Academic literature on the topic 'Intra-operative errors'
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Journal articles on the topic "Intra-operative errors"
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Haklar, Uğur, Ertuğrul Ulusoy, and Tayfun Şimşek. "Radiological Comparison and Functional Outcomes of Robotic Assisted Medial Unicompartmental Knee Arthroplasty with Metal-Backed Onlay Tibial Components." Orthopaedic Journal of Sports Medicine 5, no. 2_suppl2 (February 1, 2017): 2325967117S0010. http://dx.doi.org/10.1177/2325967117s00101.
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Robotic surgery studies have been increasing considering operative advantages on reducing error and improving functional success in partial knee arthroplasty. We have been curious whether planning and application of knee implants assisted robotically correspond to their radiological outcomes. Moreover, we were also curious about functional outcomes. Methods: Data were prospectively collected in 42 patients (62 knees) who underwent MAKOplasty, robotic assisted unicondylar medial knee arthroplasty, between June 2013 – December 2015 For evaluation of components’ accuracy, intra-operative robotic analyses were compared with post-operative radiographic alignment. Statistical analysis was done on these values using paired T-Test. Additionally in our clinic with an average follow-up time of 22 months. Clinical outcomes were evaluated with American Knee Society Scoring (AKSS) System. Results: Difference between intra-operative robotic plans and post-operative radiographs was evaluated for the flexion angle of the femoral component, posterior slope of the tibial component and the varus angle of the tibial component. A novel method is used to evaluate the varus angle of the tibial component. All of the errors are <=0.5°, approximately 86% of the errors are <=0.3° while 18% of errors are zero. No significant difference was observed statistically (paired t-test, p<0.05). Post-operatively all 42 patients had excellent knee scores (mean, 99.67) and functional scores (mean, 99.04) on AKSS while pre-operatively 2 were scored fair, 40 were score poor, and functionally 14 were scored fair and 28 were scored poor. Conclusion: The difference between robotic plans and radiographic outcomes was statistically not significant where metal-backed onlay tibial components were used.
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Khoramnia, Ramin, Gerd Auffarth, Grzegorz Łabuz, George Pettit, and Rajaraman Suryakumar. "Refractive Outcomes after Cataract Surgery." Diagnostics 12, no. 2 (January 19, 2022): 243. http://dx.doi.org/10.3390/diagnostics12020243.
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A post-operative manifest refractive error as close as possible to target is key when performing cataract surgery with intraocular lens (IOL) implantation, given that residual astigmatism and refractive errors negatively impact patients’ vision and satisfaction. This review explores refractive outcomes prior to modern biometry; advances in biometry and its impact on patients’ vision and refractive outcomes after cataract surgery; key factors that affect prediction accuracy; and residual refractive errors and the impact on visual outcomes. There are numerous pre-, intra-, and post-operative factors that can influence refractive outcomes after cataract surgery, leaving surgeons with a small “error budget” (i.e., the source and sum of all influencing factors). To mitigate these factors, precise measurement and correct application of ocular biometric data are required. With advances in optical biometry, prediction of patient post-operative refractory status has become more accurate, leading to an increased proportion of patients achieving their target refraction. Alongside improvements in biometry, advancements in microsurgical techniques, new IOL technologies, and enhancements to IOL power calculations have also positively impacted patients’ refractory status after cataract surgery.
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Groom, Robert, Joan Tryzelaar, Richard Forest, Kevin Niimi, Giovanni Cecere, Desmond Donegan, Saul Katz, et al. "Intra-operative quality assessment of coronary artery bypass grafts." Perfusion 16, no. 6 (December 2001): 511–18. http://dx.doi.org/10.1177/026765910101600611.
