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Surgery is a medical treatment requiring specific manual procedures and instruments. Arthroscopy is a minimally invasive surgery for diagnosing and treating joint problems. The operation is performed by using special instruments and an arthroscope through incisions. This is involves complex manipulation that generally needs an assistant surgeon to hold the arthroscope. A vibration problem due to an unstable holding induces motion sickness of the lead surgeon. This research aims to design and construct a passive manipulator for holding an arthroscope during surgical operation. The designed passive manipulator consists of 7 degrees of freedom (DOF) with integrated electromagnetic brakes. A single switch is used to control the brakes, thus the surgeon can manipulate the arthroscope and fix its position and its orientation as needed. The provided range of motion of the designed device is verified by simulation that it is sufficient for knee arthroscopy and shoulder arthroscopy. The deflection due to the weight and loads is analyzed. The downward drift of the end effector is evaluated and the result is 3.90 mm which needs further improvement. [ABSTRACT FROM AUTHOR]

Additive manufacturing (AM) technology has found promising applications in the drug delivery and medical sectors. It is a manufacturing process that creates a physical model from computerised data. The advancement of 3D printing has opened up new possibilities for improving healthcare, from speeding up the manufacturing of implants to altering the way surgical operations are planned. Patient-specific 3D-printed anatomical models are gaining popularity as a tool for precision medicine and individualized care. There will be fewer people waiting for transplants and more lives saved if 3D-printed implantable organs become widely accessible in the future. Despite the fact that additive manufacturing in healthcare is still very much a work in progress, it is currently employed in many different ways in an industry that is already struggling under enormous pressure to provide optimum performance at lower prices. In this context, this review aims to visualise the application and development of 3D printing technology in the healthcare industry. [ABSTRACT FROM AUTHOR]

Drilling is done in an orthopaedic surgical procedures for the fixation of implants and screws. During bone drilling, excessive heat and forces can induce damage to the bone. Control and minimization of excessive torque, force and temperature during drilling procedures is essential. In particular, bone drilling torque needs to be controlled as it leads to severe problems such as drill bit seizure or breakage, and micro cracks in surrounding drill site. In this paper, drilling experiments are carried out in cortical human femur bone using Taguchi's L9 orthogonal array design. Feed rate and spindle speed are the two input parameters used in this work. Torque signals are obtained from Kistler force dynamometer. Input parameters are optimized for minimal torque values. The optimized parameters obtained from this study can be used to minimize the bone damage in actual surgery. It can also be used for robotic bone drilling process and surgical simulators. [ABSTRACT FROM AUTHOR]

One of the most commonly used surgical operations among patients with bladder cancer is radical cystectomy. An important stage of the operation is the choice of the method of urinary derivation. The aim of the study was to analyze the survival of patients with three different methods of urinary derivation. [ABSTRACT FROM AUTHOR]

Nanotechnology is an area of study involving different disciplines, constituting wide and different devices groups derivative of engineering, biology, physics as well as chemistry. Enhancement in Engineered Nanoscopic scale materials utilization for biomedical implementations as well as improved treatment is because of the latest developments in the fields of nanotechnology and biotechnology. In medical nanorobotics, physics is utilized on the nanoscopic scale for the execution of advanced work abilities in robotic agents free from tether proposed for eventual operations in limited physiologic surroundings of the human body. In lab circumstances, nanorobots can carry material to specific locations, in the organisms, this is the result of comprehensive research and accelerated advancement regarding the biomedical utilization of nanorobots. On the micro-scale, nanorobots can carry out several chores, for instance, less intrusive diagnostics, cure of illnesses, delivery of the drug to specific parts as well as local surgical procedures. Even if there are advancements, there is finite research concerning liabilities associated with nanorobots as well as the discussion is finite about the possible control of nanorobots. [ABSTRACT FROM AUTHOR]

The paper presents the correct stopping of bleeding during surgical operations and their disadvantages are indicated. A method for delivering hemostatic powder to the area of surgical operation is proposed. A pneumatic system that allows to do this is presented, and some of its settings are considered. Conclusions regarding the relevance of the proposed system are made. [ABSTRACT FROM AUTHOR]

