37 research outputs found
Crime and Punishment in the Royal Navy: Discipline on the Leeward Islands Station, 1784-1812 (England).
This dissertation is based primarily on the manuscript sources pertaining to the Leeward Islands station between 1784 and 1812 found in the Public Record Office. Its thesis is quite simple: Discipline in the Royal Navy in the age of sail was maintained in much the same fashion that law and order was enforced in the localities of eighteenth-century England. In short, justice afloat was administered according to the principles and practices used in the system of criminal law ashore
Robotic proctectomy for rectal cancer: analysis of 71 patients from a single institution
BackgroundDespite increasing use of robotic surgery for rectal cancer, few series have been published from the practice of generalizable US surgeons.MethodsA retrospective chart review was performed for 71 consecutive patients who underwent robotic low anterior resection (LAR) or abdominoperineal resection (APR) for rectal adenocarcinoma between 2010 and 2014.Results46 LARs (65%) and 25 APRs (35%) were identified. Median procedure time was 219 minutes (IQR 184–275) and mean blood loss 164.9 cc (SD 155.9 cc). Radial margin was negative in 70/71 (99%) patients. Total mesorectal excision integrity was complete/near complete in 38/39 (97%) of graded specimens. A mean of 16.8 (SD+/− 8.9) lymph nodes were retrieved. At median follow‐up of 21.9 months, there were no local recurrences.ConclusionsRobotic proctectomy for rectal cancer was introduced into typical colorectal surgery practice by a single surgeon, with a low conversion rate, low complication rate, and satisfactory oncologic outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139933/1/rcs1841_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139933/2/rcs1841.pd
Perceptual impairment and psychomotor control in virtual laparoscopic surgery
Background: It is recognised that one of the major difficulties in performing laparoscopic surgery is the translation of two-dimensional video image information to a three-dimensional working area. However, research has tended to ignore the gaze and eye-hand coordination strategies employed by laparoscopic surgeons as they attempt to overcome these perceptual constraints. This study sought to examine if measures related to tool movements, gaze strategy, and eye-hand coordination (the quiet eye) differentiate between experienced and novice operators performing a two-handed manoeuvres task on a virtual reality laparoscopic surgical simulator (LAP Mentor™). Methods: Twenty-five right-handed surgeons were categorised as being either experienced (having led more than 60 laparoscopic procedures) or novice (having performed fewer than 10 procedures) operators. The 10 experienced and 15 novice surgeons completed the "two-hand manoeuvres" task from the LAP Mentor basic skills learning environment while wearing a gaze registration system. Performance, movement, gaze, and eye-hand coordination parameters were recorded and compared between groups. Results: The experienced surgeons completed the task significantly more quickly than the novices, used significantly fewer movements, and displayed shorter tool paths. Gaze analyses revealed that experienced surgeons spent significantly more time fixating the target locations than novices, who split their time between focusing on the targets and tracking the tools. A more detailed analysis of a difficult subcomponent of the task revealed that experienced operators used a significantly longer aiming fixation (the quiet eye period) to guide precision grasping movements and hence needed fewer grasp attempts. Conclusion: The findings of the study provide further support for the utility of examining strategic gaze behaviour and eye-hand coordination measures to help further our understanding of how experienced surgeons attempt to overcome the perceptual difficulties inherent in the laparoscopic environment. © 2011 The Author(s).published_or_final_versionSpringer Open Choice, 21 Feb 201
Books Reviewed
Book reviews by Stanley L. Paulson, Vincent Luizzi, Robert M. Byrn, John T. Bannon, and Thomas L. Shaffer
Books Reviewed
Book reviews by Stanley L. Paulson, Vincent Luizzi, Robert M. Byrn, John T. Bannon, and Thomas L. Shaffer
Books Reviewed
Book reviews by Stanley L. Paulson, Vincent Luizzi, Robert M. Byrn, John T. Bannon, and Thomas L. Shaffer