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Early coronary artery bypass graft (CABG) failure is a troubling complication that may result in a wide range of problems, including refractory angina, myocardial infarction, low cardiac output, arrhythmia, and fatal heart failure. Early graft failures are related to poor quality and size of the distal native vascular bed, coagulation abnormalities, or technical problems involving the graft conduits and anastomoses. Unfortunately, graft failure is difficult to detect during surgery by visual assessment, palpation, or conventional monitoring. We evaluated the accuracy and utility of a transit-time, ultrasonic flow measurement system for measurement of CABGs. There were no differences between transit-time measurements and volumetric-time collected samples in an in vitro circuit over a range of flows from 10 to 100 ml/min (Bland and Altman Plot, 1.96 SD). Two hundred and ninety-eight CABGs were examined in 125 patients. Graft flow rate was proportional to the target vessel diameter. Nine technical errors were detected and corrected. Flow waveform morphology provided valuable information related to the quality of the anastamosis, which led to the immediate correction of technical problems at the time of surgery.
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Gorišek, B., M. Rebolj Stare, and I. Krajnc. "Accuracy of Intra-Operative Frozen Section Analysis of Ovarian Tumours." Journal of International Medical Research 37, no. 4 (August 2009): 1173–78. http://dx.doi.org/10.1177/147323000903700423.
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During operative treatment for ovarian tumours assistance is frequently required to make decisions regarding malignancy status and the extent of the ensuing procedure. Intra-operative frozen section analysis may be useful, provided there is adequate acquaintance with the correlation between using frozen sections and permanent histopathological sections for diagnosis at the institution where the operation is being undertaken. This retrospective study aimed to determine this correlation. Findings from 131 intraoperative frozen sections were compared with the subsequent diagnosis from permanent histopathological sections for women with benign, borderline and malignant ovarian tumours at the Maribor Teaching Hospital (now the University Clinical Centre Maribor) between 1 January 1993 and 31 December 2001. Frozen-section findings corresponded to histopathological findings in 84.7% of cases, with 15.3% false-negative and no false-positive results. For benign, borderline and malignant ovarian tumours, sensitivity was 100.0%, 76.1% and 89.0%, respectively, and specificity was 90.6%, 90.6% and 100.0%, respectively. The majority of errors occurred in diagnosing mucinous borderline tumours. Precise preoperative diagnosis is extremely important in the treatment of ovarian tumours.
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Gidwani, Roopam Kishore, Falguni Jay Goswami, Arpan Mehta, Nirali V. Shah, Shobhana Ashok Prajapati, and Manisha M. Shah. "Frozen Section Diagnosis: Accuracy and Errors; with Emphasis on Reasons for Discordance." Annals of Pathology and Laboratory Medicine 8, no. 2 (February 28, 2021): A33–38. http://dx.doi.org/10.21276/apalm.2932.
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Background: Frozen section is a multistep process involving surgical resection, intraoperative preparation of slides and their microscopic examination. It is important to assess concordant, discordant and deferred diagnosis rates from intra-operative frozen section diagnosis with final diagnosis on paraffin section and to determine the reasons for discordance. An integral part of quality assurance in surgical pathology entails the correlation of intra-operative frozen section diagnosis with final diagnosis on permanent section.
Methods: A retrospective analysis of 117 cases of frozen section biopsy was carried out which were reported in the Histopathology department between July 2007 to June 2012. The correlation between the frozen section diagnosis with final histological diagnosis was performed in order to check the accuracy of the technique. The number and type of discrepancies were compared, causes for the discrepancies were analyzed in order to decrease the avoidable errors and improve on the frozen section diagnoses.
Results: The overall accuracy of frozen section diagnoses over 5years was 90.60% with false positive rate of 0.85%, false negative rate of 6.84% and 1.71% of deferred diagnosis. Sensitivity was 87.69% and Specificity was 98%. The discrepancies were mainly due to the interpretation error, sampling error and technical artefacts.
Conclusions: Gross inspection, sampling by pathologist, frozen section complemented with cytological and histological review and cooperation between consultants can avoid certain limitations and provide rapid, reliable, cost effective information necessary for optimum patient care.
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Yapp, Liam Z., Patrick G. Robinson, Nicholas D. Clement, and Chloe E. H. Scott. "Total Knee Arthroplasty and Intra-Articular Pressure Sensors: Can They Assist Surgeons with Intra-Operative Decisions?" Current Reviews in Musculoskeletal Medicine 14, no. 6 (December 2021): 361–68. http://dx.doi.org/10.1007/s12178-021-09724-5.
