software applications do not meet some key requirements for clinical routine use, such as high computational speed and user-friendliness. This work aims to develop an intuitive platform for anatomical understanding and pre-operative planning by integrating the information content of radiological images and cryoprobe specifications either in a 3D virtual environment (desktop application) or in a hybrid simulator, which exploits the potential of the 3D printing and augmented reality functionalities of Microsoft HoloLens. The proposed platform was preliminarily validated for the retrospective planning/simulation of two surgical cases. Results suggest that the platform is easy and quick to learn and could be used in clinical practice to improve anatomical understanding, to make surgical planning easier than the traditional method, and to strengthen the memorization of surgical planning.
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Dias, Tiago Rocha, João de Deus da Costa Alves Junior, and Nitamar Abdala. "Learning curve of radiology residents during training in fluoroscopy-guided facet joint injections." Radiologia Brasileira 50, no. 3 (April 27, 2017): 162–69. http://dx.doi.org/10.1590/0100-3984.2015.0176.
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Abstract Objective: To develop a simulator for training in fluoroscopy-guided facet joint injections and to evaluate the learning curve for this procedure among radiology residents. Materials and Methods: Using a human lumbar spine as a model, we manufactured five lumbar vertebrae made of methacrylate and plaster. These vertebrae were assembled in order to create an anatomical model of the lumbar spine. We used a silicon casing to simulate the paravertebral muscles. The model was placed into the trunk of a plastic mannequin. From a group of radiology residents, we recruited 12 volunteers. During simulation-based training sessions, each student carried out 16 lumbar facet injections. We used three parameters to assess the learning curves: procedure time; fluoroscopy time; and quality of the procedure, as defined by the positioning of the needle. Results: During the training, the learning curves of all the students showed improvement in terms of the procedure and fluoroscopy times. The quality of the procedure parameter also showed improvement, as evidenced by a decrease in the number of inappropriate injections. Conclusion: We present a simple, inexpensive simulation model for training in facet joint injections. The learning curves of our trainees using the simulator showed improvement in all of the parameters assessed.
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Wolfsberger, Stefan, André Neubauer, Katja Bühler, Rainer Wegenkittl, Thomas Czech, Stephan Gentzsch, Hans-Gerd Böcher-Schwarz, and Engelbert Knosp. "ADVANCED VIRTUAL ENDOSCOPY FORENDOSCOPIC TRANSSPHENOIDAL PITUITARY SURGERY." Neurosurgery 59, no. 5 (November 1, 2006): 1001–10. http://dx.doi.org/10.1227/01.neu.0000245594.61828.41.
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Abstract OBJECTIVE Virtual endoscopy (vE) is the navigation of a camera through a virtual anatomical space that is computationally reconstructed from radiological image data. Inside this three-dimensional space, arbitrary movements and adaptations of viewing parameters are possible. Thereby, vE can be used for noninvasive diagnostic purposes and for simulation of surgical tasks. This article describes the development of an advanced system of vE for endoscopic transsphenoidal pituitary surgery and its application to teaching, training, and in the routine clinical setting. METHODS The vE system was applied to a series of 35 patients with pituitary pathology (32 adenomas, three Rathke's cleft cysts) operated endoscopically via the transsphenoidal route at the Department of Neurosurgery of the Medical University Vienna between 2004 and 2006. RESULTS The virtual endoscopic images correlated well with the intraoperative view. For the transsphenoidal approach, vE improved intraoperative orientation by depicting anatomical landmarks and variations. For planning a safe and tailored opening of the sellar floor, transparent visualization of the pituitary adenoma and the normal gland in relation to the internal carotid arteries was useful. CONCLUSION According to our experience, vE can be a valuable tool for endoscopic transsphenoidal pituitary surgery for training purposes and preoperative planning. For the novice, it can act as a simulator for endoscopic anatomy and for training surgical tasks. For the experienced pituitary surgeon, vE can depict the individual patient's anatomy, and may, therefore, improve intraoperative orientation. By prospectively visualizing unpredictable anatomical variations, vE may increase the safety of this surgical procedure.