Introduction: Birth of a fetus by using a surgical incision into the uterine wall after 28 weeks of pregnancy is called Cesarean Section. This surgical operation is identified as quicker, safer, and more prestigious method of child delivery to the pregnant. This work aims to determine the associated factors and causes of cesarean delivery in Najaf province-Iraq which comes on achieving the sustainable development goals. Methodology: Using a cross-sectional design, this work was done from 2021/2/1 to 2021/4/31. This study was conducted in Al Najaf city at Al-Zahra Teaching Hospital. The samples were selected randomly. Results: This study found that 50.8% of women had a previous cesarean delivery, and the primigravida women were 24.9%, 19.8% suffered from old infertility; however, 19.2% had a previous abortion. There was a highly significant correlation between primigravida, previous births, previous cesarean and age group under p-value 0.01. Also, there was a significant correlation under p-value 0.05 between abortion, cause of cesarean and age. In addition, significant correlation was found between previous cesarean, primigravida and geographical area. Conclusion.There was a crucial correlation between some medical and obstetrical conditions and cesarean section, and there were some associated factors leading to do it. [ABSTRACT FROM AUTHOR]

Robotic surgery has become one of the necessary techniques in many surgeries, including gynecological surgeries, urology, prostate, cardiac operations, catheters, arteries, and brain surgeries. The research problem is small wounds that, in the past, required a high level of expertise and an absolute focus to perform them. The robot helps the surgeon in surgeries that require working through tiny incisions; the robot can fix the telescope without movement or fatigue. The doctor was able to control its movements very accurately. Robots today assist the surgeon in many surgical interventions; minimally, the robot supports the surgeon with excellent vision, image, and precision to perform accurate surgeries with minimal surgical intervention. In this research, a general systematic literature review was performed on surgery robots. [ABSTRACT FROM AUTHOR]

To control the efficiency of surgery, it is ideal to have actual starting times of surgical procedures coincide with their planned start time. This study analysed over 4 years of data from a large metropolitan hospital and identified factors associated with surgery commencing close to the planned starting time via statistical modelling. A web application comprising novel visualisations to complement the statistical analysis was developed to facilitate translational impact by providing theatre administrators and clinical staff with a tool to assist with continuous quality improvement. [ABSTRACT FROM AUTHOR]

Paramedian Forehead Flap is one of the complex surgical techniques that requires high competence from residents who wish to specialize in plastic surgery, due to several considerations that must be considered such as the use of the side used as a flap and blood supply. The facial simulators that are anatomically accurate are sold at quite high prices, because of the complexity of the manufacturing process. Research on simplifying the simulator manufacturing method is needed so that it is easily produced and used as a tool to increase resident's competencies and experiences. The anatomy depicted in the simulator is adapted to the layers that are on the human face. With the use of 3D printing as a basis for manufacturing methods, materials that can simulate the mechanical properties of each layer are selected based on references from other studies. An assessment process is carried out on the results of the simulator production to evaluate whether each layer has represented the original layer on the human face and its use as a tool to increase resident competencies. Although still far from achieving the best results, the simplification of the manufacturing method mentioned in this study will provide chances for further studies. [ABSTRACT FROM AUTHOR]

Currently, Bangladeshi surgeons approach surgeries by observing 2D reports or very often 3D photographic views of the affected body parts to assume a 3D construction of that body part, which is surely a difficult process and also may lack in assumption sometimes. Most often, students in operation theatre (OT) being large in number fails to understand the surgical procedures due to the lack of proper visualization. Even due to not having a sufficient level of experience, they don't get the chance to perform any practice surgery, so they have to learn only by visualization, which is definitely a long-time process. Moreover, medical students sometimes face financial problems in buying costly human bones. To get rid of these shortcomings, this study aims to introduce the manufacturing of patient-specific 3D printed models. Proper application of this technology will work as an aid to be able to provide low budget 3D printed human bones required for educational purposes, increase the learning proficiency of medical students by giving them chances to perform practice surgeries and also lessen patient's intraoperative bleeding time, anaesthetic exposure and heat loss through proper pre-surgical planning by surgeons as the outcome of practice surgery, which will lead to achieving a higher satisfaction level of the patients that promises to change the current medical scenario of Bangladesh tremendously. [ABSTRACT FROM AUTHOR]

Computer Aided Design (CAD) and 3D printing are increasingly bringing innovation to orthopedic surgery by allowing customization of surgical procedures. This study proposes the design and 3D printing of patient-specific surgical cutting guides (PSCG) that can be implemented in orthopedic surgery. Cutting guides are surgical tools that allow surgeons to perform cutting operations more accurately, achieving the desired result with high accuracy. During an osteotomy, for example, the surgeon will be able to better determine the position of the cutting line and its direction. This study aims to propose an advanced method of designing cutting guides for an orthopedic surgery procedure. Proposed tools are obtained by an additive manufacturing process that starts with a 3D model of the patient's bone obtained from CT scan images and ends by designing the patient-specific cutting guide model in a CAD environment. Virtual surgical planning (VSP) allows for increasing the surgeon's awareness for developing an orthopedic surgical strategy and allows for the design of cutting guides designed around the patient's specific anatomy. [ABSTRACT FROM AUTHOR]

