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At least 469 records · Page 26Linked to original sources
PubMed1997

Montgomery thyroplasty implant system.

A standardized system has been developed to treat unilateral vocal cord paralysis by medialization of the paralyzed cord. The Montgomery Thyroplasty Implant System consists of a medialization implant, measuring devices, and surgical instruments. The surgical instruments are used to locate, measure, and create a window in the thyroid lamina in which the implant is placed. The measuring devices are used to predetermine the correct implant size. There are five sizes for males (8 to 12 mm) and five for females (6 to 10 mm), with the size representing the distance of medialization. The implant consists of a firm, three-tiered base that locks the implant in the cartilage, and a soft, triangular top that serves to medialize the cord. The standardization of the base allows for revision or reversal at a later date without disturbing the window. The thyroplasty system and surgical procedures are described. Preliminary results of 176 patients who have undergone the Montgomery Thyroplasty Implant System procedure are presented.

Humans↗
PubMed2005

Improving precise positioning of surgical robotic instruments by a three-side-view presentation system on telesurgery.

For faultless collaboration among the surgeon, surgical staffs, and surgical robots in telesurgery, communication must include environmental information of the remote operating room, such as behavior of robots and staffs, vital information of a patient, named supporting information, in addition to view of surgical field. "Surgical Cockpit System, " which is a telesurgery support system that has been developed by the authors, is mainly focused on supporting information exchange between remote sites. Live video presentation is important technology for Surgical Cockpit System. Visualization method to give precise location/posture of surgical instruments is indispensable for accurate control and faultless operation. In this paper, the authors propose three-side-view presentation method for precise location/posture control of surgical instruments in telesurgery. The experimental results show that the proposed method improved accurate positioning of a telemanipulator.

Humans↗
PubMed2004

Biomechanical modelling of segmental instrumentation for surgical correction of 3D spinal deformities using Euler-Bernoulli thin-beam elastic deformation equations.

A simplified computer-modelling technique intended to analyse 3D spinal deformity correction with segmental instrumentation is presented. The spine was modelled as a thin beam-composed structure linked by implants to two deformable rods. The Landau vector representation of Euler-Bernoulli beam elastic deformation equations was used to formulate the simulation approach. All types of essential deformation (bending, torsion, tension, compression) were considered. An iterative numerical method was proposed to obtain an appropriate load, able to deform the spine axial curve to the desired post-operative shape. A simulation based on the spine of a real scoliotic patient (thoracic and lumbar Cobb angles: 39 degrees and 8 degrees), corrected using surgical instrumentation intervention, is presented. Force loads within the range of 20-350 N were able to deform the pre-operational spine axial curve to the post-operational one with a root mean square approximation error of 3.7 mm. Similarly good corrections were obtained using different force patterns. This highlights the uncertainty of which corresponding surgical instrumentation to use. Such uncertainty is related to the 'ill-posed problems' property of mechanical systems.

Algorithms↗
PubMed2001

Tissue distribution of protease resistant prion protein in variant Creutzfeldt-Jakob disease using a highly sensitive immunoblotting assay.

BACKGROUND: Variant Creutzfeldt-Jakob disease (vCJD) has a pathogenesis distinct from other forms of human prion disease: disease-related prion protein (PrP(Sc)) is readily detectable in lymphoreticular tissues. Quantitation of risk of secondary transmission, and targeting of risk reduction strategies, is limited by lack of knowledge about relative prion titres in these and other peripheral tissues, the unknown prevalence of preclinical vCJD, and a transmission barrier which limits the sensitivity of bioassay. We aimed to improve immunoblotting methods for high sensitivity detection of PrP(Sc) to investigate the distribution of PrP(Sc) in a range of vCJD tissues. METHODS: We obtained tissues at necropsy from four patients with neuropathologically confirmed vCJD and from individuals without neurological disease. Tissues were analysed by sodium phosphotungstic acid precipitation of PrP(Sc) and western blotting using high sensitivity enhanced chemiluminescence. FINDINGS: We could reliably detect PrP(Sc) in the equivalent of 50 nL 10% vCJD brain homogenate, with a maximum limit of detection equivalent to 5 nl. PrP(Sc) could be detected in tissue homogenates when present at concentrations 10(4)-10(5) fold lower than those reported in brain. Tonsil, spleen, and lymph node were uniformly positive for PrP(Sc) at concentrations in the range of 0.1-15% of those found in brain: the highest concentrations were consistently seen in tonsil. PrP(Sc) was readily detected in the retina and proximal optic nerve of vCJD eye at levels of 2.5 and 25%, respectively of those found in brain. Other peripheral tissues studied were negative for PrP(Sc) with the exception of low concentrations in rectum, adrenal gland, and thymus from a single patient with vCJD. vCJD appendix and blood (Buffy coat fraction) were negative for PrP(Sc) at this level of assay sensitivity. INTERPRETATION: We have developed a highly sensitive immunoblot method for detection of PrP(Sc) in vCJD tissues that can be used to provide an upper limit on PrP(Sc) concentrations in peripheral tissues, including blood, to inform risk assessment models. Rectal and other gastrointestinal tissues should be further investigated to assess risk of iatrogenic transmission via biopsy instruments. Ophthalmic surgical instruments used in procedures involving optic nerve and the posterior segment of the eye, in particular the retina, might represent a potential risk for iatrogenic transmission of vCJD. Tonsil is the tissue of choice for diagnostic biopsy and for population screening of surgical tissues to assess prevalence of preclinical vCJD infection within the UK and other populations.

