Publications by authors named "Robert T Spychal"

Process mapping has been identified as a strategy to improve surgical efficiency but has been inconsistently applied in the literature and underutilised in surgical practice. In this journal, we recently described our utilisation of these approaches when applied to breast reconstruction. We showed that in surgery as complex as autologous breast reconstruction, process mapping can improve efficiency, and may improve surgical teaching, education and audit.

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Introduction And Background: Three dimensional (3D) printing has gained popularity in the medical field because of increased research in the field of haptic 3D modeling. We review the role of 3D printing with specific reference to liver directed applications.

Methods: A literature search was performed using the scientific databases Medline and PubMed.

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Background: Accurate volumetric analysis is an essential component of preoperative planning in both reconstructive and aesthetic breast procedures towards achieving symmetrization and patient-satisfactory outcome. Numerous comparative studies and reviews of individual techniques have been reported. However, a unifying review of all techniques comparing their accuracy, reliability, and practicality has been lacking.

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Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner.

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Background: Over the last decade, image-guided production of three-dimensional (3D) haptic biomodels, or rapid prototyping (RP), has transformed the way surgeons conduct preoperative planning. In contrast to earlier RP techniques such as stereolithography, 3D printing has introduced fast, affordable office-based manufacturing. We introduce the concept of 4D printing for the first time by introducing time as the fourth dimension to 3D printing.

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In reconstructive surgery, preoperative planning is essential for optimal functional and aesthetic outcome. Creating a three-dimensional (3D) model from two-dimensional (2D) imaging data by rapid prototyping has been used in industrial design for decades but has only recently been introduced for medical application. 3D printing is one such technique that is fast, convenient, and relatively affordable.

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Breast reconstruction plays an integral role in the holistic management of breast cancer, with assessment of breast volume, shape, and projection vital in planning breast reconstruction surgery. Current practice includes two-dimensional (2D) photography and visual estimation in selecting ideal volume and shape of breast implants or soft-tissue flaps. Other objective quantitative means of calculating breast volume have been reported, such as direct anthropomorphic measurements or three-dimensional (3D) photography, but none have proven reliably accurate.

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Background: A significant proportion of patients with gastroesophageal reflux disease (GERD) present with atypical symptoms (extraesophageal reflux; EER). The effectiveness of surgical fundoplication in treating classical reflux symptoms is well documented, but the role of surgery in alleviating EER symptoms is less clear. The aim of this study was to review the published literature to determine whether surgical fundoplication is effective in controlling EER.

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Our study provides an update of the incidence of oesophageal cancer in the West Midland region of England and Wales from 1992-96. A total of 2,671 cases of oesophageal cancer were identified during the 5-year study period, with an age-standardised annual incidence (ASR) of 5.24 per 100,000 (95% CI: 5.

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