High-frequency electrosurgical generator (ESG) is an efficient medical device that is used in surgery for cutting and coagulation of tissues. ESG produces high-frequency alternating current in order to reduce the stimulation of muscles and nerves. The main objectives of the proposed study are: (i) Design and analysis of ESG with cost-effective power converters; and (ii) Investigation of the effect of high switching frequency on the design and performance of the power-electronic converters. The proposed ESG consists of a buck converter (considering its parasitic elements) and H-bridge inverter connected with a high-frequency linear transformer. The proposed ESG is tested on various bio impedances to find the optimal frequency that achieves satisfactory performance. The numerical analysis and simulation results of the proposed study have concluded that, increasing the switching frequency in the DC side decreases the efficiency of the DC-DC buck converter. Also, in the AC side, the rise time of the output voltage is decreased. It is also found that increasing the switching frequency in the AC side will consequently decrease the time period of the surgical operation. These findings can successfully aid in minimizing the blood loss. [ABSTRACT FROM AUTHOR]

Since 3D printing was developed, it became the most promising technique to speed up prototyping in a wide variety of areas across the industry. Rapid prototyping allows the medical industry to customize the surgery procedures, thus predicting its result. Biomedical applications made by medical grade elastic thermoplastic polyurethane (TPU); a nontraditional plastic material which allows to obtain additional benefits in rapid 3D prototyping because of its flexibility and anti-bacteriological capabilities. The aim of this study is to assess the efficacy of TPU polymer, FDM objects sourced from CT scanned 3D surfaces for helping surgeons in preoperative planning and training for increasing environment perception, that is, geometry and feeling of the tissues, whilst performing standard procedures that require complex techniques and equipment. A research was performed to assess the physical and qualitative characteristics of TPU 3D developed objects, by developing a proper SWOT analysis against PLA, a widely used, and cost-effective option in FDM industry. Therefore, giving a proposition opposite to other known modern medical planning techniques and bringing out the benefits of the application of TPU-sourced, FDM parts on professional medical training. As a result, PLA is a reliable, wide-available process whilst TPU's flexible capabilities improves realism in 3D printed parts. Surgical planning and training with rapid prototyping, would improve accurate medical prototyping for customized-procedures, by reducing surgery times, unnecessary tissue perforations and fewer healing complications; providing experience that other FDM materials like PLA cannot be reached. [ABSTRACT FROM AUTHOR]

South Korea has a public and single-payer system for healthcare services based on fee-for-service payments. The National Health Insurance (NHI) reimbursement claim codes are used by all healthcare providers for reimbursement. This study mapped NHI reimbursement claim codes for therapeutic and surgical procedures to the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to facilitate semantic interoperability and data reuse for research. The Source codes for mapping were 2,500 reimbursement claim codes for therapeutic and surgical procedures such as surgery, endoscopic procedures, and interventional radiology. The target terminology for mapping was the 'Procedure' hierarchy of the international edition of SNOMED-CT released in July 2019. We translated Korean terms into English, clarified their meaning, extracted characteristics of the source codes, and mapped them to pre-coordinated concepts. If a source concept was not mapped to a pre-coordinated concept, we mapped it to a post-coordinated expression. The mapping results were validated internally using dual independent mapping and group discussion by trained terminologists, and by two physicians with experience of SNOMED-CT mapping. Out of 2,500 source codes, 1,298 (51.9%) codes were mapped to pre-coordinated concepts, and 1,202 (48.1%) codes were mapped to post-coordinated expressions. The mapping of the NHI reimbursement claim codes for therapeutic and surgical procedures to SNOMED-CT is expected to support clinical research by facilitating the utilization of health insurance claim data. [ABSTRACT FROM AUTHOR]

A Dental implant is a surgical procedure of fixing an artificial tooth inside the jawbone and allowed to heal over a span of time, in that performing Socket Shield Technique (SST) by preserving some part of root inside the extracted part called 'Socket' and depending upon the shield and implant position inside the socket will give different results. Aim of this study is by adapting the SST for immediate implant placement after the tooth extraction will give better stability and success rate over a period. to over the conventional technique there are number of trials going on and how to come up with optimum stress generation while implant placement and have better stability to it. Different researchers reported that by keeping the shield of 1.2-1.5 mm will give better results for selection of proper dimension of implant for implantation. The stability and success rate of dental implant is still has to be more clinically verified and more number of trials has to be adopted for conclusion. As per recent report shows the use of modified shield will have chances of getting higher success rate over one-year span, this study gives clear idea for proper selection of shield thickness and implant size to generate optimum stress over bone with less complications rate. [ABSTRACT FROM AUTHOR]

