Background: In the search for novel approaches to thoracoscopic thymectomy we assessed the feasibility of a subxiphoid approach using computer-enhanced instruments and sternal lifting.
Methods: In 12 pigs, after lifting of the sternum, ports were placed subxiphoid (stereoscope) and in the left and right fourth intercostal space (instruments). Using computer-enhanced instruments, dissection of the thymus and anterior mediastinal fat pads was started at the diaphragm and continued cephalad.
Results: After setup of the robot system (23 +/- 6 min, mean +/- SD), the thymus, including both superior horns, and fat pads in the anterior mediastinum and cardiophrenic angles were dissected (109 +/- 23 min), with excellent view of the phrenic nerves. Visual inspection after sternotomy after the procedure showed all thymic and fatty tissue was removed.
Conclusions: In the pig, endoscopic extended thymectomy can be safely performed by subxiphoid access using computer-enhanced instruments, sternal lifting, and three ports total.
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http://dx.doi.org/10.1007/s00464-003-9161-2 | DOI Listing |
Background: Physician educators must balance the need for resident procedural education with clinical time pressures as well as patient safety and comfort. Alternative educational strategies, including e-learning tools, may be beneficial to orient novice learners to new procedures and speed proficiency. We created an e-learning tool (computer-enhanced visual learning [CEVL] neuraxial) to enhance trainee proficiency in combined spinal-epidural catheter placement in obstetric patients and performed a randomized controlled 2-center trial to test the hypothesis that use of the tool improved the initial procedure performed by the anesthesiology residents.
View Article and Find Full Text PDFJ Neuroeng Rehabil
August 2018
Department of Neurorehabilitation, Kliniken Schmieder, Zum Tafelholz 8, D- 78476, Allensbach, Germany.
Background: Motor deficits are the most common symptoms after stroke. There is some evidence that intensity and amount of exercises influence the degree of improvement of functions within the first 6 months after the injury. The purpose of this pilot study was to evaluate the feasibility and acceptance of semi-autonomous exercises with an upper extremity exoskeleton in addition to an inpatient rehabilitation program.
View Article and Find Full Text PDFPLoS One
September 2017
Department for Biostatistics and Clinical Epidemiology, Charité Medical School, Humboldt-University of Berlin, Berlin, Germany.
Background: Traditional teaching concepts in medical education do not take full advantage of current information technology. We aimed to objectively determine the impact of Tablet PC enhanced training on learning experience and MKSAP® (medical knowledge self-assessment program) exam performance.
Methods: In this single center, prospective, controlled study final year medical students and medical residents doing an inpatient service rotation were alternatingly assigned to either the active test (Tablet PC with custom multimedia education software package) or traditional education (control) group, respectively.
Med Sci Monit
June 2016
Department of Cardiology, Chinese PLA General Hospital, Beijing, China (mainland).
BACKGROUND A standard resting electrocardiogram (ECG) shows limited sensitivity and specificity for the detection of coronary artery disease (CAD). Several analytic methods exist to enhance the sensitivity and specificity of resting ECG for diagnosis of CAD. We compared a new computer-enhanced, resting ECG analysis device, the cardiac quantum spectrum (CQS) technique, with coronary angiography in the detection of CAD.
View Article and Find Full Text PDFInt J Med Robot
June 2016
Department of Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Background: While there is little doubt that robotic interventions have already opened new horizons in surgery due to its inherent complexity, there is still an unmet need for tools allowing center-to-center performance comparisons. A complexity score could be a valuable instrument for further research.
Methods: The items of the robotic oncologic complexity score (ROCS) were based on risk factors identified in previous studies.
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