Metrics for Evaluating Surgical Microscope Usage During Myringotomy

Abstract Although teaching and learning surgical microscope manoeuvring is a fundamental step in middle ear surgical training, currently there is no objective method to teach or assess this skill. This thesis presents an experimental study designed to implement and test sets of metrics capable of numerically evaluating microscope manoeuvrability and qualitatively assessing surgical expertise of a subject during a middle ear surgery called myringotomy. The experiment involved performing a myringotomy on a fixed cadaveric ear. As participants, experienced ear-nose-throat (ENT) surgeons and ENT surgical residents were invited. While performing the procedure, their microscope manoeuvring motions were captured as translational and angular coordinates using an optical tracker. These data were analyzed in terms of motion path length, velocity, acceleration, jitter, manoeuvring volume, smoothness, rotation and time. Participants’ hand motion, body posture and microscopic view were also video recorded to qualitatively assess their surgical expertise. Several metrics were statistically identified as discriminatory. These metrics will be incorporated into a myringotomy surgical simulator to train ENT residents

Medical Imaging of Microrobots: Toward In Vivo Applications

Medical microrobots (MRs) have been demonstrated for a variety of non-invasive biomedical applications, such as tissue engineering, drug delivery, and assisted fertilization, among others. However, most of these demonstrations have been carried out in in vitro settings and under optical microscopy, being significantly different from the clinical practice. Thus, medical imaging techniques are required for localizing and tracking such tiny therapeutic machines when used in medical-relevant applications. This review aims at analyzing the state of the art of microrobots imaging by critically discussing the potentialities and limitations of the techniques employed in this field. Moreover, the physics and the working principle behind each analyzed imaging strategy, the spatiotemporal resolution, and the penetration depth are thoroughly discussed. The paper deals with the suitability of each imaging technique for tracking single or swarms of MRs and discusses the scenarios where contrast or imaging agent's inclusion is required, either to absorb, emit, or reflect a determined physical signal detected by an external system. Finally, the review highlights the existing challenges and perspective solutions which could be promising for future in vivo applications

A methodology for design and appraisal of surgical robotic systems

Surgical robotics is a growing discipline, continuously expanding with an influx of new ideas and research. However, it is important that the development of new devices take account of past mistakes and successes. A structured approach is necessary, as with proliferation of such research, there is a danger that these lessons will be obscured, resulting in the repetition of mistakes and wasted effort and energy. There are several research paths for surgical robotics, each with different risks and opportunities and different methodologies to reach a profitable outcome. The main emphasis of this paper is on a methodology for ‘applied research’ in surgical robotics. The methodology sets out a hierarchy of criteria consisting of three tiers, with the most important being the bottom tier and the least being the top tier. It is argued that a robotic system must adhere to these criteria in order to achieve acceptability. Recent commercial systems are reviewed against these criteria, and are found to conform up to at least the bottom and intermediate tiers, the most important first two tiers, and thus gain some acceptability. However, the lack of conformity to the criteria in the top tier, and the inability to conclusively prove increased clinical benefit, is shown to be hampering their potential in gaining wide establishment

Southwest Research Institute assistance to NASA in biomedical areas of the technology

Significant applications of aerospace technology were achieved. These applications include: a miniaturized, noninvasive system to telemeter electrocardiographic signals of heart transplant patients during their recuperative period as graded situations are introduced; and economical vital signs monitor for use in nursing homes and rehabilitation hospitals to indicate the onset of respiratory arrest; an implantable telemetry system to indicate the onset of the rejection phenomenon in animals undergoing cardiac transplants; an exceptionally accurate current proportional temperature controller for pollution studies; an automatic, atraumatic blood pressure measurement device; materials for protecting burned areas in contact with joint bender splints; a detector to signal the passage of animals by a given point during ecology studies; and special cushioning for use with below-knee amputees to protect the integrity of the skin at the stump/prosthesis interface

Advances in Ophthalmology

This book focuses on the different aspects of ophthalmology - the medical science of diagnosis and treatment of eye disorders. Ophthalmology is divided into various clinical subspecialties, such as cornea, cataract, glaucoma, uveitis, retina, neuro-ophthalmology, pediatric ophthalmology, oncology, pathology, and oculoplastics. This book incorporates new developments as well as future perspectives in ophthalmology and is a balanced product between covering a wide range of diseases and expedited publication. It is intended to be the appetizer for other books to follow. Ophthalmologists, researchers, specialists, trainees, and general practitioners with an interest in ophthalmology will find this book interesting and useful

Corneal biomechanical properties : Measurement, modification and simulation

Esta tesis aborda la medición de las propiedades biomecánicas de la córnea. Se desarrollaron técnicas para medir la rigidez de la córnea in vitro con el fin de estudiar el comportamiento de la córnea como una función de diferentes factores (tales como la hidratación, la geometría, la presión intraocular y la rigidez de la córnea). Los datos experimentales se utilizaron para construir modelos numéricos capaces de reproducir la respuesta biomecánica observada de la córnea. Se aplicaron modelos numéricos para recuperar los parámetros biomecánicos de mediciones de deformación in vivo y para estudiar el efecto de la implantación de segmentos de anillos intraestromales. En particular, se utilizaron el método de inflación en ojos enteros y botones córneales, la extensiometría bídimensional, un soplo de aire combinado con tomografía de coherencia óptica (OCT), microscopía de Brillouin y OCT-vibrografía para las mediciones experimentales. Para el análisis numérico, se construyeron modelos de elementos finitos para estudiar la inflación de ojos enteros y botones córneales, la respuesta de la córnea después de un soplo de aire, el comportamiento del ojo bajo vibración y los cambios refractivos después de la implantación de anillos intraestromales. This thesis addresses the measurement of the corneal biomechanical properties. Techniques were developed to measure the corneal stiffness in vitro in order to study the corneal behavior as a function of different factors (such as hydration, geometry, intraocular pressure, corneal stiffness). Experimental data were used to build numerical models, which were able to reproduce the observed biomechanical response of the cornea. Numerical models were applied to retrieve biomechanical parameters from in vivo deformation measurements and to study the outcome with implantation of intrastromal ring segments. In particular whole-eye / corneal inflation, 2D extensiometry, an air-puff technique combined with optical coherence tomography (OCT), Brillouin microscopy and OCT-vibrography were used for the experimental measurements. For the numerical analysis, finite element models were built for eye inflation, corneal response following an air-puff, ocular vibration behavior and refractive changes after ICRS implantation

Aerospace Medicine and Biology: Cumulative index, 1979

This publication is a cumulative index to the abstracts contained in the Supplements 190 through 201 of 'Aerospace Medicine and Biology: A Continuing Bibliography.' It includes three indexes-subject, personal author, and corporate source