Application Experience of Eyesi Operation Simulation Training System in the Teaching of Cataract Surgery for Ophthalmology Masters

Objective:To explore the application effect of the Eyesi surgical simulator in the teaching of cataract surgery for professional ophthalmology postgraduate students.Methods:The professional postgraduate students who were trained in the third year of ophthalmology at the First Affiliated Hospital of Xi’an Medical University were selected as the research objects.After passing the theoretical examination,they were randomly divided into the pig eyeball group,Eyesi group,and pig eye+Eyesi group,with 5 students in each group.The pig eyeball,Eyesi surgery simulator,and pig eye+Eyesi surgery simulator were used for microscopic technique operation and cataract surgery steps training,respectively.After the training,the overall training effects of the three groups of postgraduates were scored,and questionnaires were used to objectively evaluate the three training methods.Results:The scores of the students in the pig eye+Eyesi group were better than those in the Eyesi group,and the students in the Eyesi group were better than those in the pig eyeball group.Conclusion:The Eyesi surgical simulation training system can evaluate the microsurgical skills of professional masters and improve their surgical skills.This system is of great significance for the training of the cataract surgery skills of professional masters.

A new robot-assisted orthopedic surgery simulation system

The paper proposes a novel desktop virtual surgical simulation system capable of not only surgical training but also operative planning, surgery rehearsal and telesurgery, which is mainly used on the robot-assisted orthopedic surgery system, HIT-RAOS. The paper first introduces the hardware system: HIT-RAOS. Then presents several major characters of the virtual system: developing tools, building schemes and collision detection algorithm. Additionally, virtual reality based telesurgery is implemented. Based on these works, experiments of locking of intramedullary nails are conducted, and results are content.

Understanding the effects of structured self-assessment in directed,self-regulated simulation-based training of mastoidectomy:A mixed methods study

Objective:Self-directed training represents a challenge in simulation-based training as low cognitive effort can occur when learners overrate their own level of performance.This study aims to explore the mechanisms underlying the positive effects of a structured self-assessment intervention during simulation-based training of mastoidectomy.Methods:A prospective,educational cohort study of a novice training program consisting of directed,self-regulated learning with distributed practice(5x3 procedures)in a virtual reality temporal bone simulator.The intervention consisted of structured self-assessment after each procedure using a rating form supported by small videos.Semi-structured telephone interviews upon completion of training were conducted with 13 out of 15 participants.Interviews were analysed using directed content analysis and triangulated with quantitative data on secondary task reaction time for cognitive load estimation and participants’self-assessment scores.Results:Six major themes were identified in the interviews:goal-directed behaviour,use of learning supports for scaffolding of the training,cognitive engagement,motivation from self-assessment,selfassessment bias,and feedback on self-assessment(validation).Participants seemed to self-regulate their learning by forming individual sub-goals and strategies within the overall goal of the procedure.They scaffolded their learning through the available learning supports.Finally,structured self-assessment was reported to increase the participants’cognitive engagement,which was further supported by a quantitative increase in cognitive load.Conclusions:Structured self-assessment in simulation-based surgical training of mastoidectomy seems to promote cognitive engagement and motivation in the learning task and to facilitate self-regulated learning.

Recent advances in computerized imaging and its vital roles in liverdisease diagnosis, preoperative planning, and interventional liversurgery: A review

The earliest and most accurate detection of the pathological manifestations of hepatic diseases ensures effective treatments and thus positive prognostic outcomes.In clinical settings,screening and determining the extent of a pathology are prominent factors in preparing remedial agents and administering approp-riate therapeutic procedures.Moreover,in a patient undergoing liver resection,a realistic preoperative simulation of the subject-specific anatomy and physiology also plays a vital part in conducting initial assessments,making surgical decisions during the procedure,and anticipating postoperative results.Conventionally,various medical imaging modalities,e.g.,computed tomography,magnetic resonance imaging,and positron emission tomography,have been employed to assist in these tasks.In fact,several standardized procedures,such as lesion detection and liver segmentation,are also incorporated into prominent commercial software packages.Thus far,most integrated software as a medical device typically involves tedious interactions from the physician,such as manual delineation and empirical adjustments,as per a given patient.With the rapid progress in digital health approaches,especially medical image analysis,a wide range of computer algorithms have been proposed to facilitate those procedures.They include pattern recognition of a liver,its periphery,and lesion,as well as pre-and postoperative simulations.Prior to clinical adoption,however,software must conform to regulatory requirements set by the governing agency,for instance,valid clinical association and analytical and clinical validation.Therefore,this paper provides a detailed account and discussion of the state-of-the-art methods for liver image analyses,visualization,and simulation in the literature.Emphasis is placed upon their concepts,algorithmic classifications,merits,limitations,clinical considerations,and future research trends.