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Abstract Purpose of Review Soft tissue imbalance, presenting as instability or stiffness, is an important cause of revision total knee arthroplasty (TKA). Traditional methods of determining soft tissue balance of the knee lack precision and are not reliable between operators. Use of intra-operative pressure sensors offers the potential to identify and avoid soft tissue imbalance following TKA. This review aims to summarise the literature supporting the clinical indication for the use of intra-articular pressure sensors during TKA. Recent Findings Analytical validation studies suggest that intra-operative pressure sensors demonstrate ‘moderate’ to ‘good’ intra-observer reliability and ‘good’ to ‘excellent’ interobserver reliability throughout the flexion arc. However, there are important errors associated with measurements when devices are used out-with the stated guidelines and clinicians should be aware of the limitations of these devices in isolation. Current evidence regarding patient benefit is conflicting. Despite positive early results, several prospective studies have subsequently failed to demonstrate significant differences in overall survival, satisfaction, and patient-reported outcome measures within 1 year of surgery. Summary Surgeon-defined soft tissue stability appears to be significantly different from the absolute pressures measured by the intra-operative sensor. Whilst it could be argued that this confirms the need for intra-articular sensor guidance in TKA; the optimal ‘target’ balance remains unclear and the relationship with outcome in patients is not determined. Future research should (1) identify a suitable reference standard for comparison; (2) improve the accuracy of the sensor outputs; and (3) demonstrate that sensor-assisted TKA leads to patient benefit in patient-reported outcome measures and/or enhanced implant survival.
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Kordon, Florian, Andreas Maier, Benedict Swartman, Maxim Privalov, Jan Siad El Barbari, and Holger Kunze. "Multi-Stage Platform for (Semi-)Automatic Planning in Reconstructive Orthopedic Surgery." Journal of Imaging 8, no. 4 (April 12, 2022): 108. http://dx.doi.org/10.3390/jimaging8040108.
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Intricate lesions of the musculoskeletal system require reconstructive orthopedic surgery to restore the correct biomechanics. Careful pre-operative planning of the surgical steps on 2D image data is an essential tool to increase the precision and safety of these operations. However, the plan’s effectiveness in the intra-operative workflow is challenged by unpredictable patient and device positioning and complex registration protocols. Here, we develop and analyze a multi-stage algorithm that combines deep learning-based anatomical feature detection and geometric post-processing to enable accurate pre- and intra-operative surgery planning on 2D X-ray images. The algorithm allows granular control over each element of the planning geometry, enabling real-time adjustments directly in the operating room (OR). In the method evaluation of three ligament reconstruction tasks effect on the knee joint, we found high spatial precision in drilling point localization (ε<2.9mm) and low angulation errors for k-wire instrumentation (ε<0.75∘) on 38 diagnostic radiographs. Comparable precision was demonstrated in 15 complex intra-operative trauma cases suffering from strong implant overlap and multi-anatomy exposure. Furthermore, we found that the diverse feature detection tasks can be efficiently solved with a multi-task network topology, improving precision over the single-task case. Our platform will help overcome the limitations of current clinical practice and foster surgical plan generation and adjustment directly in the OR, ultimately motivating the development of novel 2D planning guidelines.
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Faraj, Adnan, Mark Andrews, and Weiguang Li. "Inter and intra-observer errors for postoperative total hip radiographic assessment using computer aided design." Acta Orthopaedica Belgica 87, no. 1 (March 31, 2021): 65–71. http://dx.doi.org/10.52628/87.1.09.
