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"Surgical Instruments"
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Analysis and Design of Surgical Instrument Localization Algorithm
With the help of surgical navigation system, doctors can operate on patients more intuitively and accurately. The positioning accuracy and real-time performance of surgical instruments are very important to the whole system. In this paper, we analyze and design the detection algorithm of surgical instrument location mark, and estimate the posture of surgical instrument. In addition, we optimized the pose by remapping. Finally, the algorithm of location mark detection proposed in this paper and the posture analysis data of surgical instruments are verified and analyzed through experiments. The final result shows a high accuracy.
Journal Article
Empire of the scalpel : the history of surgery
\"From a renowned surgeon and historian with five decades of experience comes a remarkable history of surgery's development-spanning the Stone Age to the present day-blending meticulous medical studies with lively and skillful storytelling. There are not many events in life that can be as simultaneously life-frightening and life-saving as a surgical operation. Yet, in America, tens-of-millions of major surgical procedures are performed annually but few of us pause to consider the magnitude of these figures because we have such inherent confidence in surgeons. And, despite passionate debates about healthcare and the endless fascination with surgical procedures, most of us have no idea how surgeons came to be because the story of surgery has never been fully told. Now, 'Empire of the Scalpel' elegantly reveals the fascinating history of surgery's evolution from its earliest roots in Europe through its rise to scientific and social dominance in the United States. From the 16th-century saga of Andreas Vesalius and his crusade to accurately describe human anatomy while appeasing the conservative clergy who clamored for his burning at the stake, to the hard-to-believe story of late-19th century surgeons' apathy to Joseph Lister's innovation of antisepsis and how this indifference led to thousands of unnecessary surgical deaths, 'Empire of the Scalpel' is both a global history and a uniquely American tale. You'll discover how in the 20th century the US achieved surgical world supremacy heralded by the Nobel Prize-winning, seemingly impossible feat of transplanting a kidney and how the heart-lung machine was developed, along with much more. Today, the list of possible operations is almost infinite -- from knee and hip replacement to heart bypass and transplants to fat reduction and rhinoplasty -- and Rutkow draws on his five-decade career to show us how we got here. Authoritative, captivating, and comprehensive, 'Empire of the Scalpel' portrays the evolution of surgery in all its dramatic and life-enhancing complexity and shows that its history is truly one awe-inspiring triumph after another\"-- Provided by publisher.
Salespeople in the Surgical Suite: Relationships between Surgeons and Medical Device Representatives
Industry payments to surgeons have received public attention, but little is known about the relationships between surgeons and medical device representatives. Medical device representatives (\"device reps\") have become an integral part of operating room personnel. The effect of their presence on patient care deserves discussion.
We conducted a qualitative, ethnographic study to explore relationships between surgeons and medical device representatives, and characterize industry involvement in the training of surgeons. We used group and individual open-ended interviews to gain insight into the beliefs, values, and perspectives of surgeons and device reps. We conducted two focus groups, one with ear, nose, and throat surgeons, and one with hospital-based attending orthopedic surgeons. We also conducted individual interviews with three former or current medical device representatives, a director of a surgical residency program at an academic medical center, and a medical assistant for a multi-physician orthopedic practice.
While surgeons view themselves as indisputably in charge, device reps work hard to make themselves unobtrusively indispensable in order to establish and maintain influence, and to imbue the products they provide with personalized services that foster a surgeon's loyalty to the reps and their companies. Surgeons view industry-funded training opportunities as a necessary service. Device reps and some surgeons believe that reps benefit patient care, by increasing efficiency and mitigating deficiencies among operating room personnel (including the surgeons themselves).
Our study raises ethical questions about the reliance of surgeons on device reps and device companies for education and surgical assistance and practical concerns regarding existing levels of competence among OR personnel.
Journal Article
Empire of the scalpel : the history of surgery
\"From the sixteenth-century saga of Andreas Vesalius and his crusade to accurately describe human anatomy while appeasing the clergy who clamored for his burning at the stake, to the story of late-nineteenth-century surgeons' apathy to Joseph Lister's innovation f antisepsis and how this indifference led to thousands of unnecessary surgical deaths, Empire of the Scalpel is both a history and a uniquely American tale. Readers will learn how the United States achieved surgical leadership in the twentieth century, heralded by Harvard's Joseph Murray and his Nobel Prize-winning, seemingly impossible feat of transplanting a kidney, which ushered in a new era of transplants that continues to make procedures once thought insurmountable into achievable successes.\"-- Back cover.
Book
Enhancing Integrity and Economic Efficiency Through Effective Details Management of Operating Room Devices
This study aims to assess the impact of details management on the handling of instruments in the operating room, comprehensively evaluating its impact on device intactness, economic efficiency, overall care quality, and physician satisfaction.
We analyzed 1050 procedural packs used in our hospital from March to December 2019. The control group included 525 procedural packs with conventional management (March-August 2019), while the experimental group had 525 instrument packs with details management. Outcome measures included operating room device use, surgical care quality, and device tracking outcome.
