Training with simulation improves residents’ endovascular procedure skills

Dawson, David L.; Meyer, Jennifer; Lee, Eugene S.; Pevec, William C.

doi:10.1016/j.jvs.2006.09.003

Cited by 141 publications

(91 citation statements)

References 11 publications

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“…The interest in numerical tools, which support clinician decisions, has increased over the last few years. Rapid advances in technology and the demand for improved patient safety have led to an increased use of simulation technologies in medicine (Dawson et al 2007;Sarker and Patel 2007;Tsang et al 2008). Such support becomes increasingly important when, as in the case of endovascular treatment of cerebral aneurysms, the number of previously treated patients is limited (i.e.…”

Section: Introductionmentioning

confidence: 99%

Deployment of self-expandable stents in aneurysmatic cerebral vessels: comparison of different computational approaches for interventional planning

Bernardini

Larrabide

Petrini

et al. 2012

Computer Methods in Biomechanics and Biomedical Engineering

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JOB NUMBER: 527838 JOURNAL: GCMB Q1 Please check the affiliation details 'a and c'. Q2The reference citation 'Appanaboyina et al. (2007)' has been changed to 'Appanaboyina et al. (2008)' as per the reference list. Please check and confirm. Q3We have made a change to this sentence. Please review our edit.Q4 Please confirm our edit of the word 'modulus' to 'ratio' in this sentence. In the last few years, there has been a growing focus on faster computational methods to support clinicians in planning stenting procedures. This study investigates the possibility of introducing computational approximations in modelling stent deployment in aneurysmatic cerebral vessels to achieve simulations compatible with the constraints of real clinical workflows. The release of a self-expandable stent in a simplified aneurysmatic vessel was modelled in four different initial positions. Six progressively simplified modelling approaches (based on Finite Element method and Fast Virtual Stenting -FVS) have been used. Comparing accuracy of the results, the final configuration of the stent is more affected by neglecting mechanical properties of materials (FVS) than by adopting 1D instead of 3D stent models. Nevertheless, the differences showed are acceptable compared to those achieved by considering different stent initial positions. Regarding computational costs, simulations involving 1D stent features are the only ones feasible in clinical context.

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Section: Introductionmentioning

confidence: 99%

Deployment of self-expandable stents in aneurysmatic cerebral vessels: comparison of different computational approaches for interventional planning

Bernardini

Larrabide

Petrini

et al. 2012

Computer Methods in Biomechanics and Biomedical Engineering

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“…It is possible that experienced neurointerventionalists do not require the same yearly procedural volumes for maintaining their skills. Recently, alternative training techniques such as simulation models and virtual reality training have become available for a variety of endovascular procedures 15,16 and should be fully explored as an option to enhance skills of neurointerventionalists in the face of limited availability of endovascular procedures. Another major contributing factor to the overall low number of high-volume hospitals remains the undertreatment of acute stroke patients.…”

Section: Discussionmentioning

confidence: 99%

Neurointerventional Procedural Volume per Hospital in United States

Grigoryan

Chaudhry

Hassan

et al. 2012

Stroke

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Background and Purpose-Availability of neurointerventional procedures is recommended as a necessary component of a comprehensive stroke center by various regulatory guidelines that also emphasize adequate procedural volumes. We studied the volumes of neurointerventional procedures performed in various hospitals across the United States with subsequent comparisons with rates of minimum procedural volumes recommended by various professional bodies or used in clinical trials to ensure adequate operator experience. Methods-We reviewed the Nationwide Inpatient Sample database in the United States for the years 2005 to 2008. UsingInternational Classification of Disease-Clinical Modification, 9th revision, and Medicare severity diagnosis-related group codes, we identified among hospitals that admit stroke patients those that met the minimum criteria for overall and individual procedural volumes specified in various guidelines. We then compared the characteristics between the high-volume hospitals that performed at least 100 cervicocerebral angiograms and met Ն1 other procedural criterion (nϭ79) and low-volume hospitals (nϭ958). Results-Proportions of hospitals that met individual procedural volume criteria over the 4-year period according to procedure were: cervicocerebral angiography (7.0%-7.8%); endovascular acute ischemic stroke treatments (0.4%-2.6%); carotid angioplasty/stent placement (3.0%-5.3%); intracranial angioplasty/stent placement (0.3%-1.3%); and aneurysm embolization (1.3%-2.6%). There were significant trends for increasing numbers of all the endovascular procedures except intracranial angioplasty/stent placement over the course of 4 years.

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“…Training simulators for such surgery includes VIST, ANGIO Mentor, and CathLabVR [34]. Many studies have proved the effectiveness of such simulator [43,44].…”

Section: Virtual Reality Surgical Simulatormentioning

confidence: 99%

Pedicle Screw Insertion Surgical Simulator

Zeller

Wang

et al. 2018

Lecture Notes in Computer Science

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Scoliosis is a sideway spinal deformity. If the curvature is measured to be more than 50 degrees, the patient can feel significant discomfort. In such cases, surgery is required to straighten the spine. Pedicle screw insertion is a common procedure for scoliosis surgery.The technique requires the placement of screws from the pedicle into the spine. A rod is used to connect all the pedicle screws. The spine is straightened during the connection process. One of the most common techniques used for pedicle screw insertion is called the free hand technique. During free hand surgery, the surgeon creates a screw channel by manually probe into the spine. The lack of visual aid requires the surgeon to rely strongly on haptics feedback. Due to the spine sensitivity and the limited operating range, small changes in force or direction can cause the probe to breach out of the spine. If the breach reaches the spine medial, the spinal cord could be damaged. Even experienced surgeons can not prevent breach. Studies have found that surgeons with 5 or more years of surgical experience have a breach rate of 10.8 %.In this thesis, pedicle screw insertion simulator is developed and examined in detail. The simulator combines visual and haptics sensation to recreate the channel creation process of the surgery. A 2DOF mechanical device is used for the haptics sensation. The device includes a linear actuator and a rotary motor. The simulator was tuned to four different surgical scenarios by 2 expert surgeons. The scenarios are soft probing, hard probing, lateral breach, and in-out-in breach. 10 additional surgeons were asked to participant in a clinical study. Measurements were collected for analysis. The focus of the study is to find if the surgeon can recognize the simulated breach scenarios. Four research questions were examined, and they are: 1. Can experience help the surgeon improve correct breach recognition rate? 2. Can experience help the surgeon improve overall correct recognition rate? 3. Is there any performance difference between surgeons with different experience iii level? 4. Can the simulation trials become a learning tool for the simulation tasks?Each question has its own null hypothesis and statistical analysis is used to determine if the null hypothesis is rejected. The main conclusion is that there is no statistically significant relationship between the wrong breach or total wrong recognition rate and surgical experience. Furthermore, there is statistically significant in hard probing scenario between surgical experience and vertical force variance. Lastly, ANOVA analysis showed that the breach force and velocity in three trials are close to statistically significant, more data may prove that the simulator can be a training tool for the tasks. Lastly but most importantly, I appropriate his endless knowledge and kind mentorship that helped me completing this thesis.

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Training with simulation improves residents’ endovascular procedure skills

Cited by 141 publications

References 11 publications

Deployment of self-expandable stents in aneurysmatic cerebral vessels: comparison of different computational approaches for interventional planning

Deployment of self-expandable stents in aneurysmatic cerebral vessels: comparison of different computational approaches for interventional planning

Neurointerventional Procedural Volume per Hospital in United States

Pedicle Screw Insertion Surgical Simulator

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