Real time cancer prediction based on objective tissue compliance measurement in endoscopic surgery.

Objective: To investigate the feasibility of real time cancer tissue diagnosis intraoperatively based on in vivo tissue compliance measurements obtained by a recently developed laparoscopic smart device.

Background: Cancer tissue is stiffer than its normal counterpart. Modern forms of remote surgery such as laparoscopic and robotic surgical techniques diminish direct assessment of this important tissue property.

Effectiveness of an audible reminder on hand hygiene adherence.

Background: Multimodal interventions aim to improve health care workers' adherence to hand hygiene guidelines. Visitors are not primarily targeted, but may spread epidemic infections. Effective interventions that improve the adherence of visitors to hand hygiene guidelines are needed to prevent the transmission of epidemic infections to or from health care environments.

Role of virtual reality simulation in teaching and assessing technical skills in endovascular intervention.

Training in endovascular intervention ultimately aims to produce interventionalists who demonstrate competence in technical skills. Herein, the authors investigate the rationale for simulation-based training by providing an overview of the psychological theories underpinning acquisition of technical skills, training and assessment history, recent advances in simulation technology, and a critical appraisal of their role in training and assessment in endovascular intervention. Simulators have potential for training and assessment and promise solution to many shortcomings of traditional 'apprenticeship' training models.

A real-time compliance mapping system using standard endoscopic surgical forceps.

In endoscopic surgery, the use of long surgical instruments through access ports diminishes tactile feedback and degrades the surgeon's ability to identify hidden tissue abnormalities. To overcome this constraint, we developed a real-time compliance mapping system that is composed of: 1) a standard surgical instrument with a high-precision sensor configuration design; 2) real-time objective interpretation of the output signals for tissue identification; and 3) a novel human-computer interaction technique using interactive voice and handle force monitoring techniques to suit operating theater working environment. The system was calibrated and used in clinical practice in four routine endoscopic human procedures.

Visual exposure using single-handed magnet-driven intra-abdominal wireless camera in minimal access surgery: is better than 30 degrees endoscope.

Background: The operative field of view in minimal access surgery is constrained by the location of the optical port, the direction of view of the endoscope, and the limited degrees of freedom of movement of rigid endoscopes through the access port. The aim of this study was to examine the feasibility of employing a special magnetic setup with a single external handle to fixate, drive, and orientate intra-abdominal wireless camera, and compare its visual exposure with that of a 30 degrees endoscope.

Methods: A wireless magnet-driven camera setup was developed comprising a mini wireless camera with integrated white light-emitting diodes, a specially constructed base unit for orientation control and smooth sliding motion, and an external magnetic handle to fixate and drive the camera from the outer surface of the abdominal wall.

Employing bending beam transducer design and statistical algorithms to develop a clinical real time tissue compliance mapping system.

In keyhole surgery, the use of long surgical instruments inserted through small ports in the body diminishes tactile feedback. Earlier methodologies to overcome this challenge never gained popularity in routine clinical practice due to either major modifications to the design of conventional surgical instruments, or relying on surgeons' subjective interpretation of compliance data that is often inaccurate with crossovers. In this paper we present a real time compliance mapping system which comprises of (i) bending beam transducer design to conventional surgical forceps, (ii) statistical analysis for real time objective interpretation of output signals, and (iii) novel human computer interaction techniques suitable for use in the operative theatre working environment.

Development of force measurement system for clinical use in minimal access surgery.

Background: Analysis of force in minimal access surgery (MAS) is important for instrument design, surgical simulators, and in the understanding of tissue trauma incurred during surgery. The aim of this study is to develop a force measuring system for use with different instruments in clinical practice.

Methods: Strain gauges were connected to both arms of a standard -5 mm interchangeable forceps handle.