Publications by authors named "Lorias Espinoza Daniel"

Background: The SpineST-01 system is an image-guided vertebrae cannulation training system. During task execution, the computer calculates performance-based metrics displaying different visual perspectives (lateral view, axial view, anteroposterior view) with the position of the instrument inside the vertebra. Finally, a report with the metrics is generated as performance feedback.

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Background: The objective of this study was to evaluate the novices' learning curves and proficiency level reached in laparoendoscopic single-site (LESS) surgery using three surgical training programs.

Material And Methods: Participants were randomly divided into three groups, who trained in a specific practice regimen for 12 days using a laparoscopic box simulator and three tasks. Group A trained in three stages using conventional laparoscopic surgery (CLS) with straight instruments, and LESS with straight and articulating instruments for four days each.

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The aim of this work is to present a new physical laparoscopy simulator with an electromyography (EMG)/accelerometry-based muscle activity recording system, , and perform objective evaluation of laparoscopic skills based on the quantification of muscle activity of participants with different levels of laparoscopic experience. . EMG and ACC signals were obtained from 14 participants (6 experts, 8 medical students) performing circular pattern cutting tasks using a laparoscopic box trainer with the Trigno (Delsys Inc, Natick, MA) portable wireless system of 16 wireless sensors.

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This article aims to present an innovative design of a steerable surgical instrument for conventional and single-site minimally invasive surgery (MIS), which improves the dexterity and maneuverability of the surgeon while offering a solution to the limitations of current tools. The steerable MIS instrument consists of a deflection structure with a curved sliding joints design that articulates the distal tip in two additional degrees of freedom (DoFs), relative to the instrument shaft, using transmission by cables. A passive ball-joint mechanism articulates the handle relative to the instrument shaft, improves wrist posture, and prevents collision of instrument handles during single-site MIS procedures.

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Objective: Metric-based surgical training can be used to quantify the level and progression of neurosurgical performance to optimize and monitor training progress. Here we applied innovative metrics to a physical neurosurgery trainer to explore whether these metrics differentiate between different levels of experience across different tasks.

Methods: Twenty-four participants (9 experts, 15 novices) performed 4 tasks (dissection, spatial adaptation, depth adaptation, and the A-B-A task) using the PsT1 training system.

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Article Synopsis
  • Surgeons' psychomotor skills in minimally invasive surgery are crucial indicators of training effectiveness, leading to the need for objective assessment methods.
  • Study involved 43 participants categorized by experience, using a simulator to analyze instrument motion data through 13 parameters.
  • The K-star classification method outperformed others with high accuracy rates in classifying surgical competence based on psychomotor skills, supporting its potential for training evaluation.
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Background: Diverse techniques have been described for pediatric inguinal hernia repair, based on extraperitoneal [1-4] and intraperitoneal [5-8] methodologies. In this video, we describe a novel technique to repair pediatric inguinal hernia using an Endo Close™ suturing device by percutaneous puncture with a single incision.

Methods: With a transumbilical approach, a 5-mm trocar is inserted for a 30° laparoscope.

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Article Synopsis
  • Navigation technology is crucial for training in medical fields, particularly for image-guided spinal surgeries; however, there is a lack of affordable surgical simulators.
  • A new low-cost spinal surgery simulator, Spine MovDigSys 01, was developed to enhance 3D navigation without restricting a surgeon's natural movements using an anatomical lumbar model and two webcams.
  • Initial testing of the simulator with surgeons showed promising results in capturing key operational metrics and providing valuable feedback, demonstrating its potential for developing essential surgical skills in trainees.
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Purpose: This study was aimed to establish the construct validity of a video-tracking system based on orthogonal cameras approach for assessment of laparoscopic psychomotor skills in training environments.

Methods: The camera-tracking system consists of two webcams placed in orthogonal configuration at a distance of 13.5 cm.

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Article Synopsis
  • The study emphasizes the importance of mastering visual perspectives in laparoscopic surgery, focusing on a low-cost training system that simulates an angled laparoscope for skill development.
  • Nine participants completed tasks to evaluate spatial adaptation to visual perspectives at 30 degrees, with measurements of time and error rate to assess performance.
  • Results showed that junior residents outperformed senior residents, suggesting the training system effectively enhances basic skills needed for laparoscopic operations without the requirement of expensive equipment.
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Background: Various methods for evaluating laparoscopic skill have been reported, but without detailed information on the configuration used they are difficult to reproduce. Here we present a method based on the trigonometric relationships between the instruments used in a laparoscopic training platform in order to provide a tool to aid in the reproducible assessment of surgical laparoscopic technique.

Materials And Methods: The positions of the instruments were represented using triangles.

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Evaluation of movement disorders is a useful tool for the diagnostic and monitoring of diseases related with damage of the motor control systems, such as Parkinson's disease. The evaluation of well characterized movement disorders has been proposed using different techniques each one with their advantages and limitations. This document propose the use a system based on inertial sensors and wireless technology for the measurement and evaluation of three of the most common movement disorders related with Parkinson's disease.

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It is widely documented that laparoscopic surgeons require training, and an objective evaluation of the training that they receive. The most advanced evaluation systems integrate the digitization of the movement of laparoscopic tools. A great number of these systems, however, do not permit the use of real tools and their high cost limits their academic impact.

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This article presents the first clinical and experimental experiences of the PMASS (Postural Mechatronic Assistance Solo Surgery) from a prospective study carried on on thirteen laparoscopic procedures. Also, their advantages and disadvantages are identified. The PMASS is a system with three articulations; two articulations are passive and one is active; this handles the optic in real time, reducing the latency time by spatial relocation.

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Background And Purpose: Laparoscopes used in laparoscopic surgery are manipulated by human means, passive systems or robotic systems. All three methods accumulate downtime when the laparoscope is cleaned and the optical perspective is adjusted. This work proposes a new navigation system that autonomously handles the laparoscope, with a view to reducing latency, and that allows real-time adjustment of the visual perspective.

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