First experience with a public domain computer-aided surgical system

The Effect of Training, Used-Hand, and Experience on Endoscopic Surgery Skills in an Educational Computer-Based Simulation Environment (ECE) for Endoneurosurgery Training

Today, virtual simulation environments create alternative hands-on practice opportunities for surgical training. In order to increase the potential benefits of such environments, it is critical to understand the factors that influence them. This study was conducted to determine the effects of training, used-hand, and experience, as well as the interactions between these variables, on endoscopic surgery skills in an educational computer-based surgical simulation environment. A 2-hour computer-based endoneurosurgery simulation training module was developed for this study. Thirty-one novice- and intermediate-level resident surgeons from the departments of neurosurgery and ear, nose, and throat participated in this experimental study. The results suggest that a 2-hour training during a 2-month period through computer-based simulation environment improves the surgical skills of the residents in both-hand tasks, which is necessary for endoscopic surgical procedures but not in dominant hand tasks. Based on the results of this study, it can be concluded that computer-based simulation environments potentially improve surgical skills; however, the scenarios for such training modules need to consider especially the bimanual coordination of hands and should be regularly adapted to the individual skill levels and progresses.

Biomechanical and clinical implications of distraction osteogenesis in craniofacial surgery

INTRODUCTION

Craniofacial distraction osteogenesis is an established surgical procedure to correct bony malformations. Force transduction through the osteotomized bone fragments elicits defined biological responses in the gap tissue, which determines the clinical success of the distraction treatment.

OBJECTIVE

The purpose of this investigation was to evaluate clinically a new distraction protocol based on an analysis of the biological and biomechanical parameters executing direct effects on bone regeneration during distraction.

STUDY DESIGN

A multistep distraction protocol was used in 39 patients and the clinical outcome was monitored postoperatively.

RESULTS

All the distraction cases were successful with a single exception. Segmental displacements were stable clinically and radiologically.

CONCLUSION

In order to improve the clinical success of distraction osteogenesis, individual treatment protocols are recommended.

Update on craniofacial surgery

Over the course of the past year, many interesting aspects of the multidisciplinary approach to the treatment of craniofacial disorders have been furthered. Several authors have shared their experiences, and new innovations have been described. Traditional ideas with regard to bone healing and growth have been expanded upon, and the role of alloplasts also is better understood now. Diagnosis and treatment planning have come a long way with the advent of new imaging techniques and applications. The ongoing discussion regarding absorbable fixation devices has continued, and the development of new technology has been presented. Some new techniques have also been brought to the forefront. Of note, distraction osteogenesis has been embraced as a viable alternative to traditional maxillomandibular surgery with bone grafting as well as other morbid procedures.