A dental implant's success and survival rate is often affected by the complexities involved during the dental implantation. This has led the dental implant research towards the techniques and ideas in minimizing the complexities during surgery and increasing the survival. The implantation involving the unavailability of bone quantity must be treated with a solution of complicated bone augmentation techniques. Short implants are now considered as a viable alternative to these complicated techniques. The emphasis of this review article has been on the information about the various influences that govern the success of short implants. It is important to consider the various biomechanical factors and prosthetic design parameters so as to avoid the failure of short implants. Also, several Randomized Controlled Clinical Trials (RCTs) of short implants have been considered that experimentally test the effectiveness of short implants. A review of FEA studies has been included that give the solution for difficult problems involving complex geometries. Thus, a detailed understanding of the short implants would help the dentist to decide the length and diameter of the short implants which are important parameters. This can also help in reducing the complex surgical procedures. However, further research is necessary so as to see how the variation in several factors at the same time affects the survival rate and success of short implants. [ABSTRACT FROM AUTHOR]

The terms correction and manipulation in the surgical management of scoliosis define a harmonization of several measures performed individually or simultaneously to realign a deformed spine into its normal state on sagittal or coronal views. Scoliosis surgical procedures are modified due to the fact that they are complex procedures with frequent complications and unsatisfactory surgical outcomes. This technique combines rod and screws corrective manipulations applied to each vertebral segment according to the pathobiomechanic state of the deformity to simplify the manipulation process and achieve a good surgical outcome. A preliminary experimental study was done on modifications to the screw application technique, rod application for vertebral segment maneuver techniques during manipulation, and connecting rod use. Surgical outcomes were compared between the rod and screw corrective manipulation (RSCM) and conventional techniques in patients who underwent corrective surgery for scoliosis. Twelve scoliosis patients who underwent the RSCM technique had better complication rates, operative time, estimated blood loss, length of hospital stay, and sagittal alignment correction outcome compared with the 15 scoliosis patients who underwent surgery via the conventional technique. The RSCM technique was not complex, and it was easy to apply and provided better corrective outcomes. Hence, this is a promising treatment of choice for the surgical management of scoliosis patients. [ABSTRACT FROM AUTHOR]

Periodontal disease can be treated with a surgical procedure using a bone graft. Tooth graft is an alternative graft for Guided Tissue Regeneration because tooth graft consists of organic and inorganic materials which are very similar to bone. The purpose of this study was to analyze the potential of hydroxyapatite from tooth graft as an alternative for conventional bone graft using OPG and RANKL as parameters. This research is a study on Wistar mice by post only control group design. In this study, 18 Wistar mice divided into 2 groups, control group, and tooth graft groups. On the tooth graft group, the mice socket post extraction was filled with hydroxyapatite, while the sockets from the control group were left untreated. OPG and RANKL expressions were analyzed on the fourteenth day after the application of hydroxyapatite. Independent T-test is used to analyze the results. The result of the expression of OPG between the control group and the tooth graft group showed that p<0,05 which mean that there was a significant difference. The result of the expression of RANKL between the control group and the tooth graft group showed that p<0,05 which mean that there was a significant difference. The expression of OPG and RANKL in the tooth graft group showed that p>0,05, which mean there was no significant difference. From this study can be concluded that the hydroxyapatite tooth graft is able to enhance the expression of OPG and RANKL. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the pitting corrosion behavior on cerclage wire under the effect of Nd:YAG laser welding. The application of a modern surgical procedure for the femoral treatment is a target for contribution. A stainless steel wire 316L according to ASTM F 138 (UNS S31673) with a diameter of 1.5 mm as a surgical implant of the orthopedic surgeon was used in this experiment. The charge voltage, multi – frequency, and width of the laser pulse are the studied variables. The corrosion testing was conducted by using electrochemical test in 9 g/L NaCl solution at 37±1°C which was evaluated by potentiodynamic polarization. Effect of heat input was discussed on corrosion behavior. It was found that using the high value of the laser parameters, which have a high heat input delivered to a cerclage wire, resulted in increasing of corrosion current density icorr and corrosion potential Ecorr. The lowest heat input of 17.09 J/cm or the combination of the charge voltage of 80 volts, pulse– frequency of 6 Hz and the pulse width of 1.5 ms provided high efficiency pitting corrosion resistance in this study. [ABSTRACT FROM AUTHOR]

