Three Dimensional Motion Analysis of Hand Tremors During Endoscopic Ear Surgery

[Background] Endoscopic surgery is developing in various clinical specialties. During ear endoscopic surgery, a surgeon has to hold an endoscope with one hand and operate the surgical instruments with another hand. Therefore, the stability of the surgeon’s hand affects the field of surgical view and quality of the surgery considerably. There are few techniques which are used during surgery to stabilize the endoscope. However, no study has evaluated the efficacy of such techniques in detail. This study examined the three dimensional movement of an endoscope to compare and evaluate the effect of various stabilization techniques to reduce the hand tremor while using the endoscope. [Methods] A non-randomized controlled trial involving 15 medical students was conducted in Tottori University, Japan. Subjects held an endoscope with their non-dominant hand and manipulated it using three different stabilization techniques i.e. with resting the elbow on the table, resting the endoscope on the ear canal, both with the elbow on the table and endoscope on the ear canal. For the control, subjects were made to use the endoscope without any stabilization technique. The endoscopic movement was measured with and without using the stabilization techniques. [Results] The results obtained in this study indicated that manipulating the endoscope with resting the elbow on the table restrains both vertical (Y-axis) and optical axis (Z-axis) direction of tremor, and manipulating the endoscope by resting it on the ear canal restrains both vertical (Y-axis) and horizontal axis (X-axis) direction while the combined use of both the techniques reduces the endoscope movement in all the three X, Y and Z axes. [Conclusion] In conclusion, concomitant use of both techniques appears to be clinically beneficial in endoscopic ear surgery

A autopsy case of biliary fistula to the retroperitoneal space

A seventies age man was admitted complaining of epigastric pain. Computed tomography of the abdomen showed the fluid collection and inflammation in the retroperitoneal space besides pancreas. We suspected acute pancreatitis, and started the treatment by the medications. However, the treatment was not effective. Because we suspected of perforation, we underwent the operation. In the operation, there was a large amount of bile in the retroperitoneal space. We performed intraperitoneal drainage because of uncertain cause. After the operation, he got worse, and died on the ５５th day. The autopsy showed the biliary fistula at right hepatic duct to the retroperitoneal space. The biliary fistula to the retroperitoneal space was very rare case, therefore we must understand the pathological condition due to save the life

サイセンタン ノ サンジゲン イメージング システム : シンゾウ ケッカン ゲカ ニオケル Virtual Reality ギジュツ ノ ユウヨウセイ

滋賀医科大学心臓血管外科では医療用画像を三次元構築し、臓器を立体表示するVirtual Reality (VR) 技術を用いて心臓血管系の3D解析研究を進めている。VRでは臓器の内腔を可視化することができ、また3D構築した画像に直接介入し、従来の2D解析では評価困難であった複雑な構造も術者の視点で直観的に計測できるという利点がある。あらゆる医療画像データを三次元化し, かつ直感的な立体計測が可能なVR技術は, これまでの診断精度を上回る形態学的な情報を臨床医に提示し得ると考えられる。特に外科医にとって有用な手術支援VR画像は, 難易度が高い手術の治療成績を向上させる可能性が高い。Adequate preoperative planning may facilitate successful procedures in cardiovascular surgery. We have newly developed a system the Vesalius 3D suite, combining three-dimensional (3D) image-processing software with an optic-tracking spatial navigation, allowing quick, accessible 3D image interpretation for virtual reality (VR) exploration and measurement of complex anatomy. In this review, we present a novel method of virtual imaging analysis for preoperative planning and simulation in cardiovascular operation using this 3D-VR system. Based on unimodal or multimodal medical imaging data, DICOM data sets can be reconstructed for 3D visualization. Virtually reconstructed images can be viewed on stereoscopic 3D display, revealing each patient’s specific anatomy and the internal structures in exquisite detail. Highly accessible 3D interpretation promptly permits precise and intuitive measurements of repair-relevant anatomical parameters including geometrically complex shapes. This technology may promote understanding of form and function in the cardiovascular system, and facilitate operative procedures in more challenging cases. Furthermore, this system can be especially valuable for any surgeon to gain experience in practicing for rarely-performed procedures or uncommon patient-specific preoperative surgical simulations

JASMINE: Near-infrared astrometry and time-series photometry science

The Japan Astrometry Satellite Mission for INfrared Exploration (JASMINE) is a planned M-class science space mission by the Institute of Space and Astronautical Science, the Japan Aerospace Exploration Agency. JASMINE has two main science goals. One is Galactic archaeology with a Galactic Center survey, which aims to reveal the Milky Way’s central core structure and formation history from Gaia-level (∼25 ${\mu}$as) astrometry in the near-infrared (NIR) Hw band (1.0–1.6 ${\mu}$m). The other is an exoplanet survey, which aims to discover transiting Earth-like exoplanets in the habitable zone from NIR time-series photometry of M dwarfs when the Galactic Center is not accessible. We introduce the mission, review many science objectives, and present the instrument concept. JASMINE will be the first dedicated NIR astrometry space mission and provide precise astrometric information on the stars in the Galactic Center, taking advantage of the significantly lower extinction in the NIR. The precise astrometry is obtained by taking many short-exposure images. Hence, the JASMINE Galactic Center survey data will be valuable for studies of exoplanet transits, asteroseismology, variable stars, and microlensing studies, including discovery of (intermediate-mass) black holes. We highlight a swath of such potential science, and also describe synergies with other missions