Development of a Virtual Laparoscopic Trainer using Accelerometer Augmented Tools to Assess Performance in Surgical training

Previous research suggests that virtual reality (VR) may supplement conventional training in laparoscopy. It may prove useful in the selection of surgical trainees in terms of their dexterity and spatial awareness skills in the near future. Current VR training solutions provide levels of realism and in some instances, haptic feedback, but they are cumbersome by being tethered and not ergonomically close to the actual surgical instruments for weight and freedom of use factors. In addition, they are expensive hence making them less accessible to departments than conventional box trainers. The box trainers in comparison, although more economical, lack tangible feedback and realism for handling delicate tissue structures. We have previously reported on the development of a modified digitally enhanced surgical instrument for laparoscopic training, named the Parkar Tool. This tool contains wireless accelerometer and gyroscopic sensors integrated into actual laparoscopic instruments. By design, it alleviates the need for both tethered and physically different shaped tools thereby enhancing the realism when performing surgical procedures. Additionally the software (Valhalla) has the ability to digitally record surgical motions, thereby enabling it to remotely capture surgical training data to analyse and objectively evaluate performance. We have adapted and further developed our initial single training tool method as used with a laparoscopic pyloromyotomy scenario, to an enhanced method using multiple Parkar wireless tools simultaneously, for use in several different case scenarios. This allows the use and measurement of right and left handed dexterity with the benefit of using several tasks of differing complexity. The development of a 3D tissue-surface deformations solution written in OpenGL gives us several different virtual surgical training scenario approximations to use with the instruments. The trainee can start with learning simple tasks e.g. incising tissue, grasping, squeezing and stretching tissue, to more complex procedures such as suturing, herniotomies, bowel anastomoses, as well as the original pyloromyotomy as used in the first model

Heterotopic pregnancy in an assisted reproduction conception; case report and literature review

Infertility management by assisted reproduction techniques has had rapid increase. While there is robust evidence supporting the efficacy and safety of assisted reproduction technique (ART), complications are encountered. Heterotopic pregnancy, defined as the presence of both an intrauterine and an ectopic gestation, is a rare eventuality of early pregnancy. A 42 years old patient (Para 0+1) with a diagnosis of secondary infertility is presented; she had In Vitro fertilization (IVF) with egg donation. Two weeks after the IVF, a positive serum Beta Human Chorionic Gonadotropin confirmed the pregnancy and she continued with intake of progestins for luteal phase support. At 7 weeks gestation she presented at a local hospital with acute pelvic pain. A diagnosis of heterotopic pregnancy was made after transvaginal showed right slow leaking ectopic pregnancy andintrauterine missed abortion. Laparoscopic surgery, right salpingectomy and manual vacuum aspiration were performed with good subsequent recovery. The case presented, discusses the aetiology, clinical presentation, diagnosis and management of heterotopic pregnancy

Role of the cluster structure of 7^7Li in the dynamics of fragment capture

Exclusive measurements of prompt $\gamma$-rays from the heavy-residues with various light charged particles in the $^7$Li + $^{198}$Pt system, at an energy near the Coulomb barrier (E/$V_b$ $\sim$ 1.6) are reported. Recent dynamic classical trajectory calculations, constrained by the measured fusion, $\alpha$ and $t$ capture cross-sections have been used to explain the excitation energy dependence of the residue cross-sections. These calculations distinctly illustrate a two step process, breakup followed by fusion in case of the capture of $t$ and $\alpha$ clusters; whereas for $^{6}$He + $p$ and $^{5}$He + $d$ configurations, massive transfer is inferred to be the dominant mechanism. The present work clearly demonstrates the role played by the cluster structures of $^7$Li in understanding the reaction dynamics at energies around the Coulomb barrier.Comment: 6 pages, 4 figures, Accepted for publication in Phys. Letts.

Investigation of complete and incomplete fusion in 7^{7}Li+124^{124}Sn reaction around Coulomb barrier energies

The complete and incomplete fusion cross sections for $^{7}$Li+$^{124}$Sn reaction were measured using online and offline characteristic $\gamma$-ray detection techniques. The complete fusion (CF) cross sections at energies above the Coulomb barrier were found to be suppressed by $\sim$ 26 \% compared to the coupled channel calculations. This suppression observed in complete fusion cross sections is found to be commensurate with the measured total incomplete fusion (ICF) cross sections. There is a distinct feature observed in the ICF cross sections, i.e., $\textit{t}$-capture is found to be dominant than $\alpha$-capture at all the measured energies. A simultaneous explanation of complete, incomplete and total fusion (TF) data was also obtained from the calculations based on Continuum Discretized Coupled Channel method with short range imaginary potentials. The cross section ratios of CF/TF and ICF/TF obtained from the data as well as the calculations showed the dominance of ICF at below barrier energies and CF at above barrier energies.Comment: 9 pages, 8 figure

Fusion of 6^{6}Li with 159^{159}Tb} at near barrier energies

Complete and incomplete fusion cross sections for $^{6}$Li+$^{159}$Tb have been measured at energies around the Coulomb barrier by the $\gamma$-ray method. The measurements show that the complete fusion cross sections at above-barrier energies are suppressed by $\sim$34% compared to the coupled channels calculations. A comparison of the complete fusion cross sections at above-barrier energies with the existing data of $^{11,10}$B+$^{159}$Tb and $^{7}$Li+$^{159}$Tb shows that the extent of suppression is correlated with the $\alpha$-separation energies of the projectiles. It has been argued that the Dy isotopes produced in the reaction $^{6}$Li+$^{159}$Tb, at below-barrier energies are primarily due to the $d$-transfer to unbound states of $^{159}$Tb, while both transfer and incomplete fusion processes contribute at above-barrier energies.Comment: Phys. Rev. C (accepted

Small Quadrupole Deformation for the Dipole Bands in 112In

High spin states in $^{112}$In were investigated using $^{100}$Mo($^{16}$O, p3n) reaction at 80 MeV. The excited level have been observed up to 5.6 MeV excitation energy and spin $\sim$ 20$\hbar$ with the level scheme showing three dipole bands. The polarization and lifetime measurements were carried out for the dipole bands. Tilted axis cranking model calculations were performed for different quasi-particle configurations of this doubly odd nucleus. Comparison of the calculations of the model with the B(M1) transition strengths of the positive and negative parity bands firmly established their configurations.Comment: 10 pages, 11 figures, 2 table