Three successful interventions show that involving surgeons in the design and testing phase of product development leads to a novel instrument positioner that can be used safely in a clinical setting. It can be concluded that the system is simple and intuitive to use, as there was no learning curve.
Introduction Halo gravity traction (HGT) is increasingly used pre-operatively in the treatment of children with complex spinal deformities. However, the design of the current halo crowns is not optimal for that purpose. To prevent pin loosening and to avoid visual scars, fixation to the temporal area would be preferable. This study aims to determine whether this area could be safe for positioning HGT pins. Methods A custom made traction setup plus three human cadaver skulls were used to determine the most optimal pin location, the resistance to migration and the load to failure on the temporal bone. A custom-made spring-loaded pin with an adjustable axial force was used. For the migration experiment, this pin was positioned at 10 predefined anatomical areas in the temporal region of adult cadaver skulls, with different predefined axial forces. Subsequently traction force was applied and increased until migration occurred. For the load-to-failure experiment, the pin was positioned on the most applicable temporal location on both sides of the skull. ResultsThe most optimal position was identified as just antero-cranial to the auricle. The resistance to migration was clearly related to the axial tightening force. With an axial force of only 100 N, which corresponds to a torque of 0.06 Nm (0.5 in-lb), a vertical traction force of at least 200 N was needed for pin migration. A tightening force of 200 N (torque 0.2 Nm or 2 in-lb) was sufficient to resist migration at the maximal applied force of 360 N for all but one of the pins. The load-to-failure experiment showed a failure range of 780-1270 N axial force, which was not obviously related to skull thickness. ConclusionThe temporal bone area of adult skulls allows axial tightening forces that are well above those needed for HGT in children. The generally applied torque of 0.5 Nm (4 in-lb) which corresponds to about 350 N axial force, appeared well below the failure load of these skulls and much higher than needed for firm fixation.
The new prototype was tested by a panel of experts and novices during an indicative ergonomic experiment. A major advantage of the MIM seems to be the possibility to perform laparoscopic surgery in a sitting position, in line with the working axis, instead of standing at the side of the patient. At an estimated cost level of 10% of the da Vinci system, the MIM can be an economical alternative for the enhancement of laparoscopy ergonomics. However, further development for clinical feasibility is necessary.
Objectives: To report our experience with cystoscopic laser ablation for the prenatal treatment of posterior urethral valves (PUV). Methods: Twenty pregnant women with a presumptive isolated PUV were treated with fetal cystoscopy under local anesthesia. Identification and fulguration of the PUV by firing-contacts with diode laser was attempted in two experienced fetal therapy units. Perinatal and long-term outcomes were prospectively recorded. Results: Median gestational age at procedure was 18.1 weeks (range 15.0-25.6). Access to the urethra was achieved in 19/20 (95%) cases with a median operation time of 24 minutes (range 15-40). After surgery, normalization of bladder size and amniotic fluid was observed in 16/20 (80%). After treatment, 9 cases (45%) opted for terminations of pregnancy and 11 (55%) delivered a liveborn baby at a mean gestational age of 37.3 (29.1-40.2) weeks. No infants developed pulmonary hypoplasia and all are alive at 11-106 months. Eight (40% of all fetuses, 72.7% of newborns) have normal renal function and 3 (27.3%) have renal failure awaiting renal transplantation. Conclusions: Fetoscopic laser ablation for selected cases of PUV can be a life-saving single procedure by achieving normalization of amniotic fluid. In spite of technical success, the possible benefit in avoiding progression to renal failure pre or postnatally remains to be elucidated.Objectives: The shortage of highly trained sonographers worldwide limits the wider adoption of ultrasound (US) as a diagnostic tool in obstetrics. The aim of this study was to develop a learning software
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.