• Title/Summary/Keyword: Surgical education

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Stepwise Training for Reconstructive Microsurgery: The Journey to Becoming a Confident Microsurgeon in Singapore

  • Ramachandran, Savitha;Ong, Yee-Siang;Chin, Andrew Y.H.;Song, In-Chin;Ogden, Bryan;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.209-212
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    • 2014
  • Microsurgery training in Singapore began in 1980 with the opening of the Experimental Surgical Unit. Since then, the unit has continued to grow and have held microsurgical training courses biannually. The road to becoming a full-fledged reconstructive surgeon requires the mastering of both microvascular as well as flap raising techniques and requires time, patience and good training facilities. In Singapore, over the past 2 decades, we have had the opportunity to develop good training facilities and to refine our surgical education programmes in reconstructive microsurgery. In this article, we share our experience with training in reconstructive microsurgery.

Early Outcomes of Sutureless Aortic Valves

  • Hanedan, Muhammet Onur;Mataraci, Ilker;Yuruk, Mehmet Ali;Ozer, Tanil;Sayar, Ufuk;Arslan, Ali Kemal;Ziyrek, Ugur;Yucel, Murat
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.165-170
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    • 2016
  • Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

Dental Surgery Simulation Using Haptic Feedback Device (햅틱 피드백 장치를 이용한 치과 수술 시뮬레이션)

  • Yoon Sang Yeun;Sung Su Kyung;Shin Byeong Seok
    • KIPS Transactions on Software and Data Engineering
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    • v.12 no.6
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    • pp.275-284
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    • 2023
  • Virtual reality simulations are used for education and training in various fields, and are especially widely used in the medical field recently. The education/training simulator consists of tactile/force feedback generation and image/sound output hardware that provides a sense similar to a doctor's treatment of a real patient using real surgical tools, and software that produces realistic images and tactile feedback. Existing simulators are complicated and expensive because they have to use various types of hardware to simulate various surgical instruments used during surgery. In this paper, we propose a dental surgical simulation system using a force feedback device and a morphable haptic controller. Haptic hardware determines whether the surgical tool collides with the surgical site and provides a sense of resistance and vibration. In particular, haptic controllers that can be deformed, such as length changes and bending, can express various senses felt depending on the shape of various surgical tools. When the user manipulates the haptic feedback device, events such as movement of the haptic feedback device or button clicks are delivered to the simulation system, resulting in interaction between dental surgical tools and oral internal models, and thus haptic feedback is delivered to the haptic feedback device. Using these basic techniques, we provide a realistic training experience of impacted wisdom tooth extraction surgery, a representative dental surgery technique, in a virtual environment represented by sophisticated three-dimensional models.

Awareness and Attitude of Nurses in Regard to Providing Hospice Care

  • Aghdam, Alireza Mohajjel;Aghaei, Mir Hossein;Hassankhani, Hadi;Rahmani, Azad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6941-6945
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    • 2015
  • Background: Awareness and attitudes of nurses regarding end of life care are important factors in providing hospice care. In an extensive literature review, we found no related articles investigating Iranian nurses awareness and attitudes about providing such care. Objectives: The aims of this study were to investigate the awareness and attitudes of Iranian nurses in providing hospice care. Materials and Methods: In this descriptive-correlational study, 240 nurses employed in six educational centers were selected by non-randomized stratified sampling. The data collection instruments included an awareness test and attitudes regarding providing end of life care in hospice questionnaire. The data were analyzed using descriptive statistics and independent sample t-tests, one-way ANOVA, and Pearson correlation tests. Results: The nurses' awareness score was 14.3 out of 29 and 55.7% of them stated that they had not received any education in providing end of life care. Also, by obtaining the score of 91.7 out of 120 the attitudes of participants in providing end of life care in hospices were positive. In addition, the highest attitudes score of nurses were in the dimensions of benefits of implementation and health care team. Conclusions: Considering low awareness of nurses about end of life care in hospices, continuing education should be provided for them in this regard. Especially, by considering the positive attitude of nurses, providing such programs could help develop hospice care in Iran.

Prevalence of Operation Room-Related Syncope and Presyncope among Medical Students (의학과 학생들의 수술실 임상실습 중 실신 및 실신 전조증상 경험 빈도)

  • Choi, Seong Jin;Park, Kyung Hye;Han, Kyoung-Hee;Park, Eun Young;Kim, Sung Hoon;Uh, Young
    • Korean Medical Education Review
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    • v.20 no.2
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    • pp.112-117
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    • 2018
  • Attending the operation room is an essential part of surgical clerkships. Syncope or presyncopal attacks in the operation room may negatively affect students' learning and career development. This study set out to identify the prevalence of syncope and presyncopal attacks in the operation room during medical students' surgical clerkships. Data from 420 medical students (303 men and 117 women) in their 3rd year of clerkship were collected between 2014 and 2017. An anonymous questionnaire was distributed to assess the prevalence and degree of syncope and presyncopal symptoms. A total of 27% of the respondents had experienced syncope or presyncopal symptoms, 49.6% of the female students and 18.8% of the male students (p<0.001). Fifty students (43.5%) had been attending as observers at the time of the syncopal attack, while 65 students (56.5%) had been participating as assistants. Thirty-four students (29.6%) had recently eaten at the time of the syncopal attack, while 81 students (70.4%) had not recently eaten. Prodromal symptoms included the urge to sit down (21.2%), sweating (19.3%), nausea (16.9%), a feeling of warmth (13.3%), darkened vision (12.6%), yawning (11.7%), palpitation (11.0%), ear fullness (10.2%), black spots in one's vision (7.6%), and hyperventilation (7.1%). This study showed the prevalence of syncope and presyncopal symptoms in the operation room during surgical clerkships. For students' safety and effective clerkship learning, thorough proactive education on syncopal attacks is required.