There were many cases reported for ovarian cysts and it was difficult to recognize the size of cyst whether it is a large or a small cyst. Thus, this research was conducted to predict the size of benign cysts according to the patient's symptoms and its risk factors, to analyze the relationship between the size of benign cyst and the type of surgical procedures that the patient needs to undergo and to obtain which variable gives most important effect to the model. Retrospective observation study has been applied in this research since the data was collected from the monthly census file for year 2016 in Ward of Obstetrics and Gynecology from Hospital A, Johor Bahru. From the 89 patients of benign ovarian cysts, only 26 of the patient have small cysts and the other 63 patients have large benign cysts. From analysis, it found that the significant symptoms towards the predicting of Size of Benign Cyst were Abdominal Pain and Intermenstrual Bleeding. There were no significant for the risk factors. There was a significant relationship between the Size of Benign Cysts and the Type of Surgical Procedure. From the association, it can be concluded, if the patient had a large size of cysts, they will need to undergo laparotomy surgery. By using log-linear analysis, it is found that the most important effect in model was Type of Operation. [ABSTRACT FROM AUTHOR]

Three-Dimensional Printing (3DP) technology using Polylactic Acid (PLA) has been applied in numerous medical applications and successfully improved surgical procedures. Unfortunately, the quality of the transferring process from scanning the human organ to the production of organ prototypes remain inaccurate and inconsistent. This study aims to develop and to validate the sequencing process of designing and producing prototyping models of a human internal organ as a virtual tool to reduce the possibility of failures in the surgery. The image processing steps of volume rendering, segmentation, and refinement followed by prototype production with ratio 1:1 applied to the three-dimensional scanning imaginary data of normal and abnormal patients. The validation techniques consist of qualitative and quantitative methods. The qualitative approach reveals that the 3DP using PLA could enhance the existing modality to visualize the real condition of the patient. The quantitative approach shows that the length of normal and abnormal organ prototypes respectively was 7.5 cm and 13.5 cm. The volume from three different formats of the human organ model was 33.790 cm³ in DICOM format, 34.592 cm³ in STL format, and 35.000 cm³ in prints. The validation techniques conclude that the PLA prototypes of the human internal organ are similar to the imaging data and satisfying for virtual surgical planning. [ABSTRACT FROM AUTHOR]

In orthopaedics, ‘bone drilling’ is a universal surgical method generally employed in internal fracture fixation, install implants, or to carryout reconstructive surgery. The main purpose of bone drilling is to produce holes for fixing screws, wires and plates to fasten the fractured parts for immobilisation. Investigation on drilling of bones have found importance in recent times to reduce bone tissue damage i.e. osteonecrosis (ON) and unwanted complications for successful surgery. This review aims to provide an overview on the work reported by various authors in the area of bone drilling and addresses valid clinical problems. The determination of optimal process variables found beneficial to perform surgical operations more efficiently. [ABSTRACT FROM AUTHOR]

Objective to analyze the diagnosis, surgical technique and therapeutic effect of multiple intramedullary spinal core ependymomas. Methods the clinical data of 16 cases of multiple intramedullary spinal core ependymomas treated from 2013 to 2017 were retrospectively analyzed. Results in 16 patients with spinal ependymomas, there are 10 cases of cervical spinal cord ependymomas, and 5 cases of thoracolumbar ependymoma, as well as 1 case of recurrence. Postoperative MRI showed no tumor residues in 15 patients and partial paravertebral tumor residued in 1 patient. Conclusion Microsurgical technique can achieve complete resection of multiple intramedullary ependymomas under microscope. [ABSTRACT FROM AUTHOR]

ICD-10-PCS coding is challenging because of the large number of codes, non-intuitive terms and paucity of the ICD-10-PCS index. We previously repurposed the richer ICD-9-CM procedure index for ICD-10-PCS coding. We have developed the MAGPIE tool based on the repurposed ICD-9-CM index with other lexical and mapping resources. MAGPIE helps the user to identify SNOMED CT and ICD-10-PCS codes for medical procedures. MAGPIE uses three innovative search approaches: cascading search (SNOMED CT to ICD-9-CM to ICD-10-PCS), hybrid lexical and map-assisted matching, and semantic filtering of ICD-10-PCS codes. Our evaluation showed that MAGPIE found the correct SNOMED CT code and ICD-10-PCS table in 70% and 85% of cases respectively, without any user intervention. MAGPIE is available online from the NLM website: magpie.nlm.nih.gov. [ABSTRACT FROM AUTHOR]

