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R M Satava

Publications and source records attributed to R M Satava.

At least 37 records · Page 2Linked to original sources
PubMed2001

Evaluation of structured and quantitative training methods for teaching intracorporeal knot tying.

BACKGROUND: We evaluated the effectiveness of five training methods-four structured and one unstructured-for teaching intracorporeal knot tying. METHODS: Forty-three graduate students without prior laparoscopic experience were randomly assigned to one of five training groups, and their performance in 10 intracorporeal knot tying trials was evaluated, using time to complete a knot as the outcome measure. RESULTS: The average knot tying times for the four structured groups were significantly faster than the unstructured group (p < 0.0001). Among the four structured groups, the minimally invasive surgical trainer-virtually reality (MIST-VR) and the box trainer drills showed the most rapid improvements. The MIST-VR improved average suturing time from trial one to trial two (P = 0.05), the box trainer drills group improved from trial one to trial four (P = 0.01), and the other two groups showed slower improvements. Statistically significant correlations were observed between scores on MIST-VR tasks and average knottying times (R > 0.7, p < 0.05). CONCLUSION: Structured training can be useful for the development of laparoscopic skills. MIST-VR is a valuable part of this training, particularly in the objective evaluation of performance.

Adult↗
PubMed2001

Accomplishments and challenges of surgical simulation.

For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

Anatomy, Cross-Sectional↗
PubMed2001

Information age technologies for surgeons: overview.

This overview summarizes the revolutionary changes that are occurring in medicine today and looks beyond medicine to the other disciplines of science that contribute to the overall revolution of the Information Age. The concept of "information equivalent," representing real objects within a computer as information, is explained. The application of today's emerging information technologies is divided into the components of patient care--diagnosis, consultation, treatment, and education--and illustrations are given of how information sciences are changing the practice of surgery.

General Surgery↗
PubMed2001

Surgical education and surgical simulation.

The science of virtual reality provides an entirely new opportunity in the area of simulation of surgical skills using computers for training, evaluation, and eventually certification. A taxonomy of the types of simulators is proposed based upon the level of complexity of the task which is being simulated. These tasks are precision placement, simple manipulation, complex manipulation, and integrated procedure. Representative simulators in each category are illustrated and discussed in the context of their contribution to the education and training of a surgeon. The importance of a curriculum is to give content to the role of simulators as another advanced tool for education. Simulators must be integrated into a comprehensive curriculum and not considered as a stand-alone system. The current accomplishments as well as challenges are discussed.

Clinical Competence↗
PubMed2000

Preparing surgeons for the 21st century. Implications of advanced technologies.

An entire spectrum of advanced technologies and concepts has been presented, from the new clinical applications to highly speculative possibilities. Not all of these technologies will survive the long process to clinical usefulness, but those that do may revolutionize surgery. With such change comes the ethical and moral responsibility to consider them not only in the light of improvement of patient care but also in their impact on society as a whole. If the remarkable rate of change of the past 2 decades continues, it is impossible to conceive of the role of future surgeons. Thus, to be prepared, surgeons must have an open mind, a willingness to consider and evaluate new directions, and the honesty and courage to change when a new approach is proven to be of value. A prepared mind is an open mind.

Colonoscopy↗
PubMed2000

New imaging strategies for laparoscopic management of cancer.

The Information Age has brought to the medical and surgical community the tools of digital imaging and 3-dimensional (3-D) visualization. These tools provide new methods for diagnosis and treatment of cancer. Using 3-D reconstructions from computed tomography and magnetic resonance imaging scans of patient-specific anatomy, diagnosis from virtual endoscopy is supplementing or replacing invasive endoscopic procedures. These same images can be used for preoperative planning of complicated procedures. At the time of surgery, data fusion of the real-time video image and the preoperative digital image provides intraoperative stereotactic navigation. These augmentations can be used in many types of procedures, from open and minimally invasive surgery to catheter-based and energy-directed therapies. This is a US government work. There are no restrictions on its use.

Humans↗
PubMed1999

Emerging technologies for surgery in the 21st century.

Laparoscopic surgery is a transition technology that marked the beginning of the information age revolution for surgery. Telepresence surgery, robotics, tele-education, and telementoring are the next step in the revolution. Using computer-aided systems such as robotics and image-guided surgery, the next generation of surgical systems will be more sophisticated and will permit surgeons to perform surgical procedures beyond the current limitations of human performance, especially at the microscale or on moving organs. More fundamentally, there will be an increased reliance on 3-dimensional images of the patient, gathered by computed tomography, magnetic resonance imaging, ultrasound, or other scanning techniques, to integrate the entire spectrum of surgical care from diagnosis to preoperative planning to intraoperative navigation to education through simulation. By working through the computer-generated image, first with preoperative planning and then during telepresence or image-guided procedures, new approaches to surgery will be discovered. These technologies are complemented by new educational opportunities, such as tele-education, surgical simulation, and a Web-based curriculum. Telementoring will permit further extension of the educational process directly into the operating room.

