Training, efficiency and ergonomics in minimally invasive surgery

Knoopsgatchirurgie (laparoscopie) heeft een aantal bewezen voordelen voor de patiënt. Voor het operatieteam gaat er een aantal uitdagingen gemoeid met deze manier van opereren. Met name op het gebied van de ergonomie en de efficiëntie van het operatieproces en op het gebied van training van chirurgen die deze techniek willen toepassen zijn verbeteringen nodig. Hierover gaat dit proefschrift. In deel 1 van dit proefschrift onderzoeken we wat de beste houding is om laparoscopische chirurgie te kunnen uitvoeren. Met name de positie van de monitor is daarbij van belang. De monitor dient ruim onder ooghoogte, dicht bij het operatieveld en in lijn met de werkrichting van de chirurg geplaatst te worden. We tonen aan dat een speciaal voor laparoscopie ontworpen operatiekamer een significante verbetering van de ergonomie en een verbeterde efficiëntie tussen de operaties door kan opleveren. In deel 2 van dit proefschrift onderzoeken we een nieuwe manier van proceduretraining op de operatiekamer. Een cohort assistenten doorloopt een curriculum voor laparoscopische galblaasoperaties. Nadat zij hun basisvaardigheden hebben geleerd op een simulator begonnen ze met proceduretraining op de operatiekamer. Gedurende 6 operaties kregen ze tijdens elke ingreep herhaaldelijk korte video-instructies over de volgende stap die moest worden uitgevoerd. Na het zien van de instructie mochten ze die stap van de operatie uitvoeren. De beoordelingen van de assistenten die op deze manier zijn getraind verbeterden sneller dan in een controle groep. We tonen aan dat deze methode effectief en uniform is terwijl de efficiëntie van het operatieproces niet benadeeld wordt

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Advances and innovations in total hip arthroplasty.

Total hip arthroplasty (THA) has been quoted as one of the most successful and cost-effective procedures in Orthopaedics. The last decade has seen an exponential rise in the number of THAs performed globally and a sharp increase in the percentage of young patients hoping to improve their quality of life and return to physically demanding activities. Hence, it is imperative to review the various applications of technology in total hip arthroplasty for improving outcomes. The development of state-of-the-art robotic technology has enabled more reproducible and accurate acetabular positioning, while long-term data are needed to assess its cost-effectiveness. This opinion piece aims to outline and present the advances and innovations in total hip arthroplasty, from virtual reality and three-dimensional printing to patient-specific instrumentation and dual mobility bearings. This illustrates and reflects the debate that will be at the centre of hip surgery for the next decade

Full Issue: Volume 1, Issue 1 - May 2023

Contents i - Editors’ Note by Payton Boere and Ari Clements ii - Foreword by Dr. Alan Hilibrand 7 - Injuries, Management, and Prevention in the Weekend Warrior by John Paulik 10 - A Practical Guide to Etiquette in the Orthopaedic OR for the Rotating Medical Student by Tyler Radack 13 - New Trends in Orthopaedic Surgery Residency Applications: The Role of Preference Signaling by J. Liam Gibbons 16 - First Job Considerations as an Orthopaedic Surgery Attending: Picking a Practice Setting by Purab Kothari 20 - A Day in the Life of an Orthopaedic Surgeon with Dr. Rachel Shakked by Anne Cohen 23 - Biologic Augmentation in Osteochondral Lesions of the Talus by Yashas Reddy 27 - Exploring the Use of Robotics in Orthopaedic Surgery by Daniel Givner 30 - Additional Strategies to Heal a Fracture: The Impact of Lifestyle Modifications to Improve Bone Repair by Katie Duquette 35 - Evaluation and Management-focused Medicare Billing Threatens Orthopaedic Practice Sustainability and Equitable Access by Nitya Venkat 37 - Summary of Early Sport Specialization in Baseball by Matthew Sabitsk

Editor\u27s Note

We are thrilled to introduce the inaugural issue of the Bone Bulletin, DePalma Orthopaedic Society’s student-run, non-peer reviewed journal for Sidney Kimmel Medical College (SKMC) students. The journal’s aim is to provide yet another way to be involved with orthopaedics in medical school and to promote student interest in orthopaedics by reporting on diverse aspects of the field through editorial and opinion pieces. Under the close 1-on-1 mentorship of a physician from the Rothman Orthopaedic Institute, students have a hands-on opportunity to write about and directly engage with orthopaedic research and developments. Within the pages of this journal, you will find research articles, insightful reviews, thought-provoking interviews, and inspiring stories of clinical experiences. We believe that by providing an inclusive platform for students to express their ideas and share their research findings, we can foster a vibrant community of learners and thinkers dedicated to advancing the field of orthopaedic surgery. We extend our gratitude to the writers and editorial team, who have formed the contributions featured in this issue. We would also like to express our gratitude to the mentors and physicians from the Rothman Orthopaedic Institute, who have supported us throughout this journey. Your guidance, encouragement, and expertise have been invaluable in shaping this endeavor and inspiring us to pursue excellence in the field of orthopaedics. Thank you for joining us on this exciting venture. We are beyond excited to present the invaluable contributions that everyone has made for the Bone Bulletin. Sincerely,Payton Boere & Ari ClementsEditors-in-Chief, The Bone Bulleti

Real-time integration between Microsoft HoloLens 2 and 3D Slicer with demonstration in pedicle screw placement planning

We established a direct communication channel between Microsoft HoloLens 2 and 3D Slicer to exchange transform and image messages between the platforms in real time. This allows us to seamlessly display a CT reslice of a patient in the AR world.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Research supported by projects PI122/00601 and AC20/00102 (Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Asociación Española Contra el Cáncer and European Regional Development Fund “Una manera de hacer Europa”), project PerPlanRT (ERA Permed), TED2021-129392B-I00 and TED2021-132200B-I00 (MCIN/AEI/10.13039/501100011033 and European Union “NextGenerationEU”/PRTR) and EU Horizon 2020 research and innovation programme Conex plus UC3M (grant agreement 801538). APC funded by Universidad Carlos III de Madrid (Read & Publish Agreement CRUE-CSIC 2023)