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Plain radiographic assessment of primary total hip arthroplasty following surgery remains to be the commonest radiological assessment. The current paper, studies the accuracy and concordance between observers reviewing these radiographs. A prospective radiographic and medical note review of ten patients who underwent total hip replacement for primary osteoarthritis, with a mean age of 69 years. Early and 6 weeks postoperative x-rays were assessed for hip profile and version profile using computer aided design (CAD) by two observers on two different occasions. The observers were Orthopaedic surgeons who perform arthroplasty of the hip. The results were analyzed statistically. Dimensions, including Femoral offset, medial offset and ilioischial offset showed a high degree of inter- film and intra-film correlation, with inter-class correlation (ICC) over 0.8. Except of the intra-film correlation of ilioischial offset measured on the post- operative films (p=0.067) by the first rater, all the intra and inter film correlation were significantly over the benchmark of 0.6. In terms of stem alignment, cup inclination and cup version, the intra-film correlation by rater n°2 ranges from 0.574 to 0.975 and were significantly over the benchmark of 0.6, except in the case of cup inclination measured on the 6 th? week follow-up ; meanwhile the intra-film correlation by rater n°1 ranges from 0.581 to 0.819 and none were significantly over the benchmark of 0.6. The inter-rater reliability and inter-film correlation showed a dichotomy of results among different dimensions of the measurement. Dimensions of femo- ral offset, medial offset and ilioischial offset showed a substantial degree of reliability in terms of inter-rater reliability, inter-film correlation, and intra-rater/film reliability.
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Su, Chia-Wei, Cheng-Li Lin, and Jing-Jing Fang. "Reconstruction of three-dimensional lumbar vertebrae from biplanar x-rays." Biomedical Physics & Engineering Express 8, no. 1 (November 10, 2021): 015001. http://dx.doi.org/10.1088/2057-1976/ac338c.
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Abstract Objective. Vertebrae models from computer tomographic (CT) imaging are extensively used in image-guided surgical systems to deliver percutaneous orthopaedic operations with minimum risks, but patients may be exposed to excess radiation from the pre-operative CT scans. Generating vertebrae models from intra-operative x-rays for image-guided systems can reduce radiation exposure to the patient, and the surgeons can acquire the vertebrae’s relative positions during the operation; therefore, we proposed a lumbar vertebrae reconstruction method from biplanar x-rays. Approach. Non-stereo-corresponding vertebral landmarks on x-rays were identified as targets for deforming a set of template vertebrae; the deformation was formulated as a minimisation problem, and was solved using the augmented Lagrangian method. Mean surface errors between the models reconstructed using the proposed method and CT scans were measured to evaluate the reconstruction accuracy. Main results. The evaluation yielded mean errors of 1.27 mm and 1.50 mm in in vitro experiments on normal vertebrae and pathological vertebrae, respectively; the outcomes were comparable to other template-based methods. Significance. The proposed method is a viable alternative to provide digital lumbar to be used in image-guided systems, where the models can be used as a visual reference in surgical planning and image-guided applications in operations where the reconstruction error is within the allowable surgical error.
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Ellenbogen, JR, V. Narbad, H. Hasegawa, and R. Selway. "P32 Targeting accuracy of the neuromate robot in DBS implantation for paediatric dystonia." Journal of Neurology, Neurosurgery & Psychiatry 90, no. 3 (February 14, 2019): e33.2-e33. http://dx.doi.org/10.1136/jnnp-2019-abn.105.
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ObjectivesTo quantify the accuracy of DBS electrode implantation for movement disorder in paediatric patients utilising the neuroinspire™ software and neuromate® robot.DesignRetrospective, single-centre, cohort study.SubjectsFifteen patients with dystonia (67% female; median age 11 years, range 8–18 years) underwent intervention since May 2017.MethodsDBS procedures were planned on the neuroinspire™ software and electrodes were implanted using the Renishaw neuromate® robot and Renishaw guide tubes and secured with a dog-bone plate under general anaesthetic. Post-operative CT imaging with the intra-operative O-arm was fused to pre-operative imaging. Planned entry and target coordinates were compared to actual entry and final target coordinates in order to obtain absolute and directional errors in x (medial-lateral), y (anterior-posterior) and z (dorsal-ventral) planes. Euclidean error was calculated for each electrode. Wilcoxon signed-rank test was used to analyse error.ResultsBilateral GPi were targeted and Medtronic DBS systems were implanted for each patient (n=30). Overall median Euclidean error for electrode implantation was 2.13 mm (range, 0.71–4.85; p<0.001). No discrepancy between left- and right-sided electrodes was seen (p=0.346). Absolute errors in x (med 1.25 mm, range 0.10–4.10), y (med 0.80 mm, range 0–2.70) and z (med 1.45 mm, range 0–3.90) planes were individually significant (p<0.001). On overall anterior displacement of leads was observed (med 0.55+0.85 mm, p=0.001) but there was no significant directional bias in x (p=0.219) or z (p=0.077) planes.ConclusionsWe observed an improvement in the discrepancy seen between planned and actual lead location compared to a previously reported series using the Leksell frame in a similar cohort. Addressing possible compounding factors such as drilling techniques and electrode fixation should increase accuracy further. The neuromate® Robot is a reliable and accurate alternative to the Leksell frame.
