Motion Tracking System in Surgical Training

Introduction: Simulation technology is evolving and becoming the focus of attention in surgical training. The development of this technology in assessing open surgical skills is far behind when compared to minimally invasive surgery (MIS) training. Surgical skills such as suturing and tying surgical knots are assessed by an observational tool. It is labour-intensive and time-consuming. Therefore, we explored the potential use of motion tracking system as a non-observational assessment tool for basic surgical skills

A Study to Design an Objective Scoring System for Basic Surgical Skills (BSS)

Background Simulation technology is rapidly evolving and becoming the focus of attention in surgical training. However, the development of this technology in assessing open surgical skills is far behind when compared to minimally invasive surgery (MIS) training and assessment. Aim The overall objective of this thesis is to investigate the assessment tools that are readily available for assessing basic open surgical skills and develop an automated system that could be used in the simulation setting. Materials & Methods We evaluated the observer-dependant assessment tool in assessing basic surgical skills including one-handed knot tying and simple interrupted suturing skills. We established a hand tracking system that consists of an off-the-shelf motion analysis device and software created by our co-supervisor which generates numerical metrics. We investigated the validity of these metrics and we examined the potential application of this invaluable assessment tool. Results The results demonstrated that the observer-dependant assessment tool has poor inter-rater agreement despite its validity in assessing open surgical skills. The validity of the novel hand tracking system was established. We also demonstrated its application in assessing surgical trainees’ progress and also in proficiency-based assessment. Conclusion The hand motion tracking system is a valid assessment tool in evaluating performance in open surgical skills and has a potential significant role in the proficiency-based surgical training programme.</p

You’ve got to hand it to them: assessing final year medical students knowledge of hand anatomy and pathology

Background: Knowledge of hand anatomy and pathology is important for final year medical students as it frequently appears in examinations as a short case or in a written paper. Studies have shown that doctors in the Emergency Department have a deficient grasp of musculoskeletal anatomy secondary to a lack of dedicated teaching in medical school. Methods: A questionnaire was handed out to 111 final year medical students. Students were asked to fill it out before and after dedicated upper limb teaching sessions during their rotation. The questionnaire consisted of an anatomical and pathological component. Students were tested on basic anatomy and pathology of several common upper limb conditions. Results: There was a significant improvement in the medical students knowledge after the dedicated hand teaching. The identification of the carpal bones showed the most improvement overall. Conclusions: Basic musculoskeletal knowledge is essential to the practice of medicine. The majority of medical students gravitate towards a career in general practice or emergency medicine and good knowledge of upper limb anatomy is important. We have piloted a new interactive dedicated upper limb teaching module and have shown that there has been a significant improvement in students knowledge

You’ve got to hand it to them: assessing final year medical students knowledge of hand anatomy and pathology

Background: Knowledge of hand anatomy and pathology is important for final year medical students as it frequently appears in examinations as a short case or in a written paper. Studies have shown that doctors in the Emergency Department have a deficient grasp of musculoskeletal anatomy secondary to a lack of dedicated teaching in medical school. Methods: A questionnaire was handed out to 111 final year medical students. Students were asked to fill it out before and after dedicated upper limb teaching sessions during their rotation. The questionnaire consisted of an anatomical and pathological component. Students were tested on basic anatomy and pathology of several common upper limb conditions. Results: There was a significant improvement in the medical students knowledge after the dedicated hand teaching. The identification of the carpal bones showed the most improvement overall. Conclusions: Basic musculoskeletal knowledge is essential to the practice of medicine. The majority of medical students gravitate towards a career in general practice or emergency medicine and good knowledge of upper limb anatomy is important. We have piloted a new interactive dedicated upper limb teaching module and have shown that there has been a significant improvement in students knowledge

A Novel Approach to Facial Reanimation and Restoration Following Radical Parotidectomies

Background: Parotidectomies are indicated for a variety of reasons. Regardless of the indication for surgery, facial reanimation may be required because of facial nerve sacrifice or iatrogenic damage. In these cases, facial restoration performed concurrently with ablative surgery is considered the gold standard, and delayed reanimation is usually not attempted. Methods: A retrospective review of all patients who underwent parotidectomies from 2009 to 2022 in a single institution was performed. Indications, surgical techniques, and outcomes of an algorithmic template were applied to these cases using the Sunnybrook, Terzis scores, and Smile Index. A comparison was made between immediate vs. late repairs. Results: Of a total of 90 patients who underwent parotidectomy, 17 (15.3%) had a radical parotidectomy, and 73 (84.7%) had a total or superficial parotidectomy. Among those who underwent complete removal of the gland and nerve sacrifice, eight patients (47.1%) had facial restoration. There were four patients each in the immediate (n = 4) and late repair (n = 4) groups. Surgical techniques ranged from cable grafts to vascularized cross facial nerve grafts (sural communicating nerve flap as per the Koshima procedure) and vascularized nerve flaps (chimeric vastus lateralis and anterolateral thigh flaps, and superficial circumflex perforator flap with lateral femoral cutaneous nerve). Conclusions: The algorithm between one technique and another should take into consideration age, comorbidities, soft tissue defects, presence of facial nerve branches for reinnervation, and donor site morbidity. While immediate facial nerve repair is ideal, there is still benefit in performing a delayed repair in this algorithm