Forecasting↗
PubMed1998

Otolaryngology in the information age: enabling technologies for the future of surgery. Enabling technologies for the future of surgery.

Enabling technologies for the future, whether exemplified by endoscopic, minimally invasive, or microdexterity systems or surgical and nonsurgical image-guided procedures, continue with an evolution so rapid that before one change has been accepted and perfected, another even more dramatic change promises to replace it. These information-based surgical and procedural interventions are just now becoming accepted standards of surgical, radiologic, and medical practice, and yet the promise of more advanced technologies blurs even these new boundaries, constantly redefining the concept of "surgery." It is essential that otolaryngologists, as part of the broader spectrum of physicians, understand these changes and prepare to adapt and improve each and every one of their technical and cognitive skills.

Computer Simulation↗
PubMed1998

Laparoscopic surgery. Transition to the future.

The twenty-first century will usher in a fundamentally new approach to the practice of medicine. It will be based heavily on information technologies, broadly defined as the devices that acquire information; those that process, transmit, and distribute information; and those that use information to provide therapy. Although conventional surgery will continue to have a presence, there will be radically different surgical approaches and technologies that may become the predominant form of surgery. The medical record may become a three-dimensional visual representation of the individual patient (like the Visible Human Project), which can be the vehicle that integrates the entire spectrum of health care. Examples of the technologies and infrastructures that support this new approach to medicine are discussed and illustrated, with emphasis on how technologies improve individual patient care.

Forecasting↗
PubMed1998

Three-dimensional ultrasonographic telepresence.

We have developed a three-dimensional ultrasound telepresence system for remote consultation. Three-dimensional ultrasound data-sets can be acquired by relatively unskilled operators. The data are stored in the remote unit and then transmitted to a consultant equipped with a similar unit. A telepresence pointing device enables the consultant to re-slice that data-set in any plane. During the study period, 72 volumetric scans of male and female volunteers aged 18-45 years were performed in Bosnia. Field users of limited ultrasound experience (most with less than 30 min of training) were able to acquire volumetric scans, send volume data and interact with remote consultants over standard communications lines at distances of up to 20,000 km. Communications links from 9.6 to 1500 kbit/s were used. Technical limitations included lack of motion data, lack of colour data, scan artefacts and increased scan-to-diagnosis time. However, our preliminary experience indicates that this technique may eventually prove to be a useful adjunct to telesonography. Further studies of the technique are needed to determine its value in the broader clinical setting.

Adolescent↗
PubMed1998

Accelerating technology transfer: new relationships for academia, industry and government.

The budget deficit, reduction in Defense spending and the lack of return in the "peace dividend" has resulted in reduced federal funding for research. A number of programs have attempted to remedy the problem, with the use of collaborative funding as one of the major solutions. However, within the medical research community, there continues to be a very long technology transfer cycle. By mimicking the processes of non-medical high technology research and employing a number of these innovative solutions to medical research could afford the pathway to success. A template of how this could be accomplished through cooperative efforts of academia, industry and government is presented by using examples of success and failure in the past.

Academic Medical Centers↗
PubMed1997

Virtual reality and telepresence for military medicine.

For decades, warfighters have been putting in place a sophisticated "digital battlefield", an electronic communication and information system to support advanced technology. Medicine is now in a position to leverage these technologies to produce a fundamental revolution, and the keystone is the digital physician. Today nearly all information about a patient can be acquired electronically, and with the new technologies of teleoperation and telesurgery we can provide remote treatment and even surgery through telemedicine. The following framework for military medicine will leverage upon the current electronic battlefield. A personnel status monitor (PSM) will have a global positioning locator to tell the position of each soldier and a suite of vital signs sensors. When a soldier is wounded, the medic will instantly know the location of the soldier, and how serious is the casualty. This will permit the medic to locate the most critically wounded soldier. Once stabilised, he will be placed in a critical care pod, a fully automated intensive care unit in a stretcher, which will monitor his vital signs, administer fluids and medications and provide environmental protection. If immediate surgery is needed, a remote telepresence surgery vehicle will come to the wounded soldier, the medic will place him in the vehicle, and a surgeon will operate remotely using telepresence surgery from a distant Mobile Advance Surgical Hospital (MASH) to the combat zone. Also, the expertise from any specialist will be available from the rear echelons as far back as the home country. For education and training in combat casualty care, virtual reality simulators are being implemented. This same scenario can be utilised in civilian health care, especially in providing care to patients in remote areas who do not currently have access to simple, let alone sophisticated, health care.

Computer Simulation↗