Details management showed significantly higher device intactness (97.73%), a marked decrease in device preparation errors (0.00%), and more efficient device checking time (1.13±0.41) compared to conventional management (84.09%, 11.36%, 2.85±1.03) (P < .05). The experimental group had higher scores in intraoperative nursing ability, nursing operating specification, nursing staff professionalism, and device care quality (9.08±0.31, 9.23±0.32, 9.17±0.55, 97.81±0.96) compared to the control group (8.11±0.67, 7.98±0.98, 8.35±0.69, 75.25±1.87) (P < .05). Details management was associated with higher economic efficiency and lower incidences of device loss and mix-up compared to conventional management (P < .05).
Implementing details management in instrument handling positively affects device intactness, economic efficiency, overall care quality, and physician satisfaction. It enhances device intactness, reduces device checking time, improves economic efficiency and overall care quality, and increases physician satisfaction. The findings provide insights into the benefits of a detailed instrument management approach in a hospital setting.
Journal Article
Preliminary design and evaluation of a remote tele-mentoring system for minimally invasive surgery
BackgroundTele-mentoring during surgery facilitates the transfer of surgical knowledge from a mentor (specialist surgeon) to a mentee (operating surgeon). The aim of this work is to develop a tele-mentoring system tailored for minimally invasive surgery (MIS) where the mentor can remotely demonstrate to the mentee the required motion of the surgical instruments.MethodsA remote tele-mentoring system is implemented that generates visual cues in the form of virtual surgical instrument motion overlaid onto the live view of the operative field. The technical performance of the system is evaluated in a simulated environment, where the operating room and the central location of the mentor were physically located in different countries and connected over the internet. In addition, a user study was performed to assess the system as a mentoring tool.ResultsOn average, it took 260 ms to send a view of the operative field of 1920 × 1080 resolution from the operating room to the central location of the mentor and an average of 132 ms to receive the motion of virtual surgical instruments from the central location to the operating room. The user study showed that it is feasible for the mentor to demonstrate and for the mentee to understand and replicate the motion of surgical instruments.ConclusionThe work demonstrates the feasibility of transferring information over the internet from a mentor to a mentee in the form of virtual surgical instruments. Their motion is overlaid onto the live view of the operative field enabling real-time interactions between both the surgeons.
Journal Article
Bleeding risk of transbronchial cryobiopsy compared to transbronchial forceps biopsy in interstitial lung disease – a prospective, randomized, multicentre cross-over trial
Background
Bronchoscopic cryobiopsy is a new method of bronchoscopic tissue sampling in interstitial lung disease. In case of transbronchial biopsies, the resultant tissue samples are of high quality, and the lung parenchyma seen in the samples is adequate for a histological diagnosis in most cases. Bleeding after transbronchial biopsy is the most important procedure- associated complication and may be life threatening. This study addresses the risk of bleeding of transbronchial cryobiopsy.
Methods
In this prospective, randomized, controlled multicentre study 359 patients with interstitial lung disease requiring diagnostic bronchoscopic tissue sampling were included. Both conventional transbronchial forceps biopsy and transbronchial cryobiopsy were undertaken in each patient. The sequence of the procedures was randomized. Bleeding severity was evaluated semi-quantitatively as “no bleeding”, “mild” (suction alone), “moderate” (additional intervention) or “severe” (prolonged monitoring necessary or fatal outcome), for each intervention.
Results
In 359 patients atotal of 1160 cryobiopsies and 1302 forceps biopsies were performed. Bleeding was observed after forceps biopsy in 173 patients (48.2%) and after cryobiopsy in 261 patients (72.7%).
Bleeding was significantly greater in the cryobiopsy group (cryobiopsy/forceps biopsy: no bleeding 27.3%/51.8%; mild 56.5%/44.0%; moderate 15.0%/4.2%; severe 1.2%/0%;
p
< 0.001). The rate of clinically relevant bleeding (moderate or severe) was higher after the cryobiopsy procedures compared to the forceps biopsies (16.2% vs. 4.2%,
p
< 0.05). No fatal bleeding complications occurred.
Conclusions
Compared to transbronchial forceps biopsy, transbronchial cryobiopsy was associated with an increased risk of bleeding which is of clinical relevance. Therefore training and additional precautions for bleeding control should be considered.
Trial registration
The study was registered with clinicaltrials.gov (
NCT01894113
).
Journal Article
Optimized loading effects on pressure steam sterilization of loaned surgical instruments using product family categorization
Wet packs of loaned surgical instruments have always been a challenge for the Central Sterile Supply Department. Compared to other factors affecting pressure steam sterilization, loading is full of variables in practice. Based on the Product Family Categorization Theory, this project scientifically evaluates the steam penetration resistance level of each kit of loaned surgical instruments according to their different attributes to guide the sterilization staff to standardize the loading. By optimizing the loading method, the sterilization staff can quickly determine the most difficult to sterilize the loaned surgical instruments package in each batch, and select the best sterilization procedure according to its level, reducing their subjective judgment, and making the selection of sterilization procedures more standardized. That is to reduce the generation of wet packs, but also to ensure the safety of the use of patient equipment. However, due to manpower and time constraints, this study was only conducted in loaned surgical instruments and was a single-center study, and the sample size can be further expanded in the future to provide a basis for further improvement of the theory.
Journal Article