Conference papers on the topic "Intra-operative errors"
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Fieten, L. J., K. Radermacher, M. A. Kernenbach, and S. Heger. "Integration of model-based weighting into an ICP variant to account for measurement errors in intra-operative A-Mode ultrasound-based registration." In 2010 32nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2010). IEEE, 2010. http://dx.doi.org/10.1109/iembs.2010.5628071.
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Raghu Prasad, M. S., and M. Manivannan. "Design and Analysis of a Novel 5-DoF Bimanual Laparoscopic Impedance Skills Trainer With Haptics Feedback." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3547.
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Laparoscopic surgery has widely replaced open surgery due to the advantages it has for patients both during surgery and post-surgery recovery. Due to inversion and remote access to the surgical site, haptics feedback is altered with laparoscopic surgical instruments [1]. This leads to excessive exertion of force [2]. Many intra operative errors like tissue injury in laparoscopic surgery are due to texertion of large forces [2]. Over the years, virtual reality (VR) based laparoscopic surgical simulators with haptics feedback have been instrumental in teaching basic and advanced laparoscopic skills to residents and surgeons [3]. However, a major limitation in modern day VR based simulator training systems is that they do not effectively teach the bimanual impedance-based laparoscopic skills. Past studies on VR based laparoscopic training have captured the skills sets of residents and surgeons using force and psychomotor metrics [3, 4]. However, till date none have explored the effects of experience on impedance based training. In this study, we analyze the impedance skills of residents and surgeons using custom developed novel bimanual laparoscopic skills trainer.
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Onbasıog˘lu, Esin, Bas¸ar Atalay, Dionysis Goularas, Ahu H. Soydan, Koray K. S¸afak, and Fethi Okyar. "Visualisation of Burring Operation in Virtual Surgery Simulation." In ASME 2010 10th Biennial Conference on Engineering Systems Design and Analysis. ASMEDC, 2010. http://dx.doi.org/10.1115/esda2010-25233.
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Virtual reality based surgical training have a great potential as an alternative to traditional training methods. In neurosurgery, state-of-the-art training devices are limited and the surgical experience accumulates only after so many surgical procedures. Incorrect surgical movements can be destructive; leaving patients paralyzed, comatose or dead. Traditional techniques for training in surgery use animals, phantoms, cadavers and real patients. Most of the training is based either on these or on observation behind windows. The aim of this research is the development of a novel virtual reality training system for neurosurgical interventions based on a real surgical microscope for a better visual and tactile realism. The simulation works by an accurate tissue modeling, a force feedback device and a representation of the virtual scene on the screen or directly on the oculars of the operating microscope. An intra-operative presentation of the preoperative three-dimensional data will be prepared in our laboratory and by using this existing platform virtual organs will be reconstructed from real patients’ images. VISPLAT is a platform for virtual surgery simulation. It is designed as a patient-specific system that provides a database where patient information and CT images are stored. It acts as a framework for modeling 3D objects from CT images, visualization of the surgical operations, haptic interaction and mechanistic material-removal models for surgical operations. It tries to solve the challenging problems in surgical simulation, such as real-time interaction with complex 3D datasets, photorealistic visualization, and haptic (force-feedback) modeling. Surgical training on this system for educational and preoperative planning purposes will increase the surgical success and provide a better quality of life for the patients. Surgical residents trained to perform surgery using virtual reality simulators will be more proficient and have fewer errors in the first operations than those who received no virtual reality simulated education. VISPLAT will help to accelerate the learning curve. In future VISPLAT will offer more sophisticated task training programs for minimally invasive surgery; this system will record errors and supply a way of measuring operative efficiency and performance, working both as an educational tool and a surgical planning platform quality.