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Kazmitcheff, Guillaume, Yann Nguyen, Mathieu Miroir, Fabien Péan, Evelyne Ferrary, Stéphane Cotin, Olivier Sterkers, and Christian Duriez. "Middle-Ear Microsurgery Simulation to Improve New Robotic Procedures." BioMed Research International 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/891742.
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Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery. To plan new procedures that exploit the capacities given by the robot, a surgical simulator is developed. The simulation reproduces with high fidelity the behavior of the anatomical structures and can also be used as a training tool for an easier control of the robot for surgeons. In the paper, we introduce the middle ear surgical simulation and then we perform virtually two challenging procedures with the robot. We show how interactive simulation can assist in analyzing the benefits of robotics in the case of complex manipulations or ergonomics studies and allow the development of innovative surgical procedures. New robot-based microsurgical procedures are investigated. The improvement offered by RobOtol is also evaluated and discussed.
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Bertolini, Michele, Michael Mullen, Georgios Belitsis, Angel Babu, Giorgio Colombo, Andrew Cook, Aigerim Mullen, and Claudio Capelli. "Demonstration of Use of a Novel 3D Printed Simulator for Mitral Valve Transcatheter Edge-to-Edge Repair (TEER)." Materials 15, no. 12 (June 17, 2022): 4284. http://dx.doi.org/10.3390/ma15124284.
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Mitral regurgitation is a common valvular disorder. Transcatheter edge-to-edge repair (TEER) is a minimally invasive technique which involves holding together the middle segments of the mitral valve leaflets, thereby reducing regurgitation. To date, MitraClip™ is the only Food and Drug Administration (FDA)-approved device for TEER. The MitraClip procedure is technically challenging, characterised by a steep learning curve. Training is generally performed on simplified models, which do not emphasise anatomical features, realistic materials, or procedural scenarios. The aim of this study is to propose a novel, 3D printed simulator, with a major focus on reproducing the anatomy and plasticity of all areas of the heart involved and specifically the ones of the mitral valve apparatus. A three-dimensional digital model of a heart was generated by segmenting computed tomography (CT). The model was subsequently modified for: (i) adding anatomical features not fully visible with CT; (ii) adapting the model to interact with the MitraClip procedural equipment; and (iii) ensuring modularity of the system. The model was manufactured with a Polyjet technology printer, with a differentiated material assignment among its portions. Polypropylene threads were stitched to replicate chordae tendineae. The proposed system was successfully tested with MitraClip equipment. The simulator was assessed to be feasible to practice in a realistic fashion, different procedural aspects including access, navigation, catheter steering, and leaflets grasping. In addition, the model was found to be compatible with clinical procedural imaging fluoroscopy equipment. Future studies will assess the effect of the proposed training system on improving TEER training.
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Cai, Bohong, Kanagasuntheram Rajendran, Boon Huat Bay, Jieying Lee, and Ching‐Chiuan Yen. "The Effects of a Functional Three‐dimensional (3D) Printed Knee Joint Simulator in Improving Anatomical Spatial Knowledge." Anatomical Sciences Education 12, no. 6 (January 24, 2019): 610–18. http://dx.doi.org/10.1002/ase.1847.
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Borger van der Burg, Boudewijn L. S., T. M. Hörer, D. Eefting, T. T. C. F. van Dongen, J. F. Hamming, J. J. DuBose, M. Bowyer, and R. Hoencamp. "Vascular access training for REBOA placement: a feasibility study in a live tissue-simulator hybrid porcine model." Journal of the Royal Army Medical Corps 165, no. 3 (September 17, 2018): 147–51. http://dx.doi.org/10.1136/jramc-2018-000972.
