医用生物蛋白胶在胸外科手术中的应用

目的:观察医用生物蛋白胶对胸外科手术术后引流量的影响.方法:对同期胸外科手术实验组55人及观察组53人进行术后24h引流量及引流总量进行观察比较.结果:使用医用生物蛋白胶的实验组术后24h引流量及引流总量明显少于观察组(P＜0.05).结论:医用生物蛋白胶可有效减少胸外科手术的术后24h引流量及引流总量,促进术后恢复.     

悄然兴起的新型手术刀——激光刀

随着激光技术的发展,激光在临床医学领域的应用也日益增多.本文概述了激光手术刀的特点及应用领域,阐明了工程技术对医学的发展起着日益广泛而更加深刻的推动作用.     

Feasibility of tracking laparoscopic instruments in a box trainer using a Leap Motion Controller

Motion analysis is employed to assess minimally invasive surgical psychomotor skills in box trainers. Tracking of laparoscopic instruments requires sensor-based systems that can be expensive, limit movements and modify their ergonomic properties. We evaluate the feasibility of using Leap Motion as a cheap, unobtrusive alternative. Four experiments were performed to determine its precision while tracking a laparoscopic instrument inside and outside a box trainer. Static long and short term precision of the Leap Motion was <2.5 mm. Precision between 12 different positions within the box trainer was <0.7 mm for all measured distances between neighbors. Dynamic precision when moving the instrument for 200 mm ranged between 2 and 15 mm. Leap Motion presents acceptable precision values inside a box trainer. Improvements are still required (e.g.: multiple instruments’ tracking). Once solved, a validation study should verify the usefulness of Leap Motion to objectively measure skills of novices and residents during training.     

Haptic feedback and control of a flexible surgical endoscopic robot

A flexible endoscope could reach the potential surgical site via a single small incision on the patient or even through natural orifices, making it a very promising platform for surgical procedures. However, endoscopic surgery has strict spatial constraints on both tool-channel size and surgical site volume. It is therefore very challenging to deploy and control dexterous robotic instruments to conduct surgical procedures endoscopically. Pioneering endoscopic surgical robots have already been introduced, but the performance is limited by the flexible neck of the robot that passes through the endoscope tool channel. In this article we present a series of new developments to improve the performance of the robot: a force transmission model to address flexibility, elongation study for precise position control, and tissue property modeling for haptic feedback. Validation experiment results are presented for each sector. An integrated control architecture of the robot system is given in the end.     

Spiritual struggle related to plasma interleukin-6 prior to cardiac surgery.

Spiritual struggle appeared consistently to predict poor health outcomes, including mortality. Despite surging interest in the health benefits of religion and spirituality, the health hassle of existential conflicts and proinflammatory cytokines as a potential physiological mechanism has been overlooked. Based on psychological and theological assumptions, we argue for the universal nature of spiritual struggle, a crisis-related existential conflict, and for investigating its physiological influence as essential to understanding human nature. Increased levels of inflammatory cytokines such as interleukin-6 (IL-6) have been linked with adverse health outcomes and negative emotions. This study thus examined spiritual struggle related to plasma IL-6 in 235 adult patients undergoing cardiac surgery, along with positive religious coping, general coping, and optimism, controlling for standardized clinical medical indicators. Multiple regression analysis, following a preplanned sequence, showed that spiritual struggle (p = .011), behavioral coping (p = .013) were positively associated with excess plasma IL-6, controlling for medical correlates (e.g., left ventricular ejection fraction). We conclude that spiritual struggle, indicating the crisis in an existential relation, and behavioral coping strategies are associated with elevated pre-operative plasma IL-6. The interdisciplinary implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An analysis of the length of hospital stay for cataract patients in Japan using the discrete-type proportional hazard model

We analyze the length of hospital stays of patients hospitalized for cataract and related diseases (Diagnosis Related Groups (DRG) 2041) in Japan, utilizing the data pertaining to 3436 patients on whom one-eye lens operations are performed. We use the discrete-type proportional hazard model to analyze variables that may affect the length of stay.     

Comparing endoscopic systems on two simulated tasks

Endoscopes are slender instruments for performing medical procedures through small incisions or natural body orifices. Three experiments examined the performance effects of various endoscope systems when naive participants executed tasks in a bladder-like environment. The systems involved a direct endoscope, requiring the user to look through a lens at the outer part of the endoscope, and a video endoscope that picks up the image via a camera attached to the endoscope and displays it on a video monitor. The results indicate that the participants performed the tasks better with video than with direct endoscopes, and showed more transfer of practice with video endoscopic surgery from a small to a large task environment than vice versa. The optimal position of the monitor with video endoscopic surgery appeared to involve a reasonable angle relative to the operating area (45° was used). Performance was less at a greater angle (90°), but also at a small angle (10°). It did not matter whether the monitor was located left, right or above the operating area. As performance did not fully transfer to differently sized task environments, endoscopists should initially train with task environments of different, and especially small, sizes.     

Overview of Human Factors and Ergonomics in the OR,with an Emphasis on Minimally Invasive Surgeries

Operating rooms (OR) are where medical teams work to improve the health of a patient. However, because of the complexity of the procedures, errors and unsafe situations are likely to occur. These complications can lead to harm to the patient or medical professionals. Human factors and ergonomic professionals have been working to improve these unsafe conditions in the OR for over a century. However, with advances in technology, increased surgical complexity, as well as an increase in medical team members in the OR, there are still numerous improvements yet to be accomplished. Minimally invasive surgeries require an even more advanced approach to prevent errors due to technology, fatigue, and miscommunication. Human factors and ergonomic techniques provide the ability to greatly improve conditions for patients and surgeons alike. It is imperative that human factors and ergonomics continue to grow and facilitate technological advancements in healthcare. © 2012 Wiley Periodicals, Inc.     

颅颌面整复术前规划虚拟截骨研究

虚拟外科手术是虚拟现实技术在医学领域的一个重要研究方向．建立颅颌面虚拟手术可通过分析病人的个体手术计划及步骤，降低颅颌面外科手术风险并提高手术精度．虚拟截骨是虚拟手术中的重点及难点，故侧重探索颅颌面虚拟术前规划技术中关键的虚拟截骨，以整形外科手术中的下颌角骨组织切除作为研究内容．以MC算法实现头颅的DICOM格式CT图像三维重建；利用二元树结构定义在重建出的三维头颅模型上分离出下颌升支；再研究虚拟截骨算法并对下颌升支实施虚拟截骨．虚拟截骨结果表明，本研究采用的三维重建算法及截骨算法得到成功应用，该系统具备一定的应用价值．     

用于微创外科手术的遥控机器人系统研究现状及趋势

用于微创外科手术(Minimally Invasive Surgery 简称MIS)的主从式遥控机器人 系统是医疗中的MIS技术与遥操作技术的结合, 本文主要对具有力觉临场感的比率遥控机器 人用于MIS时的控制特点要求和控制理论技术的研究现状进行了综述,强调了用于MIS和用于 生物工程、微机械等领域的遥控机器人系统在控制上的异同, 对用于MIS的比率遥控机器人 系统控制中有待研究的一些关键问题提出了见解.