As a part of the existing senior design class for biomedical engineering students, we have implemented the introduction of surgical procedures and demonstration in orthopedic medical device design process. It is aimed at senior biomedical engineering students to increase student interest and understanding in orthopedic medical device design. The objectives of this course are to teach students many aspects of medical device design through hands-on projects with multiple lecture topics such as the FDA design control process. The course includes lectures about various topics and requires that each student group present research and design proposals to address a specific engineering/design need, work in labs for hand-on practice, and complete a project to develop a design and/or working prototype to address the need. The class was assessed in compliance with the design control process, documentation, laboratory reports, final design, and analysis. For the specific group who chose orthopedic implant, the students were asked to design the devices without consideration of the surgical procedure. After students had a design completed, the surgical procedure was introduced to the groups, and the student groups investigated if there were needs to revise the design based on the consideration of surgical procedure. At the end of the semester, a special assessment was conducted for these groups only, and results showed that consideration of surgical procedure led to changes in final design and a better understanding of orthopedic medical devices. Student self-assessment was completed during three academic years starting in 2014-2015 and the results are presented in this article. This paper also discusses the changes that were made in response to student feedback. [ABSTRACT FROM AUTHOR]

In Japan diagnostic criteria for lymphedema after gynecological cancer surgery have not been established, and it is difficult to accurately determine the rate of incidence of its occurrence [1]. As the length of hospitalizations has been shortened, there are many patients who are discharged from the hospital without having sufficient knowledge and skills to prevent the onset of lymphedema [2]. This study aims to determine factors influencing the lymphedema onset of gynecologic cancer patients who have undergone surgery, to conduct intervention programs to promote self-management of lymphedema prevention, and to establish the effect of the interventions. The study participants were gynecologic cancer patients who had undergone lymph node dissection in the participating hospitals. Inclusion criteria are patients aged between 20 and 74, and who are able to perform the self-management, participate in all the programs with physically and mentally stable conditions. We provided instruction about the self-management to prevent lymphedema for the intervention group. After discharge from the hospital, patients were given health instruction once a month by phone. The femoral circumference and body weight were measured and recorded weekly from 3 to 5 days after surgery (before discharge). For the control group, the femoral circumference and weight were measured and recorded before discharge and 6 months after surgery. Surveys were conducted twice, before discharge and 6 months after the surgery. Surveyed items were the right and left femoral circumferences and body weight, and any presence of lymphedema. We also administered a self-rating questionnaire survey, with questions of demographic characteristics, health conditions, self-efficacy with health problems, and ability to conduct self-management activities. The questionnaire was collected by mail, and the significance level of the statistical measures was set as below 0.05. This study was conducted in accordance with commonly accepted ethical considerations. We explained the outline of the study to 130 patients, and 108 expressed consent. We randomly divided the patients into two groups: 56 as an intervention group, and 52 as a control group. Before the discharge, 55 valid responses (98%) to the questionnaire were collected from the intervention group and 51 (98%) from the control group, and 6 months after surgery, from 51 (92.7%) of the intervention group, and from 45 (88.2%) of the control group. At discharge there were no significant differences in femoral circumference and body weight, or in presence of lymphedema in the groups. Six months after the surgery, the body weight and incidence of lymphedema were significantly lower in the intervention group. The intervention group reported some mild symptoms of health problems, and this group scored significantly better in the meaningfulness of sense of coherence (SOC), overall quality of life (QOL), physical area of QOL, and self-efficacy with health problems in the questionnaire. For the self-management behavior, the intervention group showed significantly higher scores in the interactions with medical personnel and in coping with symptoms. As a result of the multiple logistic regression analysis using the presence of lymphedema as an objective variable, there were differences between the groups and in the coping with symptoms as factors influencing the onset of lymphedema. The possibility of not developing lymphedema was 4.1 times higher in the intervention group, and 1.9 times higher in patients who are able to cope with symptoms. Traditionally, emphasis has been placed on physical self-management to prevent the onset of lymphedema after gynecological cancer surgery. The program here was developed by further assuming that it is important to make physical, mental and social adjustments, and we developed a program paying close attention to these aspects of recovery. As the differences between the groups and the coping with symptoms have been shown to be factors influencing lymphedema onset, it is suggested that providing interventions addressing physical, mental, and social aspects concurrently will enable patients to acquire the skills necessary to cope with symptoms by themselves. [ABSTRACT FROM AUTHOR]