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BackgroundThe use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with severe haemorrhagic shock is increasing. Obtaining vascular access is a necessary prerequisite for REBOA placement in these situations.MethodsDuring the EVTM workshop (September 2017, Örebro, Sweden), 21 individuals participated in this study, 16 participants and five instructors. A formalised curriculum was constructed including basic anatomy of the femoral region and basic training in access materials for REBOA placement in zone 1. Key skills: (1) preparation of endovascular toolkit, (2) achieving vascular access in the model and (3) bleeding control with REBOA. Scoring ranged from 0 to 5 for non-anatomical skills. Identification of anatomical structures was either sufficient (score=1) or insufficient (score=0). Five consultants performed a second identical procedure as a post test.ResultsConsultants had significantly better overall technical skills in comparison with residents (p=0.005), while understanding of surgical anatomy showed no difference. Procedure times differed significantly (p<0.01), with residents having a median procedure time of 3 min and 24 s, consultants 2:33 and instructors 1:09.ConclusionThis comprehensive training model using a live tissue-simulator hybrid porcine model can be used for femoral access and REBOA placement training in medical personnel with different prior training levels. Higher levels of training are associated with faster procedure times. Further research in open and percutaneous access training is necessary to simulate real-life situations. This training method can be used in a multistep training programme, in combination with realistic moulage and perfused cadaver models.
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Forero, Juan Sebastián Avila, Manuel Martínez Torán, and Marco De Rossi Estrada. "Design of an Anatomical Simulator for Medical Training. A 3D Printing Project of Industrial Designers and Medical Students." International Journal on Integrating Technology in Education 7, no. 1 (March 30, 2018): 13–24. http://dx.doi.org/10.5121/ijite.2018.7102.
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Berg, Dale, and Katherine Berg. "S-Vest: a novel hybrid method to allow standardised patients to put on the objective physical examination findings of a disease." BMJ Innovations 5, no. 2-3 (April 2019): 78–81. http://dx.doi.org/10.1136/bmjinnov-2018-000312.
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BackgroundSimulation hybrids combine single modality simulation such as simulated patients (SP) with low-fidelity simulation to create a potentially more powerful set of educational tools. To make a hybrid that is credible, standardised and inexpensive remains a challenge. We describe the development of the simulation vest (S-Vest), an inexpensive, standardised teaching tool that is ‘worn’ by an SP to form a hybrid.MethodsWe have created a vest which contains a set of speakers placed in an anatomical manner and produce sounds. The sounds played from a multitrack audio player are recorded in vivo from a patient with the real disease findings. The SP provides history while the vest provides the objective palpable and auscultatory findings. The speakers are placed in the routine standardised locations taught in physical examination.ResultsWe have developed several case scenarios designed for the vest. One of these cases is an elderly patient with aortic stenosis. The aortic stenosis case audio file has four unique tracks recorded over the precordium. Each track is played at the speaker appropriate to the physical exam findings. The SP plays an elderly man with chest pain. The vest provides the sounds of a loud systolic murmur with marked diminishment of S2 and a palpable thrill.ConclusionsThe S-Vest is a low-fidelity, low-cost simulator to use in hybrid and simulation. The S-Vest can be used in a formative and summative Objective Structured Clinical Examination (OSCE) station and in skills attainment for learners in healthcare. We believe these tools will be of significant import to teaching clinical skills.
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Wiśniewski, Tomasz, Michał Libera, and Łukasz Łapaj. "STAND FOR TRIBOLOGICAL STUDIES OF HIP JOINT ENDOPROSTHESIS WITH THE POSSIBILITY OF CHANGING ACETABULUM ANTEVERSION ANGLE AND HEAD ANTI TORSION ANGLE." Tribologia 302, no. 4 (December 30, 2022): 103–13. http://dx.doi.org/10.5604/01.3001.0016.1618.
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The article presents the construction of a hip joint movement simulator intended for friction and wear studies of hip joint endoprostheses. The simulator's design enables the fixing of hip endoprosthesis components in accordance with the anatomical structure of the human hip joint. The endoprosthesis head is mounted on a special base in the lower position with a neck-shaft angle of 135°, while the acetabular cup of the endoprosthesis is mounted in the upper part of the mounting head with an inclination angle of 45°. The production of three heads (responsible for the anteversion angle of the acetabulum) and three special bases (responsible for the anti torsion angle of the head) with different fixing angles of the components of the hip joint endoprosthesis made it possible to carry out tribological tests with nine variants of alignment settings. The hip joint endoprosthesis tester is designed to simulate the following movements: flexion and extension, as well as loads occurring in the human hip joint while walking. Thanks to the use of control in the form of electronic cams, the simulator makes it possible to recreate the variable value of the force loading the friction pair as a function of the human walking cycle. The subject of friction and wear studies were hip joint endoprostheses with a head diameter of 44 mm, made of high-carbon Co28Cr6Mo alloy. For each of the nine variants of endoprosthesis component alignment settings, average friction coefficient values were calculated based on the recorded values of the friction torque. The results of the friction and wear studies employing the simulator confirm that the mutual angle alignment setting of the head and the cup has an impact on the value of the frictional resistance occurring in the tribological pair.