Animals↗
PubMed1991

Total knee replacement: surgical technique and instrumentation.

The surgical technique and instrumentation of four systems of total knee replacement, two with intramedullary and two with extramedullary alignment systems, are discussed. The differences between the instrumentations, their advantages and disadvantages, and the basic "philosophy" of each technique are compared in four "crucial" operative stages, determinant for the final result: the anteroposterior and distal femoral osteotomies, the tibial osteotomy, and the mechanical axis. In expert hands the two systems are equally reliable. In our experience, the extramedullary system with the tensor is more versatile. The stages are more dependent on the surgeon than on the instruments, and the tensor enables the surgeon to control and balance the level of osteotomy and the soft-tissue release every time. The intramedullary femoral alignment system seems simpler: each step is a direct consequence of the previous one, except the first step, which is, of course, entrusted to the experience of the surgeon. The fact that each stage is predetermined may reduce the chances of error in less skilled hands.

Femur↗
PubMed1980

A new instrument for surgical creation of an atrial septal defect.

An instrument for surgical creation of an atrial septal defect (ASD) was designed and tested in puppies weighing an average of 4.7 kg. Oxygen saturations were obtained in both atria, the superior vena cava, and the inferior vena cava before and after septectomy. The instrument has a cutting cylinder introduced into the right atrium (RA) through the right atrial appendage with a second part (base-plate) inserted into the left atrium (LA) just posterior to the interatrial groove. In 21 animals (Group 1), a single hole was created in dogs killed 48 hours later. In 9 animals (Group 2), an attempt was made to create two adjoining holes. In 14 animals (Group 3), a single hole was created and the dogs were allowed to triple their body weight before they were killed. Group 1 dogs demonstrated a 10% increase in average venae cavae--RA oxygen saturation immediately after septectomy and a 9.4 +/- 0.37 mm diameter of the ASD at death; in Group 2, there was a 14% average step-up and a 12.7 +/- 0.6 mm diameter of the ASD; and in Group 3, the diameter of the ASD was 11.5 +/- 0.4 mm, representing a 50% increase in average area with dog growth compared with that of Group 1. After this experience in the production of ASDs in 44 experimental animals, we find that this instrument seems to be reliable, simple, and safe.

Animals↗
PubMed1996

Cutting force measurements platform for quantitative assessment of surgical cutting instruments.

This paper describes the design and development of a Cutting Force Measurement Platform (CFMP) in the R&D department at Valleylab, Inc. for quantitative assessment of surgical instruments used for cutting tissue. This system controls various parameters including cutting speed, while measuring the force required as a function of time. The cutting force measurements are acquired and analyzed by a data acquisition program. The relevance of the cutting force measurements with regards to electrosurgery are discussed.

Animals↗
PubMed1991

Human immunodeficiency virus-1 (HIV-1) in the vapors of surgical power instruments.

Cool vapors and aerosols produced by several common surgical power instruments and hot smoke plumes generated with electrocautery on known HIV-1 innoculated blood were gently bubbled through sterile viral culture media. Tissue culture cells were then added and cell infection was detected by the appearance of HIV-1 P-24 core antigen assayed by ELISA in the culture medium. HIV-1 was cultured from cool aerosols and vapors generated by a 30,000 RPM spinning router tip, an instrument similar to the Midas Rex and the Stryker oscillating bone saw. No infectious HIV-1 was detected in aerosols generated by a Valley Lab electrocautery or with a manual wound irrigation syringe known as a Travenol Uromatic irrigator. We have demonstrated that HIV-1 can remain viable in cool aerosols generated by certain surgical power tools and this raises the possibility of HIV transmission to medical personnel exposed to aerosols similarly generated during the care of HIV infected patients. Further work is required to determine whether such a risk exists but caution should be exercised by those exposed to aerosols generated during procedures on HIV-1 infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Development of a novel surgical support instrument and virtual system incorporating new tactile sensor technology.

Surgical practice would be significantly enhanced with robotic systems incorporating tactile sensors. Current tactile sensor technology consists mainly of strain gauge elements having a limited bandwidth. A novel tactile sensor system, has been developed using a piezoelectric transducer(PZT), to simulate the properties of the human hand for use as a surgical support instrument and a palpation probe. Visualization of tactile information as an audio signal is provided, representing tissue properties in terms of an amplitude and frequency modulated signal. Representative data measured from pig brain, lung, pancreas, tongue and liver show that the changes in frequency corresponds to tissues stiffness and contact pressure. The technology developed in this new surgical support system has potential applications in virtual systems or robotic tele-medical care.