In this paper, I have described the ways in which the surgeons do practical reasoning when they recognize and identify certain blood vessels or organ location. Because the structures of the human body configuration is fairly complicated and not identical among different persons, the recognition and identification of the structures beforehand is very important from a medical safety purpose. In order to resolve this practical problem, by using a locational formulation in a spatiotemporal way, the speakers are demonstrating their recognizing of the object here-and-now. In addition, through the gestural practices of inviting others to see and examine the same objects, the recipient's agreement/disagreement has been also made relevant, which is also crucial for medical safety purposes. [ABSTRACT FROM AUTHOR]

The lack of visible and approachable ways of training surgical skills is one of the main problems in medical education. Existing simulation training devices are not designed to teach students, and are not available due to the high cost of the equipment. Using modern technologies such as virtual reality and hands movements fixation technology we want to create innovative method of learning the technics of conducting operations in 3D game format, which can make education process interesting and effective. Creating of 3D format virtual simulator will allow to solve several conceptual problems at once: opportunity of practical skills improvement unlimited by the time without the risk for patient, high realism of environment in operational and anatomic body structures, using of game mechanics for information perception relief and memorization of methods acceleration, accessibility of this program. [ABSTRACT FROM AUTHOR]

The paper defines the therapeutic and rehabilitation approach to the patients with Angle's classification Class II dento-facial anomalies, accompanied by obstructive sleep apnea (OSA). The proposed comprehensive approach to the diagnostics and treatment of patients with posterior occlusion, accompanied by OSA, allows for objective evaluation of intensity of a dento-facial anomaly and accompanying respiratory disorders in the nasal and oral pharynx, which allows for the pathophysiological mechanisms of OSA to be identified, and an optimal plan for surgical procedures to be developed. The proposed comprehensive approach to the diagnostics and treatment of patients with Angle's classification Class II dento-facial anomalies provides high functional and aesthetic results. [ABSTRACT FROM AUTHOR]

The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required. [ABSTRACT FROM AUTHOR]

The aim of the study is to create an image processing system, which allows dentists to find pathological resorption and to build surgical guide surface automatically. X-rays images of jaws from cone beam tomography or spiral computed tomography are the initial data for processing. One patient's examination always includes up to 600 images (or tomograms), that's why the development of processing system for fast automation search of pathologies is necessary. Xrays images can be useful not for only illness diagnostic but for treatment planning too. We have studied the case of dental implantation - for successful surgical manipulations surgical guides are used. We have created a processing system that automatically builds jaw and teeth boundaries on the x-ray image. After this step, obtained teeth boundaries used for surgical guide surface modeling and jaw boundaries limit the area for further pathologies search. Criterion for the presence of pathological resorption zones inside the limited area is based on statistical investigation. After described actions, it is possible to manufacture surgical guide using 3D printer and apply it in surgical operation. [ABSTRACT FROM AUTHOR]

The aim of research was to estimate level of Toll-like receptors (TLRs) of innate immunity in patients with different stages of tubal adhesions and possibilities to use their detection for prediction of adhesions 21 women with I stage of tubal adhesions (I group) and 31-with II-IV stages of adhesions (II group) were examinated. Samples were taken from endocervix by cytobrush and by biopsy of tubes during laparoscopy. Expression of TLRs was determined using qPCR. 5-fold decrease of TLR1, which ligands are bacterial lipoproteins of gram-positive bacteria, was observed in tubal tissue in group with severe tubal adhesions. Among TLRs, which are capable to recognize viruses and nucleic acids, only TLR7 (ligand - single stranded viral DNA) had 28-fold decrease in group with severe adhesions. mRNA expression of other TLRs (TLR2, TLR3, TLR4, TLR5, TLR8 and TLR9), had no significant difference with the I group. There were no significant differences of TLRs expression in endocervix in both groups. [ABSTRACT FROM AUTHOR]

In this paper, we share insights from our user research studies for the development of the graphical user interface (GUI) design of a surgical operation robot. We had previously been developing the surgical interface (SI) for kidney tumor cryoablation by collecting eye-tracking data for fixation durations and number of fixations at informative regions from the users (Erol Barkana & Acik, 2014). Based on the analyzed data, we then explored the GUI for layout, color use and warning message communication by i) literature review, ii) evaluation using Nielsen's heuristics (Nielsen, 1994), and iii) re-design studies with design workshops. Relying on all the user feedback, we re-designed the GUI and conducted GUI design feedback survey. Here, we share our insights throughout this user research and GUI re-design process. [ABSTRACT FROM AUTHOR]