Risk Factors of Delirium Among the Patients at a Surgical Intensive Care Unit (일 종합병원 외과계 중환자실 환자의 섬망 발생 요인)

  • Chun, You Kyoung;Park, Jeong Yun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.31-40
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    • 2017
  • Purpose : This study examined the prevalence of delirium-related factors in a surgical intensive care unit (SICU). Methods : This retrospective study enrolled 73 patients who were admitted to an SICU from October 1, 2016 to March 20, 2017 and who had been hospitalized for more than 72 hours. Data was collected by reviewing electronic medical records. Results : Delirium occurred in 46 (63.0%) patients. Its related factors were age, education, mechanical ventilator, sleep, narcotics, physical restraint, and central line catheters. Conclusion : The results indicate that sleep and physical restraint are significant factors related to delirium occurrence. The results of this study can help in developing guidelines for the prevention of delirium.

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Comparison of Quality of Life of Turkish Breast Cancer Patients Receiving Breast Conserving Surgery or Modified Radical Mastectomy

  • Acil, Hande;Cavdar, Ikbal
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5377-5381
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    • 2014
  • Purpose: The aim of this study was to investigate the differences in quality of life in patients who received breast conserving surgery (BCS) or modified radical mastectomy (MRM) for breast cancer. Materials and Methods: A total of 100 women with breast cancer who underwent either BCS or MRM between September 2011 and April 2012 at a private health center and completed their chemotherapy and radiation therapy cycles were included in the study. To assess the quality of life, we used a demographic questionnaire, the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Quality of Life assessment in Breast Cancer (EORTC QLQ-BR23). Results: Using QLQ-C30, we found that patients who underwent BCS had better functional status and fewer symptoms than patients who underwent MRM. In QLQ-BR23, independent factors improving the functional scales were BCS, higher level of education and marital status (married); independent factors improving symptoms were BCS, higher level of education, younger age and low and normal body mass index (BMI). In QLQ-C30, independent factors affecting the functional and symptom scales were only BCS and higher level of education. Conclusions: We determined that patients who received BCS had better functional status and less frequent symptoms than patients who underwent MRM.

Laser Safety in Laryngeal Microsurgery Using $CO_2$Laser (후두미세수술에서 탄산가스 레이저를 이용한 레이저 수술의 안전성)

  • 이정구;정필상;정필섭
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.159-164
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    • 1998
  • The developmental and subsequent addition of laser technology to existing surgical techniques offered new and exciting Possibilities for improving traditional endoscopic operations and expanding the scope of the specialty of otolaryngology-head and neck surgery. Lasers were found to be Precise, but potentially dangerous, surgical instruments whose use was associated with certain distinct and unprecedented advantages, but also with many unique and potentially serious, and sometimes catastrophic complications. The Purpose of this study was to evaluate the of elation technique of $CO_2$laser, kinds of anesthesia, equipments of operating room, and education of medical staff. Four hundreds 4 cases of $CO_2$laser laryngeal microsurgery were reviewed for the safety of $CO_2$laser in laryngeal microsurgery. Vocal polyp (46,3%) was the most common pathology in our cases. The others were vocal nodule, Reinke`s edema, epiglottic cyst, laryngeal granuloma, laryngeal papilloma, intracordal cysts, laryngeal tuberculosis, laryngeal web, laryngotracheal stenosis, and laryngeal cancer. Following complete equipment controls, treatment area controls, maintenance, service and procedural controls, personel protective equipment, and warning signs, no complications were found in our cases. In conclusion, laryngeal microsurgery with $CO_2$laser could be done safely without complication if complete preoperative preparation and education of medical staff preceded.

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Virtual Reality for Dental Implant Surgical Education (가상현실을 이용한 치과 임플란트 수술 교육)

  • Moon, Seong-Yong;Choi, Bong-Du;Moon, Young-Lae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.169-174
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    • 2016
  • In this study, we evaluated the virtual reality model for dental implant surgery and discussed about the method to make the surgical environment for virtual reality with practical patient data. The anatomical model for patient face was fabricated by facial and oral scan data based on CT data. The simulation scenario was composed step by step fashion with Unity3D. From incision and sinus bone graft procedure which is needed to this patient model to implant installation and bone graft was included in this scenario. We used the HMD and leap motion for immersiveness and feeling of real operation. Twenty training doctor was attended this simulation study, and surveyed their satisfactory results by questionnaire. Implant surgery education program was showed the possibilities of educational tool for dental students and training doctors. Virtual reality for surgical education with HMD and leap motion had advantages, in terms of cheap prcie, easy access.