Palpation↗
PubMed2005

Computer-aided surgery of the paranasal sinuses and skull base.

Endoscopic sinus surgery is one of the most common surgical procedures in otolaryngology. However, the location of the orbit and intracranial contents in close proximity to the paranasal sinuses makes endoscopic sinus surgery potentially hazardous. Otolaryngologists have employed computer-aided surgery, or image-guided surgery, over the past two decades to enhance surgeon confidence, allow more thorough surgical dissections and possibly reduce the complication rate of endoscopic sinus surgery. Computer-aided surgery utilizes preoperative imaging to provide real-time localization of surgical instruments in the surgical field. Although computer-aided surgery originated in the neurosurgical realm, otolaryngologists soon appreciated that this technology could assist in identifying critical orbital or intracranial structures surrounding the paranasal sinuses, and potentially aid in decreasing complications. In this article, the history of image-guidance systems and their application to surgery of the paranasal sinuses and skull base will be reviewed. The components of computer-aided surgery systems and the currently available technologies for surgical instrument tracking are discussed, as well as the advantages and disadvantages of each of the tracking technologies. In addition, issues relating to the accuracy of image-guidance systems are examined. A number of institutional series noting surgeon experience with computer-aided surgery in the domain of paranasal sinus surgery are reviewed. Furthermore, the authors evaluate the utility of image-guidance technology beyond the paranasal sinuses and skull base, such as its use in surgery of the pituitary gland and pterygopalatine fossa, research and resident education. Finally, potential future applications of computer-aided surgery technology are discussed.

Endoscopy↗
PubMed2006

[Visualization and real-time tracking of the instruments in surgical navigation system].

In order to realize the visualization and real-time tracking of the instruments in surgical navigation system, we use the CAD solid model of the instruments directly or by reverse engineering, and transform the solid model to surface model. Then, the instruments, which are fixed with locator, are characterized and tested their precision. After registration between the CT model and the patient site in intra-operation, the system accurately displays the STL model of the instruments according to the tracked site and orientations. The model construction of the instruments is the base of the surgical navigation and is important to improve the security and precision of operation.

Computer Simulation↗
PubMed2004

[Danish battlefield surgery in the period between the birth of Christ and the year 500 AD].

Danish battlefield surgery in the period between the birth of Christ and the year 500 AD is exemplified by a reinterpretation of artefacts found in the sacrificial bogs at Thorsbjerg, Nydam, Ejsbøl, Illerup Adal, Vimose and Kragehul, reinterpreted in the light of classic European and Egyptian archaeological finds and ethno-archaeological parallels against the background of the author's years of experience as a practicing specialist in gynaecology and obstetrics. No surgical instruments from the Iron Age have previously been construed or identified as such in Denmark or Schleswig-Holstein. The purpose of this paper is to examine the possible finding and identificiation of surgical instruments - or what could be construed as a battlefield surgeons instruments - among artefacts deposited in the above-mentioned sacrificial bogs in the Iron Age. In this paper, the term 'surgical instrument' is defined as an instrument used in teh practice of medicine. Material for the study was collected in a review of illustrations in published works about these bog finds, localising these artefacts and examining them at the museums at which they were located. Also examined was museum storage of artefacts that had been excavated in the above-mentioned bogs. In an effort to reinterpret the function of the artefacts, they were compared with known surgical instruments found in the geographical areas controlled by the Greeks and later the Romans and with pictures of artefacts and a few written sources form the same area. They were also compared with ethnographic parallels. The material upon which the paper is based consists of a total of 67 artefacts, each identified as being from one of the above-mentioned bogs. Of these 67 artefacts, 40 can be indentifed and reinterpreted as being surgical instruments and 27 are toilet sets, i.e. tweezers for personal use or sets consisting of tweezers connected by a metal ring to either an ear pick or a nail cutter. Analysis of the artefacts revealed that in six of the bogs, 40 surgical instruments were found among sacrificed weapons: 29 scalpels, one pair of tweezers, five needles, more than 200 'wound thorns', three trephination saws and a double box. These instruments and the context, in which they were found, i.e. among sacrificed Iron Age weapons, indicate that the artefacts can be interpreted as being a battlefield surgeons instruments. It must be concluded that battlefield surgeons took part in local warfare, and that their equipment was sacrificed to the bogs in the Iron Age. It must also be concluded that these field surgeons gained their knowledge not only through contact with civilians but also from a close association with the military of the Roman Empire. This insight into the humanitarian care principles and philosophy of Iron Age civilisation is completely new and of substantial cultural and historical significance to the currently reigning view that the Roman Iron Age within the geographical area that is now Denmark was simply a callous and barbaric period.

Archaeology↗