This paper presents a study of near real-time ultrasound image guidance technique for motion tracking of the targets such as tumors during a focus ultrasound surgery. A 2D ultrasound based motion tracking system was designed and evaluated. A robot was used to control the position of the focused ultrasound device to be focused at the target. The target position was extracted from a real-time ultrasound video and tracked by the robot. The accuracy and precision of the tracking system were characterised using an egg-white gel phantom. Experiments have been conducted and results show sufficient efficiency of the image guidance algorithm. A further feasibility study using ultrasound strain elastography was conducted to assess the FUS (focused ultrasound surgery) sonication. Sonication experiments on tissue mimicking material, fresh sheep liver and Thiel sheep liver were conducted to evaluate the assessment performance of ultrasound strain elastography. This work provides a potential to combine the real time ultrasound image motion tracking and ultrasound strain elastography monitoring. [ABSTRACT FROM AUTHOR]

The article discusses the development of a slow expanding hydrogel which is used for cleft palate surgical reconstruction. It shows the applicability of hydrogels in tissue expansion devices through controlling monomer, initiator and cross-link composition and polymerization method. It also demonstrates the inducement of anisotropic expansion through thermo-mechanical processing of the preformed hydrogels which are tested on piglets.

Localization of eloquent areas is of utmost importance in neurosurgical planning, especially in epilepsy surgery. Mass, destructive, or developmental lesions may distort brain anatomy. Functional MRI (fMRI) can localize eloquent areas despite these distortions and provide useful information for the planning of tailored resections. This paper deals with the major issues concerning the use of fMRI in epilepsy surgery, including its limitations. We present results derived from the clinical experience of the Epilepsy Surgery Center at Ribeirão Preto School of Medicine, where typical finger tapping and language fMRI paradigms were applied to 40 patients being considered for resective epilepsy surgery around eloquent cortex. Our results confirmed that although fMRI may not be used as a single tool for surgical planning, in conjunction with other methods it is useful in reducing the surgical time, it improves lesion resection, and prevents functional deficits. © 2004 American Institute of Physics [ABSTRACT FROM AUTHOR]

Today, healthcare providers and policy makers are puzzled on how to improve care delivery's quality and efficiency to attain patient satisfaction and cost effectiveness. They need more than ever powerful tools to bring out-of-the box solutions to challenges of nowadays-unprecedented changes. Hopefully, an increasing number of hospitals are embracing the Lean Six Sigma (LSS) improvement methodology as a path to manage improvement and innovation. Although, the method can contribute toward achieving greater care quality and eliminating wastes, it is not designed to lead to transformational changes that are sought today. In fact, once identifying the problem's root causes, the current LSS toolbox has no tools for generating disruptive ideas. To address this shortcoming, this study aims at strengthening LSS methodology by innovation tools. This is ensured by combining the approach with Stanford Biodesign Process tools, leading to a more value-driven innovation system. This combination will not only enable doctors to identify patients' unmet-needs and create a variety of breakthrough solutions through Biodesign, but it will also allow them to deal with the intricacy of the solution's implementation in an efficient manner through LSS tools. Overall, this combined approach is intended to shape innovative solutions in the healthcare sector, ranging from treatment and surgical procedures to medical devices. [ABSTRACT FROM AUTHOR]

Using a Weberian approach to understand how rationality and values become embedded in social actions and trends, this paper explores the increasing U.S. cesarean surgery rate, which reached an all-time high of 32.3 percent in 2008 (most recent year of data). I focus specifically on the role of electronic fetal monitors (EFM) on this increase. EFM is used to monitor the labors of nearly all women who give birth in U.S. hospitals, yet there is no medical evidence that birth outcomes are improved by its use and substantial evidence that its use increases a woman's risk of cesarean surgery. The use of EFM rather than more simple and equally effective forms of observation of fetal health during labor is linked to malpractice fears of maternity providers, providers' beliefs that EFM makes labor more predictable and easier to understand, and nursing shortages. I draw on 50 semi-structured interviews of maternity providers to explore how values of risk, blame for bad outcomes, belief in science and technology, and the protection of children and fetuses become rationalizations and justifications for the use of electronic fetal monitors and the disuse of other technologies, contributing to the increasing U.S. cesarean surgery rate. [ABSTRACT FROM AUTHOR]

. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]