Stable Real-Time Surgical Cutting Simulation of Deformable Objects Embedded with Arbitrary Triangular Meshes

Surgical simulators need to simulate deformation and cutting of deformable objects. Adaptive octree mesh based cutting methods embed the deformable objects into octree meshes that are recursively refined near the cutting tool trajectory. Deformation is only applied to the octree meshes; thus the deformation instability problem caused by degenerated elements is avoided. Biological tissues and organs usually contain complex internal structures that are ignored by previous work. In this paper the deformable objects are modeled as voxels connected by links and embedded inside adaptive octree meshes. Links swept by the cutting tool are disconnected and object surface meshes are reconstructed from disconnected links. Two novel methods for embedding triangular meshes as internal structures are proposed. The surface mesh embedding method is applicable to arbitrary triangular meshes, but these meshes have no physical properties. The material sub-region embedding method associates the interiors enclosed by the triangular meshes with physical properties, but requires that these meshes are watertight, and have no self-intersections, and their smallest features are larger than a voxel. Some local features are constructed in a pre-calculation stage to increase simulation performance. Simulation tests show that our methods can cut embedded structures in a way consistent with the cutting of the deformable objects. Cut fragments can also deform correctly along with the deformable objects.

CT-based Individualized Medical Implant Design

Most implantation cases are implemented using implants selected from the available standard set, but in some cases, only those implants conforming to individual patient's skeletal morphology can serve the purpose. This paper proposes a new approach to design and fabricate custom-made exact-fit medical implants. With a real surgical case as the example,technical design details are presented; and three algorithms are given respectively for segmentation based on object features, triangular mesh defragmentation and mesh cutting.

3D Vector Reconstruction of the Typical Cervical Vertebra from Anatomical Sections of Korean Visible Human at the Laboratory of Clinical and Digital Anatomy of Paris Descartes University

Aim: To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. Material and Methods: The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kg. This man donated his body to science. Her body was frozen and cut into several anatomical sections after an MRI and CT scan. These anatomical sections were made using a special saw called a 0.2 mm thick cryomacrotome. Thus 8100 cuts were obtained. Only the sections numbered 940 to 1200 were used for our study. A segmentation by manual contouring of the different parts of the typical cervical vertebra was made using the software Winsurf version 3.5 on a laptop PC running Windows 7 equipped with a Ram of 8 gigas. Results: Our 3D vector model of the typical cervical vertebra is easily manipulated using the Acrobat 3DPDF interface. Each part of the vertebra accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. Conclusion: This original work constitutes a remarkable educational tool for the anatomical study of the typical cervical vertebra and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.

Simulation training in endoscopic skull base surgery: A scoping review

Objective:Proficiency in endoscopic endonasal skull base surgery requires both substantial baseline training and progressive lifelong learning.Endoscopic simulation models continue to evolve in an effort to optimize trainee education and preoperative preparation and improve surgical outcomes.The current scoping review systematically reviews all available literature and synthesizes the current paradigms of simulation models for endoscopic skull base surgery training and skill enhancement.Methods:In accordance with Preferred Reporting Items for Systemic Review and Meta-Analyses guidelines,we systematically searched PubMed,Embase,CINAHL,and Cochrane databases.Studies were categorized according to the type of simulation models investigated.Results:We identified 238 unique references,with 55 studies ultimately meeting inclusion criteria.Of these,19 studies described cadaveric dissection models,17 discussed three-dimensional(3D)printed models,14 examined virtual surgical planning and augmented reality-based models,and five 5 articles described task trainers.Conclusions:There are a wide variety of simulation models for endoscopic skull base surgery,including high-fidelity cadaveric,virtual reality,and 3D-printed models.These models are an asset for trainee development and preoperative surgical preparation.

Validation of a 3D-printed human temporal bone model for otology surgical skill training

Hypothesis:Three-dimensional(3D)printed temporal bones are comparable to cadaveric temporal bones as a training tool for otologic surgery.Background:Cadaveric temporal bone dissection is an integral part of otology surgical training.Unfortunately,availability of cadaveric temporal bones is becoming much more limited and concern regarding chemical and biological risks persist.In this study,we examine the validity of 3D-printed temporal bone model as an alternative training tool for otologic surgery.Methods:Seventeen otolaryngology trainees participated in the study.They were asked to complete a series of otologic procedures using 3D-printed temporal bones.A semi-structured questionnaire was used to evaluate their dissection experience on the 3D-printed temporal bones.Results:Participants found that the 3D-printed temporal bones were anatomically realistic compared to cadaveric temporal bones.They found that the 3D-printed temporal bones were useful as a surgical training tool in general and also for specific otologic procedures.Overall,participants were enthusiastic about incorporation of 3D-printed temporal bones in temporal bone dissection training courses and would recommend them to other trainees.Conclusion:3D-printed temporal bone model is a viable alternative to human cadaveric temporal bones as a teaching tool for otologic surgery.