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Filho, Francisco Vaz Guimarães, Giselle Coelho, Sergio Cavalheiro, Marcos Lyra, and Samuel T. Zymberg. "Quality assessment of a new surgical simulator for neuroendoscopic training." Neurosurgical Focus 30, no. 4 (April 2011): E17. http://dx.doi.org/10.3171/2011.2.focus10321.
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Object Ideal surgical training models should be entirely reliable, atoxic, easy to handle, and, if possible, low cost. All available models have their advantages and disadvantages. The choice of one or another will depend on the type of surgery to be performed. The authors created an anatomical model called the S.I.M.O.N.T. (Sinus Model Oto-Rhino Neuro Trainer) Neurosurgical Endotrainer, which can provide reliable neuroendoscopic training. The aim in the present study was to assess both the quality of the model and the development of surgical skills by trainees. Methods The S.I.M.O.N.T. is built of a synthetic thermoretractable, thermosensible rubber called Neoderma, which, combined with different polymers, produces more than 30 different formulas. Quality assessment of the model was based on qualitative and quantitative data obtained from training sessions with 9 experienced and 13 inexperienced neurosurgeons. The techniques used for evaluation were face validation, retest and interrater reliability, and construct validation. Results The experts considered the S.I.M.O.N.T. capable of reproducing surgical situations as if they were real and presenting great similarity with the human brain. Surgical results of serial training showed that the model could be considered precise. Finally, development and improvement in surgical skills by the trainees were observed and considered relevant to further training. It was also observed that the probability of any single error was dramatically decreased after each training session, with a mean reduction of 41.65% (range 38.7%–45.6%). Conclusions Neuroendoscopic training has some specific requirements. A unique set of instruments is required, as is a model that can resemble real-life situations. The S.I.M.O.N.T. is a new alternative model specially designed for this purpose. Validation techniques followed by precision assessments attested to the model's feasibility.
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Guliev, B. G., A. E. Talyshinskiy, E. O. Stetsik, and M. U. Agagyulov. "The non-biological simulator with the ability to regulate the position of the kidney and bone landmarks: use for training puncture access in percutaneous nephrolithotripsy." Vestnik Urologii 10, no. 1 (April 1, 2022): 5–14. http://dx.doi.org/10.21886/2308-6424-2022-10-1-5-14.
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Introduction. The non-biological simulators presented in the literature are far from the real human anatomy and are primarily aimed at developing the skill of the pyelocalyceal system (PCS) puncture without the possibility of imitating various intraoperative scenarios.Purpose of the study. To describe the manufacturing and initial testing of the ultrasound-guided PCS puncture simulator with arbitrary placement of bone landmarks and a kidney model, along with the use of a retrograde view during PCS puncture.Materials and methods. This study included training for 5 resident and 2 urologists. Each participant performed the puncture 5 times using an 18-gauge ultrasound-guided needle. A comparison was made between the number of attempts to form access, the duration of the puncture and its correctness (puncture into the small calyx through the papilla), as well as the correctness of determining the target calyx. The trajectory of the needle was retrogradely assessed using a semi-rigid ureteroscope, and the anatomical identification of the selected calyx was assessed using our mobile application.Results. The total number of attempts was 49 and 14 among residents and urologists, respectively. The average duration of the puncture step was 25.2 and 12.0 seconds. In 9/25 cases, residents were able to correctly analyze visual ultrasound information to determine the target calyx. When a contrast agent was injected into the PCS after 63 punctures, no contrast leakage was found.Conclusion. The proposed PCS puncture simulator allows to develop to develop all the necessary skills for cost-effective training of young urologists in the technique of percutaneous access.